Dr. Leon J. Schofield - Rochester's Leading ADD Expert

Psychological testing for ADD is controversial. Most insurance companies don't pay for such services since they feel it is "not medically necessary" to provide testing in order to diagnose ADD.

Interview with the patient and parents and behavior rating scales completed by teachers and parents are the standard of care. If the symptoms and behaviors fit the diagnosis of ADD, it must be ADD.

The physician usually embarks on a course of stimulant medication at that point with some follow up visits to determine effectiveness and perhaps adjust the medication.

There are a number of reasons to consider psychological testing to diagnose ADD.

These reasons include:

Interviews and rating scales are subjective; what is ADD to one person may be in the normal range for another.
The rating may be more of an expression of the rater´s frustration than the actual severity of the ADD; ratings may also be inflated to secure treatment.
It is difficult to rate inattentiveness accurately; how can we know what is in the mind of another; inattentive ADD often slips by beneath the radar for years.
Objective test data helps identify factors other than ADD that may cause or contribute to the attention problems; academic weaknesses or even learning disabilities often are present with ADD.
Objective test data establishes a baseline to measure treatment gains at a later time; improvements can be understated or overstated if subjectively estimated.
Cognitive improvements can occur early in treatment but actual academic and behavior improvements tend to be delayed due to negative attitudes and poor habits which may take time to reverse.
Testing can reveal hidden strengths that can help with developing better coping strategies; the emphasis on weaknesses and problems is disconcerting for many children and adults.
Thorough and recent psychological testing is actually mandated and necessary for standardized testing such as the SAT and for accommodations such as extended testing time at college.

A psychologist trained and experienced in ADD evaluations will provide the necessary tests to establish an ADD diagnosis. Many will use several tests of visual and auditory attention and memory. I prefer to use the Woodcock Johnson Tests of Cognitive Abilities and the Woodcock Johnson Tests of Achievement. These tests provide a single source of data that is highly researched and normed against a wide range of children and adults throughout the United States. The tests have excellent reliability and validity. I especially like that fact that most of the tests are tightly timed, with specific or subtle time limits for most tasks. In this sense, I believe the test have the ability to generalize and predict performance in the real world which moves swiftly.

There are many features of the Woodcock Johnson tests that are very helpful in the diagnosis and treatment planning for children and adults.

The cognitive abilities tests include measures of:

Broad attention
Working memory
Short term auditory and visual memory
Long term memory
Speed of retrieving stored information
Processing speed
Visual planning
Higher level cognitive reasoning and planning

The achievement tests include measures of:

Broad reading
Reading speed
Reading comprehension
Word identification and phonetic reading skills
Broad writing
Spelling and ability to correct written text
Writing speed
Quality of written expression
Broad math skills
Speed of basic calculation
Application of math to everyday problems
Oral language and expression
Listening comprehension

A complete battery of tests provides a wealth of information that can be highly useful in diagnosing and planning! Rating scales and history taking can't provide such information. For more information on what to expect in a comprehensive testing for ADD click here.