The Role of Neuropsychological Assessment in the Functional Outcomes of Children with ADHD

Abstract

The value of evidence-based services is now recognized both within clinical communities and by the public at large. Increasingly, neuropsychologists must justify the necessity of often costly and time-consuming neuropsychological assessments in the diagnosis and treatment of common childhood disorders, such as Attention-deficit/Hyperactivity Disorder (ADHD). Published medical guidelines and prominent researchers, however, have argued against the need for formal neuropsychological assessment of ADHD. The present review examines the literature on developmental outcomes in childhood ADHD, with emphasis on the utility of formal neuropsychological assessment among children diagnosed and treated in primary care settings. The review yields three central findings: 1) adherence to published diagnostic guidelines for ADHD is poor among pediatric and primary care physicians; 2) ADHD most often co-exists with other disorders, thus diagnoses made without formal psychometric assessment can be incomplete or incorrect, ultimately increasing treatment costs; and, 3) untreated children with ADHD, and those who have untreated comorbidities, are at greater risk for poor outcomes in social, academic, vocational, and practical settings. The available literature suggests that neuropsychological assessment provides information that can potentially reduce risks for poor outcomes and improve quality of life among children with ADHD. Controlled studies directly examining the impact of neuropsychological assessments in improving outcomes among children with ADHD are needed.

ADHD inattentive symptoms mediate the relationship between intelligence and academic performance in children aged 6-14

“…Considering a cognitive-to-behavioral influence on academic problems, fluid intelligence evaluation in the context of inattentive problems would be extremely relevant for better prediction of academic outcomes. 18,44 Poorer cognitive performance and high levels of inattention may increase the need for special education. 45 However, it is worth noting that the academic performance of children with the highest levels of hyperactivity-impulsivity in our sample might be explained by other abilities besides fluid intelligence.…”

Incremental Validity of Neuropsychological Assessment in the Identification and Treatment of Youth with ADHD

“…Currently, more than half of youth with ADHD are diagnosed and treated within the primary care setting (Epstein et al, 2008; Leslie, Stallone, Weckerly, McDaniel, & Monn, 2006; Leslie, Weckerly, Plemmons, Landsverk, & Eastman, 2004). Although formal guidelines for the diagnosis of ADHD are available, adherence to these guidelines (i.e., DSM-IV criteria) has been generally poor among primary care providers due to limited training in their use and insufficient time during routine visits (see Pritchard, Nigro, Jacobson, and Mahone, 2011 for review). Formal guidelines based on the recently released 5 th Edition of the Diagnostic and Statistical Manual of Mental Disorders (APA, 2013) are not yet available; however, it seems unlikely that substantial changes to these guidelines will be necessitated by the relatively minor revisions that were made to the diagnostic criteria for ADHD in this newest edition.…”

Attention Functioning Among Adolescents With Multiple Learning, Attentional, Behavioral, and Emotional Difficulties

“…In addition, such subjective evaluations can be biased and contingent on the observer's point of view (Sims & Lonigan, 2012). Interestingly, although cognitive neuropsychology at University of Otago Library on July 6, 2015 ldx.sagepub.com Downloaded from contributed significantly to current theory of ADHD (Koziol & Stevens, 2012;Pritchard et al, 2012), it offered limited, if any, contribution to the behavioral measures used for diagnosis (Lezak, Howieson, Loring, Hannay, & Fischer, 2004). Furthermore, neuropsychological assessment tools do not always provide a clear criterion that can differentiate between performance of individuals with ADHD versus those without ADHD in various tasks (Nigg, Willcutt, Doyle, & Sonuga-Barke, 2005;Willcutt, Doyle, Nigg, Faraone, & Pennington, 2005).…”