How Is The Neuropsychological Evaluation To Detect ADHD?
Detecting and diagnosing attention deficit hyperactivity disorder (ADHD) can be hard work for any mental health professional. First of all, this is because it is a very heterogeneous neurodevelopmental disorder. Under this diagnostic category are included, according to the DSM-V, all those patients who present a set of symptoms of inattention, hyperactivity and/or impulsivity present from the first years of life, which generate a negative impact on their life and remain for a period of more than six months in duration.
Although manuals such as the DSM-V are very useful for addressing mental health disorders, the approach it offers to ADHD is focused exclusively on observing the patient’s symptoms to make a diagnosis. This would relegate other types of procedures to detect ADHD such as neuropsychological evaluation, which seeks, through standardized tests, to evaluate a patient’s attentional abilities or executive functions and, thus, arrive at a more precise diagnosis. Next, we will develop the particularities of ADHD from a neurobiological point of view and explain what the neuropsychological evaluation consists of to detect this disorder.
Attention deficit hyperactivity disorder is a neurodevelopmental disorder that can be observed from a pattern of inattention and a pattern of hyperactivity-impulsivity that interferes with the person’s functioning. The diagnosis can be made to both children and adults, although the literature related to ADHD is more exhaustive in relation to children. Some of the most characteristic symptoms of inattention are difficulties concentrating on recreational activities or schoolwork for prolonged periods, high distractibility the tendency to omit details in schoolwork or at work, lose objects, not listen when someone else speaks and lack of enthusiasm for tasks that require sustained attentional effort over time.
For its part, hyperactivity is reflected in symptoms such as difficulties staying seated and could be associated with impulsivity, which translates into a child or adult who interferes in other people’s conversations, who responds before the other has finished a conversation. ask, or that you can’t wait your turn at some activity. A person can have attention deficit disorder with or without hyperactivity-impulsivity.
The brain of a person with attention deficit disorder
Currently, it is recognized that the attention deficits characteristic of ADHD have a neurobiological root. The neuronal activity of our nervous system can be studied in terms of the brain areas and the networks and circuits to which each neuron belongs. The cognitive processes that are altered in psychopathology—such as attention, memory, perception—would then be based on the malfunctioning of their corresponding neuronal system in our brain. In the case of ADHD, this system is fundamentally that of attentional networks.
The attentional network system of the human brain is composed of three neural networks, the functioning of which is altered in ADHD. On the one hand, the alert network is made up of the cerebral cortex of the right hemisphere, subcortical structures and the reticular system, and is involved in the processes of maintaining vigilance. On the other hand, the posterior network, which involves the parietal cortex, the superior colliculus and the pulvinar nucleus, is linked to the ability to prioritize certain sensory stimuli over others and orient to a task. As we know, these two faculties are clearly altered in ADHD. Finally, the anterior or executive network, which is linked to the frontal region, is involved in stimulus detection and executive functions, such as inhibitory control or working memory.
What does neuropsychological evaluation consist of?
Recognizing all the clinical symptoms is essential to detect if a person has ADHD or not. However, there are many cases in which not all of these symptoms occur but only some of them. Also There are people who experience this symptomatology but are not able to be aware of it. In these situations, neuropsychological evaluation may be essential for detecting the disorder.
As we developed, the alteration in the functioning of the brain’s attentional network system could lead to the appearance of certain cognitive characteristics in children and adults with ADHD. The neuropsychological evaluation seeks, through standardized tests or tests, to account for the person’s performance in relation to a specific function such as attention.
People with ADHD tend to present with executive dysfunction. This includes failures in planning, difficulties in inhibiting inappropriate behavior according to the social context—which translates into, for example, impulsive behaviors such as interrupting another person when they are speaking—or an alteration in cognitive flexibility, which involves difficulty in modifying a plan or strategy in an adaptive way in relation to the environment. Also, people with ADHD tend to have less semantic verbal fluency and less internalization of language than people without this developmental disorder.
There are tests that are endorsed to test these abilities and are taken into account by the professional who carries out a neuropsychological evaluation to detect if someone has ADHD. However, this process not only serves to confirm whether someone has this disorder but also to rule out the possibility that there is another hypothesis that is capable of better explaining the patient’s symptoms and neurobiological alterations than the diagnosis of ADHD (that is, making a differential diagnosis). For example, a child could have a non-verbal learning disorder, a slow cognitive tempo, a developmental intelligence disorder, high abilities, etc.
The importance of neuropsychological evaluation: a look inside
In short, the advances made in terms of scientific knowledge about the functioning of our brain – thanks to neuroimaging studies and functional magnetic resonance research – have only highlighted the importance of neuropsychological evaluation for the detection of brain disorders. development such as ADHD. Paying attention to patient symptoms remains crucial for diagnosis, but neuropsychological evaluation retains the privileged place of being able to observe alterations in cognitive functions, beyond these symptoms, which could also be key indicators for rapid detection.
