Assessment of ADHD and behavioral difficulties in an adolescent boy

¶ … ADHD Case

In the case of the 13-year-old boy, clearly there is something going on that is creating a situation where he is becoming a disturbance both at home and at school. His parents fear he may have ADHD, a fear which is backed up by a number of his teachers. In order to understand what is really going on, a clinical assessment must be fully conducted in a multifaceted way that would allow the clinical researcher to understand what's going on in the boy's head.

The multifaceted approach to assessment would include a psychometric test given to the boy's parents and teachers. This would be a way to help understand how third parties see the boy's behavior on an everyday basis. There are number of paths a clinician might take in order to find the most appropriate psychometric test. Most rating scales used today can be helpful in determining the presence of ADHD in this case. These include tests that use measurements through a Likert scale, where questions are answered on a scale from 0 to 4, 0 meaning never and 4 meaning often (Haavik et al. 2010). There are a number of tests that can be implemented which can focus on using parents and teachers as a way to help highlight behavior that the boy may not be willing to admit in the context of an interview.

Appropriate for the use of distributing to parents and teachers is the Wender Utah Rating Scale. According to the research, Wender Utah Rating Scale (WURS) is "designed to retrospectively record symptoms and signs of ADHD in childhood" (Haavik et al. 2010, p 1571). The scale is typically used by adults recalling their childhood, yet it can be adapted in order to give to the boy's parents and teachers as a way for them to help diagnose a possible case of ADHD from a retrospective position. The parents and teachers can look back on what they have seen and witnessed of the boy's behavior in order to pull out potential red flags that would lead to a score that would signify the presence of an ADHD diagnosis. This will allow his parents and teachers to answer questions about his behavior without the boy manipulating the answers in a way which would provide a result that differs from the actual true situation. Essentially, this test is a series of questions that are rated on a scale from 0 to 4. These questions revolve around a number of different primary criteria, including demographic data, developmental, academic, social, and behavioral histories. A sum score of 46 or higher on the psychometric test illustrates the presence of ADHD. Thus, "if a cutoff score of 46 was used 86 of patients with ADHD 99 of normal persons and 81% of depressed subjects were correctly classified" (Ward, Wender, & Reimherr, 1993, p 890). Such a psychometric test has been validated by clinical psychologists in countries around the world, and thus has a great deal of validity.

Additionally, in this case, the clinical psychologist can use the Weiss Functional Impairment Rating Scale (WFIRS) in the case that the WURS does not provide enough or sufficient glimpse into the boy's behavior (Haavik et al. 2010 p 1572). This could be used either as a secondary measure or in correlation with the WURS assessment test. Similar to the WURS assessment test, the WFIRS deals with a number of variables, including behavioral, social, academic, and familial history. This test is for the boy himself to take, as is the self-assessment. As such, it has been designed with a certain degree of flexibility in order to detect any possible understatements that the individual might have about themselves or their condition. With this multifaceted approach to the assessment test, combining the parents and teachers scores can help provide a more effective evaluation of the boy's behavior and current condition. This would help provide a more well-rounded approach to the diagnosis of ADHD, as it counts on the use of third-party assessments, but also assessment from the boy himself.