ADHD Assessment (continued)

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Other colleagues, such as teachers or a school nurse, can be helpful resources. At an initial level, a school nurse can be consulted to rule out other conditions (e.g., hearing loss) through general screening procedures. If other conditions might be the source of behavioral problems, then the evaluation process involves professionals with expertise in those areas of concern (e.g., an audiologist). When the school nurse suspects the presence of ADHD characteristics, the direction of the evaluation efforts is adjusted accordingly. Other teachers can conduct classroom observations to help the general educator find additional ways to improve the classroom structure and educational environment. Parents and family members are a critical resource at this stage, both for feedback regarding interventions that have been successful in the past and to maintain consistency between the home and school environments. If a variety of methods have been employed to increase attention or reduce hyperactivity, with little or no success, then a formal referral to special education is warranted.

Identification

Experts strongly suggest that the identification process for ADHD include multidimensional evaluations (Barkley & Edwards, 1998; Gordon & Barkley, 1998; Weyandt, 2001). Such comprehensive assessments would include many different . -pes of procedures such as

• Diagnostic interviews
• Medical examinations
• Behavior rating scales
• Standardized tests
• Observations

Because prescription medicines are widely used to assist in the management of hyperactivity, many parents of children with ADHD seek help from their doctors first. Thus the medical profession often is involved in these students' diagnosis, even though only three states require diagnosis by either a physician or a mental health professional as part of the eligibility determination for ADHD (Muller & Markowitz, 2004), (Only five states call out special guidelines for qualifying these students for special education services.)

Even if the student's pediatrician or family doctor makes a diagnosis of ADHD, school personnel must also make a determination about whether the student qualifies for accommodations though Section 504 or for special education services. They use a multilevel approach to gather all the information they need to understand the nature of the individual's problems and the types of supports and services needed (Merrell & Boelter, 2001; Salend & Rohena, 2003). These education professionals collect data about the student's academic performance, behavioral patterns, social interactions, and medical history. They compare this information with the DSM-IV-TR definition of ADHD to determine both needs and eligibility. The subjectivity of some of the assessment procedures (e.g., a parent's perception of hyperactivity compared to a teacher's) requires that caution be exercised. Cooperation among the many people involved in this process is vital. Remember that for a student to receive special education services, the characteristics of ADHD must be significant, must be observed across several settings, must be documented (even if retrospectively) as having existed before the age of seven, and must seriously affect educational performance.