November 2014 Conference (ADHD)
Angelika and I, as Executive Director and Board President of the Northeast Regional Biofeedback Society (NRBS) respectively, were involved in the recent three-day conference on ADHD: Biomarkers, Biofeedback, and Interventions. Angelika was instrumental in the setting up and running of the conference, which was well attended and well received. The Conference had much to say about diagnosis, treatment, ethical questions, etc.
Difficulty Diagnosing ADHD
Something it is important for the public to realize, which was apparent in many of the presentations, is the difficulty of getting a valid diagnosis of ADHD before initiating treatment. Research was reviewed that indicated that the reliability of a diagnosis that relies on a relatively brief discussion with the patient and his/her parents if the patient is a child is about fifty percent. That is, there is a fifty-fifty, or chance probability that the correct diagnosis has been made. In other words, you may as well flip a coin. If one of the typical ADHD self-report questionnaires is added to the process (to be completed by the patient and/or parents, and/or teachers), the reliability goes up a little to about sixty percent. Add relevant psychometric tests such as a Continuous Performance Task or neuropsychological tests known to assess attention, impulsivity, etc., the reliability goes up to seventy-five to eighty percent. And, if some type of a brainwave analysis is added (e.g., quantitative EEG, Event Related Potentials analysis), the reliability rises to above 90%, which is about as good as it can get.
Why is it difficult to obtain a valid diagnosis for ADHD? Inattention, hyperactivity, and impulsivity can be related to issues other than ADHD. Anxiety, stress, immaturity, depression, etc., can all have an effect on one or more of these symptoms. To receive the best treatment, you want to get a good evaluation which will lead to a valid assessment of the problem. In the case of ADHD, just talking to a health professional, whatever his/her training (e.g., pediatrician, psychiatrist, psychologist, neurologist, etc.) , is not likely to yield a diagnosis in which one can have a high degree of confidence.
So, the take-away message here is to consider pursuing a thorough evaluation if you, or someone you know, is wanting to find out if they are suffering from ADHD (or anything else for that matter).
For an explanation of how our office approaches diagnosis of ADHD, you can read a recent blog entry on the subject here.