I recently emailed a psychiatric hospital to ask about the procedure for adhd diagnosis as well as borderline personality disorder. This was their reply..."Our procedure for an ADHD diagnosis or Borderline personality Disorder is by conducting psychological assessment such as an IQ test. Treatment interventions are medications and psychotherapy."
I wasn't expecting only a IQ test. Is this standard? What should I be looking for ?
Perhaps they meant IQ test as one of the tests rather than the only one.
Once upon a time, I was in Office Assistant in a Special Ed department at a public charter school. It was within my duties to schedule testing for students with a school psychologist. (The school did not have its own psychologist, but would contract with a couple from local school districts.)
An IQ test was often paired with ADHD testing, because many students who are being assessed for ADHD are likely to also have learning disabilities.
However, what this did not do was to identify students who had ADHD but did not have learning struggles. The tests were ordered by special ed teachers, for the purpose of assessing what particular learning challenges that a student had.
For professionals who assess ADHD in children, and IQ test is probably going to be used as well. I would guess that many of those professionals might also consider an IQ test if they are assessing an adult for ADHD, simply because it is their practice to do so.
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Gifted students are likely to score very high on an IQ test, even if they have out of control ADHD.
From what I have seen, I believe the spread of IQ scores among people with ADHD follows a bell curve, just like it does for neurotypical people. I saw in a video by Dr Russell Barkley that there is a slight offset by a few points lower of average IQ for the ADHD population. I think he showed both bell curves, to show that the spread is nearly identical, but slightly offset.
• My opinion is that IQ tests, as normative tests, written and validated based on neurotypical people. For at least some IQ tests, I believe there is a time limit. If an ADHD person were given an IQ test with no time limit, and permitted to take breaks as they need them, allowed to move as their body feels like it needs to move, and maybe even allowed to snack during the test... I bet that the difference between ADHD and neurotypical IQ scores would almost completely vanish.
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[I got put in gifted and talented education in elementary school. My older brother was put in on teacher recommendation alone, and I somehow heard that he didn't pass the assessment because it was the time to test and he didn't finish the test. I know my brother well, so I know that the answers he did give we're probably all precisely correct... I don't think he knew that it was a time to test. ~ Contrary to the standard practice, I was only tested after I was already in the class. I was not told that I was putting on teacher recommendation, so I have long thought that I was put in due to a clerical error. I got to stay in the class, so I guess I scored well enough.]
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I do not think that IQ tests are a good indicator of ADHD. I do think that an IQ test might indicate them more testing is needed, in order to better determine the academic struggles of a particular individual.
However, I'm also a proponent of the multiple intelligences theory. IQ only measures a particular aspect, and does not truly represent a person's capability.
I am in the process of being evaluated for ADHD as an adult. As a child I was considered very gifted and my behavior issues and trouble getting along were attributed to being bored. I was not bored. I was fascinated by most subjects. Only did poorly in math, PE and handwriting. My problem was a strong sensitivity ri criticism to the point where being name called would result in my engaging in impulsive hitting out. My parents and the school did not realize this. I still have this sensitivity but have learned to manifest it more peacefully. As a child I did not have these skills.
My behavior was unusual for a girl and really they did not know what to do.
They would look at my IQ score and grades and say: why doesn't she figure it out? .
Too often "bright" children are presumed to be able to figure out everything on their own.
"why doesn't she figure it out?"
...the real question is, why didn't somebody have the compassion and genuine interest to help you, guide and mentor you.
School-aged children and adolescents are sometimes diagnosed as having a Conduct Disorder. Two particular conduct disorders that can be connected with ADHD are:
• Oppositional Defiant Disorder (ODD)
• Disruptive Mood Defiant Disorder (DMDD)
However, I wonder if they might be presentations of Rejection Sensitive Dysphoria (RSD).
What you mentioned about not liking to feel criticized sounds like RSD. However, actions like impulsive hitting might be likely to get a kid labelled with ODD or DMDD.
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Some kids are equally intelligent, but not interested in school, like you and I were. Those kids are more likely to be identified as troublemakers, and be presumed to have character issues.
ADHD is described by some experts as having an interest-based attention system. If a person with ADHD is interested in something, then their attention will naturally be directed towards it.
Those kids with ADHD who weren't interested in school subjects couldn't direct their attention to it well enough, and usually got a lot of attention from the school system.
Those kids (like you and me) with ADHD who were interested in school usually did not get enough attention from the school system, because our parents, teachers, and others expected that we would "figure it out" on our own.
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You mentioned doing poorly at math. There could be various reasons for that, but sometimes a person has dyscalculia (which is to math what dyslexia is to reading).
• However, as a former math tutor, I often found that students who struggle with math might have simply not been taught foundational skills. Learning math is like building a house. You need a good foundation to support the walls and roof. If the foundation isn't complete, it won't support the rest. ~ Some people might need more support with developing arithmetic skills, but might have excellent reasoning skills that would help them flourish in higher level mathematics.
[In tutoring 6th-12th grade students, I found that I could teach most math concepts and skills in at least 3-4 different ways. Textbooks and many teachers usually only teach the concept and skills in 1 or 2 ways.]
Doing poorly in PE and in handwriting sounds like you might have coordination issues. Does that sound like the case?
Of course, there's a difference between the fine motor coordination for writing and the gross motor coordination for athletic activities. Having both together might point to other issues than coordination, like dyspraxia or Ehlers-Danlos Syndrome.
Then again, I was uncoordinated in PE as a kid, then better in my 20s, then worse again in my 30s and 40s. My handwriting has always been a bit bad (but legible). I have never been diagnosed with a motor coordination issue, or even had anyone hint that I might have a disorder causing it. (Yet, nobody thought I had ADHD, until I got diagnosed as 45...then most people who knew me didn't seem surprised, only my then-wife didn't agree with the diagnosis at first.)
I suspect I may have RSD. I think my issue with math eas simply that I was not gifted in it so was not able to or willing to put out the work in it. As you point out, the interest was not strong
I avoided physical activity recreationally until recently when due to needing to lose weight I started to walk and do water aerobics. Especially in water aerobics I found a peace and ease in moving and also in being in the water. And realize that when I am active during the day I am more relaxed and focused and at peace. Moving seems to be something i need to do. Girls were taught to be still. Realizing I was not made to be silent, still or slow paced is liberating to me b
I'm glad that you have realized that.
Schools and society try to put people into boxes. But people are so unique from one another, none of us fit into the box.
As an introverted, highly-sensitive, ADHD male, I also don't fit in the box.
BTW- I think that RSD shows up differently for me. I tend to internalize criticism, and it makes me even less likely to speak up. So, while some people act out from rejection sensitivity, I clam up instead, withdrawing into myself to avoid potential conflict.
Thank you for your reply and insight. It's very helpful and valuable as I haven't been able to get this kind of information from the hospitals here. They really haven't explained the reasoning behind anything.
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