ADHD Assessments
Mind in Action is a psychology practise that works with a lot of kids with busy minds. We understand that no two kids with ADHD are alike and specialise in helping parents and kids discover and understand their quirky brains and create an effective plan for the future to best use them.
We provide both private therapy and group-based workshops to help kids work with their attention, impulsivity, planning, and organisation issues as well as all the emotional, academic and social difficulties that can go along with them. We also run dyslexia and writing programs designed for kids with working memory and attention problems as these can often go hand in hand.
ADHD Parent and teacher questionnaires/rating scales related to your child’s behaviour, cognition and school performance. These assess ADHD directly and also other disorders that may explain symptoms related to other disorders. These include social, behavioural and mood disorders.
Comprehensive clinical history and examination with parents to clarify assessment direction. This also seeks to rule out any medical issues that may be causing attention or behavioural issues such as vision and hearing, diet, sleep, mood and anxiety, medications, learning difficulties, other existing conditions.
Neuropsychological testing of specific cognitive assessment related to those difficulties often seen in ADHD and those that rule out other issues. This includes as a basis:
Attention (sustained, selective, switching and divided)
Executive functioning (cognitive flexibility, planning, organisation, reasoning, and self-monitoring)- only if over 8 years old
General intellectual (IQ) functioning-reasoning skills, processing speed & working memory
If visual or auditory processing issues are suspected then these will also be assessed
Combined Academic/learning disability assessment- It is common for children with ADHD to have concurrent academic issues. If learning issues are thought to be an issue these may also be looked into to assess specific learning disabilities in reading, writing or math.
Feedback and recommendations
There are lots of options for kids with ADHD and exploring these will be a very important part of the processes. Feedback will focus on explaining your child’s strengths and weaknesses as well as any appropriate diagnosis. We will talk about the “where to from here” and create a plan going forward. This will include recommendations and strategies for school and home as well as treatment options and referrals to any medical professionals.
Medication management
There are a lot of options for parents and children who choose not to medicate. There are also subtypes fo ADHD that are not receptive to medication. We make sure to give you lots of recommendations on how to manage ADHD without having to medicate.
If you do choose medication as an option, we are also happy t provide objective, comparative analysis of different drug effects. We are happy to test your child on and off medication to see what is in fact working also.
Pre assessment:
We will send you an intake form and a number of questionnaires to fill in before you come into clinic so that we can get a good idea about what we will need to cover
Initial session:
We will have an initial session with parents to discuss the current concerns and direction of assessment. We can do this over a Telehealth service if necessary.
Testing sessions:
Because every human mind is unique, the neuropsychological assessments provided are individual for every child depending on the core issues and underlying functional weaknesses. Which tests to use are established by talking to the parents and teachers and performing some pre-assessment questionnaires. Then as the assessment goes along adjustments in tests are made depending on what is found during testing.
Testing will happen over one or two sessions depending on the age of your child and how much needs to be covered. Normally this will require the student to take half a day off school and each session can last anywhere between 2 and 4 hrs. Parents will only be required to drop off and pick up their child.
Feedback session:
This session is also with the parents to go through the results of assessment and talk about recommendations and diagnosis if appropriate.
Assessment aims to provide you with knowledge about your child’s cognitive strengths and weakness, any other contributing factors to the clinical picture, as well as short term and long term strategies for the future. This includes strategies for home and school as well as referrals to specialists or programs for therapy or training.
Children with ADHD often have trouble controlling their attention when they need to. They may be the dreamer who gets lost in thoughts and finds it hard to organise their world. They may be the active child who acts on impulse, or finds it difficult to sit still when something is boring or hard.
As you can see, ADHD is disorder that can look very different in different kids and there are also a number of medical, psychological and cognitive difficulties that look similar. So, despite it being quite a common neurodevelopment disorder, it can be a struggle for parents and teachers to work out what is going on. Getting an accurate diagnosis is therefore very important to rule out anything else going on and provide strategies and treatment that are tailored to your child.
Normally when we are doing tasks that we find boring or hard, the CEO of our brain can help us to keep motivated in “short term pain for long term gain”. However, when we are under stress our brain cannot talk to the CEO and we make short term decisions so that we stop feeling stressed. One of the best ways to stop this stress in the brain is to promote activities that release dopamine in the brain. Dopamine is a neurotransmitter and is the cause of intrinsic motivation. It is something that is released in the brain when we see or do something that we like.
Creating opportunities for children that are interesting, foster curiosity and are achievable challenges is the key. When a child with ADHD is interested or curious about something and feels they can achieve their goal then they are able to use their CEO and can accomplish a task well (you may see this when they are playing video games or completing an activity they enjoy). Then they are able to self-motivate and monitor.
It is, therefore, the responsibility of all who work with these children to a) at times be the CEO for them b) create experiences that foster curiosity, interest and achievable challenges in the child, so they can use their CEO easily c) help them to self-monitor and have insight into when they are having a stress response to something boring or hard and to implement strategies to help.
The two things that are most aligned with loss of concentration are:
1) Boredom due to a) mastery or b) low personal relevance
2) Frustration usually due to a) repeated failure or b) lack of understanding.
When we start to feel frustrated or bored, there is a reaction in the brain. This reaction makes it very difficult to think. Children with ADHD have a lower threshold to flip into this mental override mode and this often occurs with school work or tasks they don’t like. This is not the child being naughty but is actually an acute reaction to the stress they feel when bored or frustrated. It is an evolutionary brain function that is unfortunately causing trouble with tasks they need to get done.
Specifically, when we are learning something, our brain uses both emotion and attention “filters” to help decide whether the information we are getting is interesting/important or if it is in fact stressful/uninteresting. If it likes the information, it will usually pass it on to the “CEO of the brain” – the prefrontal cortex- that will allow us to use the information and decide what to do with it next. This is referred to as executive functioning and involves things such as planning, organisation, self-control etc.
When we are under stress or frustration or boredom something different happens. There is a kind of override when the emotion system is really active and it sees a threat. The problem is, while our brain is good at assessing and running away/hiding from threats such as lions and tigers and bears, it also assesses difficult or boring school work in the same way. So instead of the information going on to the CEO and allowing us to use it, our brain passes it on straight away to the “fight/flight” motor cortex instead and makes us want to get away from the situation rather than use goal-oriented behaviour. This happens to everyone but happens more frequently and with lower level stressors to those with ADHD. Again, this is not the child being naughty but is actually an evolutionary brain function that is just a little too switched on in these kids.
In this way, ADHD a disorder that affects self-control and self-motivation in children and adults by causing difficulty with attention and executive functioning (planning, organisation, impulse control) . It means that children have more difficulty accessing their CEO or “executive” of their brain that is supposed to help organise and control behaviour and help plan for the future. Instead, the brain is operating based on what is most pleasing, stimulating or interesting, in the moment. It also means that it is a lot harder to persist when things are difficult or “boring” because the brain of an ADHD child needs a lot more stimulation to allow it to talk to the CEO than in an average child without becoming distracted or getting stressed.
Normally when we are doing tasks that we find boring or hard, the CEO of our brain can help us to keep motivated in “short term pain for long term gain”. However, when we are under stress our brain cannot talk to the CEO and we make short term decisions so that we stop feeling stressed. One of the best ways to stop this stress in the brain is to promote activities that release dopamine in the brain. Dopamine is a neurotransmitter and is the cause of intrinsic motivation. It is something that is released in the brain when we see or do something that we like.
Creating opportunities for children that are interesting, foster curiosity and are achievable challenges is the key. When a child with ADHD is interested or curious about something and feels they can achieve their goal then they are able to use their CEO and can accomplish a task well (you may see this when they are playing video games or completing an activity they enjoy). Then they are able to self-motivate and monitor.
It is, therefore, the responsibility of all who work with these children to a) at times be the CEO for them b) create experiences that foster curiosity, interest and achievable challenges in the child, so they can use their CEO easily c) help them to self-monitor and have insight into when they are having a stress response to something boring or hard and to implement strategies to help.
Tania Pickering has been conducting assessments and helping families with strategies and treatment for ADHD for many years. She has a masters in Clinical Neuropsychology and as such has the comprehensive training necessary to provide in depth assessment and ongoing support for your child. She provides a wholistic approach to assessment, taking into consideration the person in context with their life as well as in the testing environment. This means looking at the cognitive, psychological, lifestyle and social aspects of the person on an individual level. The main aim of the assessments apart from diagnosis is to help create an effective plan for the future. To help parents get the information and resources they need to help kids thrive no matter their quirks. We also work with the child’s school to make sure the information and support is continued here. There will always be an action plan for home and school provided as well as any professional referrals given. She conducts assessments on the northern beaches and North shore or Sydney Australia
