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Differential Diagnosis For Adhd

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What Can I Expect Before A Diagnostic Evaluation

Consider adult ADHD in dementia differential diagnosis

Before your provider makes a diagnosis, they will evaluate your symptoms by asking questions that go over your overall health and your medical history. It’s important to bring a list of any medications, vitamins or supplements that you take with you when you visit your providers office so they can keep a record to make sure your medications are not influencing your symptoms.

Performance Testing And Psychological Testing

Usually, the diagnosis of adult ADHD can be made from the history of childhood and adult symptoms. However, one DSM-IV-based rating scale for adults that may help the clinician affirm the diagnosis is the clinician-rated Conner’s Adult ADHD Rating Scale.30 There also are self-report behavior rating scales that may be helpful. These include the Copeland Symptom Checklist for Adult ADHD, a three-point severity rating scale for a broad range of cognitive, emotional, and social symptoms filled out by the patient 31 the Wender Utah Rating Scale, a retrospective five-point severity rating scale of childhood ADHD symptoms filled out by the patient 32 the Brown Adult ADHD Scale, a four-point frequency rating scale for cognitive symptoms associated with difficulty initiating and maintaining optimal arousal level completed by the patient 33 and the Pilot Adult ADHD Self-Report Scale , which is a frequency-based scale that matches the 18 items in the DSM-IV, has adult-specific language, and includes situational âcontextâ for describing symptoms.5

Diagnosing Adhd In Adults

ADHD often lasts into adulthood. To diagnose ADHD in adults and adolescents age 17 years or older, only 5 symptoms are needed instead of the 6 needed for younger children. Symptoms might look different at older ages. For example, in adults, hyperactivity may appear as extreme restlessness or wearing others out with their activity.

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How Is Adhd Diagnosed In Children Teens And Adults

To diagnose a child, the healthcare provider must perform three tasks. The healthcare provider must: 1) identify the presence of ADHD symptom criteria, 2) rule out alternative causes of symptoms, and 3) identify comorbid conditions .

But, the job is not yet done. Certain conditions must also be met. First, the symptom behaviors must be present in two or more settings such as at home and in school. Second, the symptoms must be impairing. Its not just that they occur as everyone engages in these behaviors sometimes. Third, symptom behaviors must have been present in childhood, typically before the age of 12 years. Last, the symptoms cannot be corollaries to another disorder that is not ADHD. For example, sometimes, when a person is depressed or anxious, inattentive behaviors may occur. The clinician will identify ADHD symptoms by asking you questions about your childs behavior s at home and school . Next, your provider will rule out other possible conditions that share some similar symptoms. These conditions include:

  • Anxiety.
  • Lead toxicity .
  • Sleep problems.

A sudden life change may also result in behaviors that could be confused with ADHD).

Sometimes, an adult will recognize the behaviors of ADHD in himself or herself when a son or daughter is diagnosed. Other times, adults will seek professional help for themselves and find that their depression or anxiety is related to ADHD.

So What Are The Differential Diagnoses For Asd Then

PPT

Following are some of the conditions that can mimic or present as ASD. I have listed them in no particular order. However, conditions in the top half of the list need to be considered more often than the conditions in the bottom half.

  • Learning Disability/Intellectual Disability : Learning disability is the term more commonly used in the UK , for any child with significant global developmental delay. Reflecting on my experience, LD/ID must be at the top of my list because of at least two crucial reasons. Firstly, many children with ASD can have a degree of LD, making the need for carrying out a developmental assessment as part of ASD evaluation, vital. Second, it is common to get children with LD confused as having ASD, as children with LD engage in repetitive behaviours for a variety of reasons. Carrying out a developmental assessment will reveal that the language abilities of children with LD are in keeping with their cognitive ability. Moreover, children with LD have better non-verbal communication ability and a reasonable degree of emotional reciprocity, while children with ASD do not.
  • Social Communication Disorder : It is easy to confuse children with SCD as having ASD because children in both these conditions have impaired verbal and non-verbal communication abilities. However, as DSM-5 manual has specified, unlike children with ASD, SCD children do not have restricted and repetitive patterns of behaviour and activities.
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    What Are The Risk Factors Of Adhd

    ADHD is largely a hereditary condition. If one or both parents have been diagnosed with ADHD, their children are more likely to have it as well. Although the exact etiology of ADHD are ill-defined, healthcare providers report other associated risk factors:

    • Biological: ADHD is associated with the way certain neurotransmitters work, especially dopamine and norepinephrine, and this difference causes changes in two different attentional networks of the brain the default network, associated with automatic attention and the task positive network, associated with directed or effortful attention.
    • Environment: Exposure to toxins in the environment has been linked to ADHD in children.
    • Prenatal substance exposure : Smoking and/or drug and alcohol use during pregnancy is associated with ADHD in children.

    Canadian Paediatric Society Mental Health And Developmental Disabilities Committee

    Members:Debbi Andrews MD , Susan Bobbitt MD, Alice Charach MD, Brenda Clark MD , Mark E Feldman MD , Johanne Harvey MD , Benjamin Klein MD, Oliva Ortiz-Alvarez MD, Sam Wong MD

    Liaisons:Sophia Hrycko MD, Canadian Academy of Child and Adolescent Psychiatry Angie Ip MD, CPS Developmental Paediatrics Section Aven Poynter MD, CPS Mental Health Section

    Principal authors:Stacey A. Bélanger MD PhD, Debbi Andrews MD, Clare Gray MD, Daphne Korczak MD

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    How Does A Differential Diagnosis Work

    Your healthcare provider will try to learn as much about your symptoms as they can to make a diagnosis. The process begins during an exam when they’ll ask questions related to your condition including:

    • What are your symptoms?
    • How long have you had those symptoms?
    • What is the severity of your symptoms?

    Next, your healthcare provider will review your medical history to see if the symptoms connect to any previous health concerns or already diagnosed conditions. Questions about your medical history include:

    • Have you experienced these symptoms before?
    • Have you noticed anything that might trigger your symptoms or make them worse or better?
    • Have you experienced any major changes in your life?
    • What medications, vitamins and/or supplements are you taking?

    Last, your healthcare provider will perform a physical examination by checking your blood pressure, heart rate and listening to your lungs.

    Your provider will compile a list of potential conditions that relate to your symptoms. To confirm your diagnosis, your provider might offer additional tests to confirm your diagnosis. Tests vary based on your symptoms and could include:

    • Laboratory tests .
    • Imaging tests like an X-ray.
    • Ultrasound.
    • Biopsy.

    After your healthcare provider reviews your symptoms, asks questions about your medical history and examines the results of any additional tests, they are able to pinpoint exactly what is causing your symptoms. They’ll then make a final diagnosis and recommended treatment.

    How Common Is Adhd

    ADHD Diagnosis Discussion Pt. 2 | Differential Diagnosis and Comorbidity

    About 11% of children between the ages of four and 17 have ADHD. Symptoms of ADHD typically first appear between the ages of three and six years old. The average age of ADHD diagnosis is seven years old. In children, its three times more common in young boys than girls.

    ADHD isnt just a childhood disorder. About 4% of American adults over the age of 18 contend with ADHD behaviors on a daily basis. In adulthood, its diagnosed equally between males and females.

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    What Behavioral Treatments Are Used To Treat Childhood And Adult Adhd

    The best prevention for ADHD, supported by substantial research, is to use a combined approach of both behavioral intervention and pharmacotherapy. Medicines are not enough to treat you or your childs ADHD. The old adage pills dont teach skills is certainly appropriate here. Thus its best to combine medical treatments with behavioral treatments.

    Behavioral treatments for childhood ADHD include:

    Behavioral treatments in adults help you navigate the demand of jobs, relationships and educational opportunities. ADHD coaches are trained and certified to assist adults with ADHD to manage the various difficulties of their lives.

    Behavioral treatments for adults with ADHD include:

    • Individual cognitive behavioral treatment to enhance a persons sense of self-efficacy.
    • Relaxation training and stress management to reduce anxiety and stress.
    • Behavioral coaching to teach strategies for organizing home and work activities.
    • Job coaching or mentoring to support better working relationships and improve on-the-job performance.
    • Family education and therapy to ensure that everyone in the family understands ADHD and its symptoms.

    How Is Adhd Diagnosed

    Healthcare providers use the guidelines in the American Psychiatric Associations Diagnostic and Statistical Manual, Fifth edition 1, to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. Using the same standard across communities can also help determine how many children have ADHD, and how public health is impacted by this condition.

    Here are the criteria in shortened form. Please note that they are presented just for your information. Only trained healthcare providers can diagnose or treat ADHD.

    Get information and support from the National Resource Center on ADHDexternal icon

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    Why Is Making A Diagnosis Of Asd Difficult And Time

    As the name implies, Autism Spectrum Disorder is a varied condition, that means, the above clinical features are present on a continuum with very mild impairment at the top end of the scale to more severe impairment of the above functions at the bottom end.

    More importantly, there are several clinical conditions, described below, that share some the features of ASD. Hence it is unsurprising that they can mistakenly be labelled as ASD. To complicate things further, many of the below-mentioned conditions can commonly co-occur with ASD. Therefore, as you can appreciate, because of the complexities involved, even the experts can get it wrong.

    Moreover, as ASD is a lifelong diagnosis and since a wrong diagnosis can lead to suboptimal or poor outcomes for the child and the family, it becomes imperative to undertake a detailed evaluation to arrive at the diagnosis of ASD, and to rule out the possibility of the below-mentioned conditions that can mimic as ASD.

    Therefore, it is crucial to undergo a thorough diagnostic evaluation, and I shall cover this is in my next article.

    Adhd Diagnosis In Children

    Differential Diagnosis of ADHD in Speech Language Pathology

    To diagnose a child with ADHD, a healthcare provider will complete the following steps:

    • Interview parents or guardians, school staff, and mental health practitioners involved with the child about their academic or behavioral problems
    • Assess the childs symptoms using tools such as behavior rating scales or checklists to ensure DSM-5 criteria for an ADHD diagnosis are met
    • Complete a physical exam and order laboratory or other tests to rule out other conditions with similar symptoms, such as a seizure disorder, thyroid disorder, sleep disorders, or lead poisoning
    • Run additional screening tests for co-occurring or other mental health conditions, including depression, anxiety, learning and language disorders, autism spectrum disorder, oppositional defiant disorder, conduct disorder, and tic disorders

    Depending on the childs symptoms, you may also need a referral to meet with a pediatric specialist for additional screenings for conditions like developmental disorders or learning disabilities.

    Verywell / Ellen Lindner

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    Differential Diagnosis Of Adhd In Speech Language Pathology: Focus On Assessment And Treatment Tatyana Elleseff Ms Ccc

    Inattentiveness, hyperactivity, and impulsivity are the most common presenting behavioral manifestations in at-risk school-aged children. This presentation discusses the causes of hyperactivity, overactivity, and inattentiveness in children beyond the ADHD diagnosis. It addresses a select variety of conditions which may mimic symptoms, including medical diagnoses, traumatic brain injury, language and literacy disorders, acquired genetic disorders, as well as psychiatric disorders with similar symptomology. Recommendations related to which standardized and clinical assessment batteries can be used for determination of language related-deficits are presented. Finally, treatment options, accommodations, modifications and compensatory strategies to improve affected performance in social and academic settings, are also provided.

    ASHA: 0.5 ASHA CEUs, Intermediate Level

    CA SLPAHB: 5.0 hrs

    Tatyana Elleseff, MA, CCC-SLP is a bilingual SLP, specializing in issues of multicultural, internationally & domestically adopted, at-risk children with communication disorders in school and private practice settings. She has been published a variety of journals as well as presented for a number of medical, academic and non-profit organizations and speech-language-hearing associations. She is a clinical instructor at the RWJ Medical School Dept. of Psychiatry & a clinical supervisor at Rutgers Day School.

    2.Describe which disorders have similar symptoms as ADHD

    What Are The Symptoms And Signs Of Adult Adhd What Is The Differential Diagnosis

    Adult ADHD patients complain of difficulty with concentration, attention, and short-term memory.20 The most common psychiatric conditions that may have overlapping symptoms with adult ADHD include mood disorders, anxiety disorders, substance use disorders, antisocial personality disorder, borderline personality disorder, developmental disabilities or mental retardation, and certain medical conditions.2

    As outlined elsewhere,2 individuals with major depressive disorder may show signs of inattention and become easily upset however, they have also experienced at least two weeks of depressed mood or loss of interest or pleasure in most activities and they complain of fatigue, loss of energy , and an appetite disturbance.2

    Adults with bipolar disorder have clear episodic mood impairments, including periods of elation, severe anger and irritability, grandiosity, decreased need for sleep , hypersexuality, and racing thoughts.2,21 They may have psychotic symptoms, such as delusions.

    Patients with anxiety disorders2 may show hyperactive behavior, such as fidgeting and inattentive behaviors, but these behaviors are accompanied by persistent fear and worries and somatic symptoms of anxiety. In substance abuse disorders, symptoms are directly related to intoxication with substances and associated withdrawal if physiologic dependence is present.2

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    If You Suspect You Have Either Adhd Or Bipolar Disorder Seek Treatment

    If you receive appropriate and qualified treatment from a mental health professional, the outcome for your condition is good, whether you have ADHD, bipolar disorder, or both. Treatment for ADHD generally involves a combination of medication and psychotherapy. Bipolar disorder is best treated initially with a stay at a residential mental health treatment facility, where youll receive around-the-clock professional care and any appropriate forms of therapy, which may include individual, group and family therapy. If you have bipolar disorder in combination with a co-occurring condition such as ADHD, a residential facility will make sure you receive comprehensive and integrated treatment for both. A treatment facility will also help you adhere to a stable diet and consistent sleep routines and will provide you with a high level of support, all of which will help you recover stronger and sooner.

    Bridges to Recovery offers comprehensive residential treatment for people struggling with mental health disorders as well as process addictions. Contact us to learn more about our renowned Los Angeles and programs and how we can help you or your loved one start the journey toward healing.

    How Should I Prepare For My Childs Appointment To Discuss Adhd

    Women With ADHD: How A Diagnosis Changed Our Lives

    If you think your child has a problem with attention, hyperactivity or impulsivity, and it seems that his or her behavior at home and performance at school are being affected, your next step is to see your pediatrician.

    If the symptoms are affecting your childs schoolwork, contact the school and request an evaluation. When making this request, be as specific as possible about the type of educational or behavioral difficulties your child is having.

    Schools are required to evaluate children if theres evidence of a disability that affects their learning. This evaluation is free and must, by law, include appropriate standardized tests. School testing can lead to accommodations in the classroom. The school will not diagnose ADHD, but will take note of the symptoms and will often assign a designation of Other Health Impaired . Get a copy of the schools report and bring it with you to the appointment with the pediatrician.

    If necessary, the family provider may suggest you take your child to a professional who specializes in ADHD and other developmental, behavioral or mental health concerns.

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    Assessing For Pharmacological Intervention

    There are no laboratory studies currently available to diagnose adult ADHD. However, the psychiatrist should monitor liver function studies and a CBC both prior to initiation of treatment with medication and serially thereafter. Hyperthyroidism should be ruled out.

    Seizure history would be a relative contraindication to the use of stimulants because they can lower the seizure threshold. If there are focal neurological findings on physical examination or if there is a history of traumatic brain injury, further neurological workup and radioimaging studies would be indicated, but otherwise they are not necessary.2 A referral can be made to a neuropsychologist if there are concerns over learning disabilities or if it is difficult to determine if the disorder had a childhood onset.34,35 Neuropsychological testing may include tests of vigilance by continuous performance testing because vigilance has been found to be abnormal in adults with ADHD.34,35 Also, there is evidence that persons with adult ADHD have abnormalities in perceptual-motor speed, working memory, verbal learning, semantic clustering, and response inhibition. A neuropsychologist also may look for a learning disability by testing in several sensory modalities to determine if the person has a deficit in one modality but not the other.

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