The Incremental Validity of Neuropsychological Assessment in the Identification of and Treatment of ADHD

Sponsored by the American Academy of Clinical Neuropsychology (AACN).

The principles of evidence-based practice have increasingly been recognized by patients, clinicians and third-party payors as critical to the effective and efficient practice of health care; thus, it is now imperative that services be justified by a solid foundation of scientific research which speaks to their effectiveness. While research on the etiology, sequelae, comorbidities, and treatment of Attention-deficit/Hyperactivity Disorder (ADHD) abound, almost no data have been published regarding the specific impact of neuropsychological assessment on treatment, symptom reduction and quality of life in children/families living with ADHD.

For children presenting with symptoms of ADHD, the individual neuropsychological examination provides a thorough assessment of the full range of neurobehavioral domains that underlie the child's unique pattern of strengths and weaknesses. At the same time, the neuropsychological examination considers the full range of potentially co-existing conditions (including those requiring formal psychometric measurement) and their neurobiological substrate, leading to a more comprehensive understanding of the brain basis of the disorder, and its association with the dynamic and changing environmental demands. As a result, assessments that include a neuropsychological examination can potentially provide broader and more targeted recommendations for families than assessments without such an exam.

The proposed study is an initial step toward more large-scale assessment of the impact of neuropsychological assessment in diagnosis and treatment of childhood ADHD. The specific aims are as follows:

Aim 1: To directly examine change in child symptoms and family perception of quality of life following comprehensive neuropsychological assessment. The working hypothesis is that children who have received individual neuropsychological assessment will have fewer symptoms and better overall quality of life ratings six months after their assessment, compared to symptom severity and quality of life ratings at the time of assessment.

Aim 2: To compare functional outcomes (symptom patterns, quality of life) among children with ADHD who have received a comprehensive neuropsychological assessment, versus those with ADHD who have not received such an assessment. The working hypothesis is that, compared to children with ADHD who have not had an individual neuropsychological assessment, those children with ADHD who have had neuropsychological assessment will be rated as experiencing fewer symptoms and will have better family ratings of quality of life at six months post-assessment.