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Clinician Observations of Preschoolers' Behavior Help to Predict ADHD at School Age

Thursday, October 3,2013

Don't rely on one source of information about your preschoolers' inattention or hyperactivity as a predictor of ADHD. Rather, consider how your child behaves at home as well as information from his or her teacher and a clinician. This suggestion comes from Sarah O'Neill based on research she published in Springer's Journal of Abnormal Child Psychology. The study examined how well parent, teacher, and clinician ratings of preschoolers' behavior are able to predict severity and diagnosis of attention deficit hyperactivity disorder (ADHD) at age six.

As might be expected, the likelihood of a reliable ADHD diagnosis increased when all three informants had rated the child as high on symptoms at age three or four. Parents' reports of preschoolers' inattention, hyperactivity, or impulsivity were critical, particularly when combined with either teacher or clinician reports. However, clinicial observations of preschoolers during psychological testing held the best prognostic utility. By comparison, teacher reports were not as useful. Needless to say, being able to identify children at risk may help educators and clinicians to plan and implement appropriate interventions and perhaps prevent or minimize poor outcomes.

Because Dr Levinson has found ADHD related to a cerebellar-vestibular or inner-ear dysfunction, all preschool children suspected of having this disorder should be neurophysiologically tested. Positive imbalance/dyscoordination evidence of an inner-ear dysfunction together with parent, teacher and/or clinical reported ADHD symptoms were found by Levinson to more reliably diagnose this disorder in all age groups. Most important, when Levinson treated preschoolers having severe dyscoordination, he was able to minimize or eliminate their reported ADHD symptoms. Thus early diagnosis and treatment suggested prevention to be possible. The longer medical treatment suppressed symptoms, the more independent many children with this impairment became of requiring the treatment.