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Self-Test for ADHD

(An ADHD SELF-TEST can be added or linked here under the ADHD Web section discussing TOTAL CONCENTRATION, & as a Tab on the front web pg. )

Background

According to Dr Levinson, there appears to be two neurophysiological forms of ADHD. The severest forms (Type-1 Cerebral ADHD) with the worst prognosis are considered to be of a primary frontal lobe cerebral or thinking brain origin. Because of the functional interaction of the higher cerebral and lower cerebellar brains of man, a primary frontal lobe impairment may secondarily trigger cerebellar-based dysfunction and related symptoms. The milder forms (Type-2 Cerebellar ADHD) tend to be of a primary inner-ear or cerebellar-vestibular origin with secondary frontal lobe involvement and have the most favorable outcomes. In Type-2 ADHD, cerebellar dysfunction sends scrambled signals to normal frontal lobe cerebral and related brain structures which secondarily fail to process them. As a result, these secondary frontal lobe ADHD forms most often have overlapping dyslexic or LD and related cerebellar-vestibular symptoms which respond most favorably to both inner-ear enhancing stimulants and antihistamines.

By analogy, Type-1 ADHD of primary cerebral origin is akin to the severe reading comprehension disorder of proven cerebra origin called Alexia, having a very poor prognosis for improvement. In comparison, Type-2 ADHD and dyslexia are of primary cerebellar-vestibular origins and thus have very favorable compensatory and therapeutic outcomes.

ADHD Self-Test: DSM-IV Criteria Encompass Only Obvious Cases

The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) contains the Diagnostic Criteria for symptomatically diagnosing Attention Deficit Hyperactivity Disorder.

Introduction

For those interested in the official (or DSM IV) diagnostic evaluation of ADHD, a link has been provided. (   ) This DSM IV evaluation has both positives and negatives. Because the criteria for diagnosis are very stringent by design, those that meet it invariably have ADHD. However, Dr Levinson believes that many with ADD/ADHD, perhaps even the majority, have fewer and less severe symptoms. Thus many are diagnostically excluded by this test and so are deprived of proper treatment.

Specific Diagnostic DSM-IV Criteria-Officially Advised

1A: ADHD — Predominantly Inattentive Type

To diagnose ADHD — Predominantly Inattentive Type, six or more of the following nine symptoms of inattention must be present:

Inattention symptoms

  1. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
  2. often has difficulty sustaining attention in tasks or play activities
  3. often does not seem to listen when spoken to directly
  4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behaviour or failure of comprehension)
  5. often has difficulty organizing tasks and activities
  6. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
  7. often loses things necessary for tasks or activities at school or at home (e.g. toys, pencils, books, assignments)
  8. is often easily distracted by extraneous stimuli
  9. is often forgetful in daily activities

2A: ADHD — Predominantly Hyperactive-Impulsive Type

To diagnose ADHD — Predominantly Hyperactive-Impulsive Type, six or more of the following nine symptoms of hyperactivity and impulsivity must be present:

Hyperactivity Symptoms

  1. often fidgets with hands or feet or squirms in seat
  2. often leaves seat in classroom or in other situations in which remaining seated is expected
  3. often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
  4. often has difficulty playing or engaging in leisure activities quietly
  5. often talks excessively
  6. is often 'on the go' or often acts as if 'driven by a motor'

Impulsivity Symptoms

  1. often has difficulty awaiting turn in games or group situations
  2. often blurts out answers to questions before they have been completed
  3. often interrupts or intrudes on others, e.g., butts into other children's games

3A: ADHD — Combined Type

To diagnose ADHD — Combined Type, both criteria 1A and 1B must be met for the past 6 months.

ADHD Self-Test — Modified to Include All With ADHD

According to Dr Levinson, the stringent DSM IV diagnostic criteria for suspected ADHD and its three subtypes should be reduced significantly. For example, only 2 vs. 6 of 9 symptoms per diagnostic category may be sufficient for a tentative diagnosis of ADHD. In fact, mild and compensated forms of ADHD were noted having only 1 of 9 symptoms. Needless to say, each and every distressing symptom merits a detailed qualitative or clinical analysis to detect its determining mechanism(s) and treatment, not just aggregates of six. This modified test encompasses all with ADHD, the mild and severe.

This modification is also important for other reasons. ADHD is a syndrome encompassing many possible symptoms. It may manifest in any given individual with 1, 2 or 9 or all 18 of the listed symptoms. And the symptoms may vary from mild to severe. Importantly, the symptoms improve with the same therapies, regardless of their number per patient, e.g., 1, 2…6…18.

The underlying impairment and improvement is not directly specified or measured by DSM IV. Only the symptomatic fallout is considered. And each and every symptom within the DSM IV questionnaire has been correlated to ADHD. Thus there is justification for focusing on individual symptoms even more than clusters of 6 or more, since every symptom has an ADHD determinant. Also there is no way to predict beforehand which of the specific symptoms will improve or how many. Are we then to state that no ADHD improvement occurred unless therapy favorably affected 6 or more symptoms? From a clinical perspective, it thus appears that diagnosing and treating ADHD only by aggregates may often be very misleading. Fortunately Dr Levinson found diagnostic ways of testing for the origins of ADHD as well as its specific symptoms without relying exclusively on the power of numbers, e.g., 6 of 9 symptoms.