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I've been told that my 11-year-old has the characteristics of what they might term "Pseudo ADD," which in my mind says that they agree that she has somewhat of an attention problem, but that her marks are not low enough to qualify for extra services. My daughter has low self-esteem and I feel that she is too intimidated to ask the teacher to slow down a bit so that she can loosen up a stumbling block if she doesn't understand the concept fully.

I have been told that ADD is a medical diagnosis. My other daughter is receiving special education services and her pediatrician has given her a diagnosis of ADHD. No medical tests were given at all. The doctor simply examined all the findings from the psychological testing given at school and teacher evaluations. She fit the mold so he signed her off. Please tell me what tests should be given if this is truly a medical diagnosis. I've done considerable research on the subject and have found that other factors might be at play, such as depression and poor nutrition, which give an impression of ADD, but might not necessarily be an ADD problem. I truly expected the doctor to order neurological testing or blood work, but he charged me to review the records.

Unfortunately, there is no definitive "test" for ADD/ADHD. But there are important steps that need to be taken to make a diagnosis. A psychologist can make a diagnosis, but only a medical doctor can prescribe medication for the condition.

To begin with, it's critical that a thorough history be taken. That's where a review of records comes in. Sometimes a neurological exam may be needed. Observational checklists, such as the Connors Scales, need to be completed by both parents and teachers. Psychological and language testing should be done, because emotional and/or language problems can appear to be ADHD. Educational testing needs to be completed to see how academic skills have been affected, but a child can be performing within the average range and still be classified as ADHD. Ideally, the child should be observed in school if that is where the problems are occurring. The picture taken in a medical office can be quite different from what's observed in a child's daily surroundings.

The greatest part of an evaluation for ADHD is usually clinical judgment. That's why it's so necessary to have someone who has a great deal of experience in diagnosing ADHD and knows about the other problems that may muddy the picture. I prefer a team approach to evaluation that will yield a full picture of your child's needs. Call the toll-free number for CHADD (Children and Adults with Attention Disorders) at 1-800-233-4050 and see if they can refer you to someone in your area who is experienced and trustworthy.

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