The VMI Infirmary requires formal psychological testing as part of the diagnostic workup for suspected Attention Deficit Hyperactivity Disorder (ADHD), including primarily inattentive type. The diagnosis should not be based solely on testing, but must be supported by testing. The diagnosis should be made based on testing, history/rating scales, and clinical interview/mental status exam to include social and emotional evaluation.
Students are sometimes prescribed stimulant medications by doctors outside VMI without meeting all the criteria above. Students can continue to receive prescribed medication from their doctors, but the VMI Infirmary is not able to write prescriptions unless all criteria are met. This is no reflection on the quality of outside doctors, but simply a cautious approach to medication which can be easily misused and abused.
To assess for the appropriateness of medication, the functional areas outlined below must be assessed. Preferred instruments are listed under each functional area. The testing clinician should choose the appropriate test for each functional area, depending on clinical presentation.
Functional Areas and Preferred Instruments
1. Formal Testing of Attention
- Test of Variables of Attention
2. Connors CPT
- Formal testing of Information Processing
- Test of Information Processing
- Wechsler Memory Scale - IV
- Information from subtests on WAIS-IV
- Woodcock –Johnson III: Tests of Cognitive Ability
3. Formal Testing of Aptitude/Cognitive Ability
- Wechsler Adult Intelligence Scale-IV
- Woodcock-Johnson: Tests of Cognitive Ability
- Kaufman Adolescent and Adult Intelligence Test
4. Assessment of Social / Emotional Functioning
- BASC – self, teacher, parent reports
5. Assessment of Academic Achievement
- Woodcock-Johnson III: Tests of Achievement
- Wechsler Individual Achievement Test - III
Most clinics/practitioners that test for causes of impaired attention will have a battery of additional potential tests, and will tailor their testing to the clinical findings in a particular patient.
The clinician should choose the instrument(s) that seem most appropriate to test each functional area in the client, as well as testing for other areas of suspected concern.
Stimulant medication (Adderall, Ritalin) may not be indicated or necessary in every case of a diagnosis of ADHD.