neuroblog

ADHD as a figure of speech

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When someoneis referredto me with the diagnosis of ADHD, this prior diagnosis carries little to no information as far as I am concerned.Likewise, when someone asks to be evaluated “for ADHD,” the narrow diagnostic workup implicit in such a request is the last thing I am going to do.Why so? Because in many lay circles and even in some professional circles ADHD has become a catch-all designation for any cognitive difficulty, whether it truly involves attention, or memory, or decision making, or anything else. If ADHD were the only condition possibly afflicting cognition, the life of a clinician like myself would be very simple indeed; but it is not. The human brain is subject to a great variety of possible neurological assaults producing a wide range of possible cognitive impairment profiles, ADHD being only one of them. A neuropsychologist is then in a position akin to that of a dentist. A patient comes points at a particular spot on the jaw and says “It hurts here.” The dentist then has the option of X-raying that spot alone or a broader region. A good dentist is likely to do the latter, minding the “referrdpain” phenomenon: the source of the problem may not be where it feels it hurts.So, too, it behooves a neuropsychologist to survey a broad range of functions, because what the patient calls “attention” may turn out to be anything but…

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