Q:
Why is it so difficult to diagnose ADHD in post-institutionalized
children?
A:International adoptees are more difficult
to diagnose because of:
Insufficient knowledge of their pre- and post-natal
circumstances and developmental milestones;
Behaviors that resemble current criteria for
ADHD, which can be the result of many other conditions (e.g.:
anxiety, stress, etc.) Early diagnosis may work to the disadvantage
of a child when a more refined understanding is reached. At
the same time, there are clearly children, for whom an early
diagnosis will make a huge difference. A competent evaluator
should examine such issues as sensory, behavioral, emotional
difficulties, learning style, temperament, history of illness
and stress, background (birth parent history, orphanage history),
developmental history, impressions from multiple environments
(home, school, sports, social world, care providers). The child
may respond variably in different environments. Observing your
child across different environments and getting as knowledgeable
as you can about the different possibilities is going to take
time and will need to be an ongoing feature of your parenting.
Also, it is a mistake to think in terms of "what is the
singular cause of this behavior" and not "what are
the multiple causes."
