Joyce’s newest Psychology Today article has been published today.
The article is titled: Strengths-Inclusive Assessment of ADHD: why strengths are key to understanding the whole neurodiverse person.
Key points include:
• Current assessments for ADHD are deficits-heavy.
• This approach doesn’t give a clear view of the whole neurodiversity picture.
• It would be more helpful to use balanced limitations and strengths-focused assessments.
Have a look at Joyce’s first Psychology Today blog on neurodiversity that was published today.
Several ideas and preconceptions we may have about ADHD are incorrect and simply not true. Below I address some of these.
Myth 1: ADHD is not a real condition
More than 10,000 scientific articles and books have been published on ADHD. Research shows several differences between those with ADHD and those with neurotypical (non-ADHD) brains. ADHD can impact major life domains in terms of functioning, including social, emotional, and academic functioning. ADHD runs in families, with a 57% chance for a child to have ADHD if a parent has it too. Taken together there is more than enough evidence to be confident that ADHD is a real, neurodevelopmental condition.
Myth 2: if you have ADHD it means you are less intelligent
There is no correlation between ADHD and intelligence. People from across the whole intelligence spectrum (very low to very high) can have ADHD. Many people with ADHD are extremely intelligent and high functioning. Altogether, having ADHD certainly does not mean that you would be less intelligent than people without ADHD.
Myth 3: ADHD is a childhood condition
Long-term studies indicated that ADHD is a lifespan disorder, with many children still having symptoms into adulthood. ADHD persists from childhood into adulthood in 35%–65% of individuals. Symptoms will likely change over time with often more symptoms of hyperactivity and impulsivity observed in children and more inattention in adults. It often happens that once a child gets diagnosed, one of the parents starts realizing they may have undiagnosed ADHD as well due to similarity in symptoms.
Myth 4: ADHD is Over-Diagnosed
The rate of ADHD diagnoses in children increases by 5% yearly. This has led some people to question if ADHD is being over-diagnosed. But shows that children are being carefully diagnosed and that most ADHD diagnoses was made following best-practice guidelines. Explanations for increased numbers of diagnoses include more awareness about ADHD, more screenings by healthcare professionals, less stigma, and availability of better therapy support options.
Myth 5: Poor Parenting Causes ADHD
Research studies point to genetic and neurological factors as the main causes of ADHD rather than parenting approach. Twin studies of individuals with ADHD show that family environments contributes extremely little to the observed differences in ADHD symptoms. Instead it is predictive whether a parent has ADHD for a child’s change of developing ADHD.
Yes! You have decided to explore assessment. Perhaps because you wonder whether you or your child may qualify for a diagnosis of ADHD or autism? Or because you have noticed certain strengths and challenges in yourself or your child that make you wonder what might explain these? In either scenario, you likely wonder what an assessment entails.
The intake session
The assessment process starts with a first session, the so-called intake session with Dr. Joyce. This is an opportunity for you to get to know Joyce and see whether she’s someone that’s a good match for you and your needs. In terms of skills and areas of specialisation as well as personality. During this first session, Joyce will also gather a lot of information about you. Some questions that you might be asked are: what are your strengths, what are those things you are struggling with, how does your home life look, and how does your work or school life look?
The general goal is to try and get to know you and what is going well and less well in your life so that the psychologist can form a good picture of what specific components the assessment process would need to include and what might be going on. Some questions may not seem directly related to psychological wellbeing or the reason for your visit, like questions about your living situation or daytime activities, but they help get a good picture of your daily functioning and are informative for many different mental health diagnoses. Finally, Joyce will discuss with you what the assessments process will look like going forward. You can book an intake session using the online calendar and / or email Dr. Joyce.
Following the intake session, Dr. Joyce will likely send you several questionnaire assessments that you can complete at home via an online link, pdf attachment, or using pen and paper. Generally, there will be at least one broader screening questionnaire too ensure we don’t overlook any difficulties or diagnoses by starting with too narrow a focus. There will also be one questionnaire more targeted to those domains that are relevant to you individually based on the intake session (e.g. ADHD-specific if we wonder whether an ADHD diagnosis may be applicable).
Generally, more than one person will be asked to complete questionnaires as it’s important to cover different domains (e.g. school and home) and perspectives (e.g. parent and child). For adults this means we will likely discuss which friend or family member could complete some questionnaires in addition to yourself.
One common component of mental health assessments is a cognitive assessment which gives us a good understanding of your individual brain’s strengths and limitations. This will help us go beyond merely a diagnosis but really get a good understanding of you as an individual and assess how cognitive profile influences strengths and difficulties in daily life. The cognitive assessment consists of a series of brief (5-10 minute) tasks. Each task is different with some assessing verbal ability (e.g. word knowledge or verbal reasoning), while others ask you to solve a visual puzzle, or re-create a pattern. Most people find these tasks quite fun.
These cognitive tasks are not like a test at school and you cannot fail this assessment. The cognitive assessment will simply tell us what your cognitive strengths and limitations are. Each task is designed in such a way that it starts with relatively simple questions and gets harder throughout so that at the end you will almost always struggle to answer. That’s just how the task is designed and no one has ever answered all questions correctly!
We will usually complete a face-to-face assessment task that focusses specifically on the issue that you want to be assessed for or that has come out of the intake session and questionnaires as a likely hypothesis for the assessment.
For an ADHD assessment this would be a 20-minute computerized task where you respond to visual stimuli with a button-click if the stimuli appear in a specific location on the screen. This task is a little boring but not difficult, and gives us lots of important information about our attention, impulsivity, and distractibility.
For an autism assessment this task would consist of a sequence of short (5-10 minute) social and question-based tasks. These tasks may include, jointly reading a book and creating a make-belief story with general objects. Dr. Joyce will discuss with you which tasks would be most informative for your assessment process during the intake session and potentially re-evaluate this with you at a later stage (e.g. after cognitive assessment or questionnaires) if new information comes up.
Analysis and report writing
Following the in-person assessment tasks and questionnaires, you are done with all the hard work for now! Dr. Joyce will analyze all the data and write a report that summarizes your profile of strengths and challenges as well as specific diagnoses that may apply. The report will also include recommendations for how to support your child or yourself optimally going forward.
The assessment outcome session
In the final assessment session, you will discuss this report, your profile of strengths and challenges, recommendations, and any potential diagnoses. During this outcome session Dr. Joyce will communicate to you what your assessments show us and what this means going forward. This outcome session is also an opportunity for you to ask any questions you may have at that point in time. You are always free to schedule more appointments with us to further discuss any questions or concerns that may pop up later and we will send you an electronic version of the report. We can also share your report with any other professionals involved if you give us permission to do so (for example a child’s teacher, GP, or paediatrician or a psychiatrist).