If you or your child has, or suspect you have, Attention Deficit/Hyperactivity Disorder (ADD or ADHD), you will most likely consult with a specialist or professional at some time, whether for diagnosis, evaluation, treatment, or remediation.
- You may decide to have a formal evaluation for ADD/ADHD that may also include testing for learning disabilities and/or neurological issues.
- You might seek an independent educational evaluation as to whether or not your child’s school is addressing his or her needs in the most constructive manner.
- You may decide your child would benefit from an after-school tutor, or your college-aged child might need help with organization and time management.
- You might be considering medication and decide to see a psychiatrist or other medical professional.
- You might deside counseling is needed, whether it is with a psychotherapist, psychologist, therapist, social worker or marriage counselor.
- You may be interested in the practical skills and accountability that would come from working with a coach.
The Importance of a “Good Fit”
You want to look for a “good fit” between you/your child and the professional—this can make a significant difference in the outcome of the treatment. However, selecting the most appropriate professional is a time-consuming and difficult task.
Based on the experiences of many of our clients, both as adults and as parents, and the suggestions of many professionals, we’ve put together certain questions you can ask, and strategies you can follow, to make this task easier and more successful. These suggestions should help, but here is the most important advice we can give you:
You are the ultimate expert on your child, and yourself. You know your child far better than anyone else does. Your opinions should be taken seriously by any professional you select to work with your child.
Don’t let yourself get caught up by an “expert” who is condescending or intimidating. Listen to your ”gut reaction. ” You are your child’s advocate. You are also your own. If you feel there is no chemistry between you and the professional, reconsider any long-term relationship. (Also be aware that the professional is not there to be your friend, to “yes” you, or to coddle you. You want honesty and directness, and sometimes you’d rather not hear what needs to be said.)
Be an informed consumer. Interview several experts to get a taste of different approaches to treatment; consider which approach might be best for your child; which approach best suits your personality. At the same time, avoid the trap of continually searching for the “ideal” professional.
While you must be responsible for making all major decisions affecting your child, do encourage the child to participate in the decision-making process, wherever appropriate. We all tend to be more invested in the outcome of events when we participate in the planning, and your child is no exception.
Keep in mind that adults with ADD/ADHD are not the best self-reporters. It is often helpful to have a spouse or someone who knows you well at the intake. After all, you want the professional to get as clear a picture of the situation as possible. Leave your ego (the part that wants to show the world only your best aspects, or minimize your child’s problems) at home.
Keep in mind that all children (particularly adolescents, although even 6 year olds) will occasionally resist regular meetings with a long-term treatment specialist (such as a tutor or therapist). However, any ongoing complaints or active non-compliance needs to be examined carefully and discussed openly with your child, listening to his or her comments and feelings. Encourage your child to “buy in” to the process. When there are problems, it may be advisable to meet with the professional to discuss this issue.
Sometimes, an individual’s needs will change over time and one therapist, whose work has been helpful in the past, will become ineffective. Plan to reassess any long-term arrangement at regular intervals, and stay flexible and responsive to your child’s/your own changing requirements.
It is difficult, as a parent, not to be drawn to the professional who provides the most positive prognosis. Try to meet with enough professionals to form a realistic picture, even if it’s not the one you would like to hear. Don’t shop around for the most optimistic diagnosis—look for the best relationship and a realistic approach to diagnosis and treatment.
Locate Suitable Professionals
Some of the professionals you may be looking for, over a period of time, may include diagnostic (pediatric neurologist, child psychiatrist, psychologist, educational evaluator, etc.) and treatment (psychologist, social worker, speech/language therapist, occupational therapist, tutor, psycho- pharmacologist, pediatrician, etc.).
Contact different sources for recommendations as to suitable professionals:
- In NYC: CHADD of New York City (212) 721-0007
- Resources for Children with Special Needs (212) 677-4650
- Advocates for Children (212) 947.9779
- The ADD Resource Center: (646) 205-8080
- Outside of NYC: Contact CHADD National for a local chapter near you: chadd.org
- Your MD
- Your child’s school
- Friends and acquaintances with similar issues
- It is recommended that you interview at least three professionals.
Initial Phone Contact
- Make this contact short and sweet.
- Indicate you are seeking a consultation.
- Give name, address, sex and age of your child.
- Offer the name of referring source (how you located this professional).
- State problem as you see it; as others (schools, etc. see it). If you suspect your child may have ADD/ADHD, say so.
- If your child has been previously diagnosed, state who did the diagnosis and when. If your child has not been previously diagnosed by a qualified professional, state this fact.
- If your child is already on ADD/ADHD medication, give the name and amount, results as you see it.
- Ask about this professional’s training and background in his/her area of expertise. If appropriate, inquire as to affiliations with hospitals, clinics, etc.
- Confirm that it is the person you are speaking with, rather than an associate, who would be seeing the child.
- Ask your questions, and set up the initial meeting, only with the person who will be seeing the child.
- Ask specifically about his/her experience working with children with ADD/ADHD and their families.
Note: This can be discussed during the actual interview, but you might be able to save time and eliminate inappropriate candidates by well-chosen telephone questions.
- Clarify the role you would like this professional to play in providing assistance to your family.
- Have questions prepared that will help you determine whether you feel this professional would be a good match for your child.
- Inquire about fees, fee scale, insurance payments, etc.
- If interested in pursuing an initial interview/consultation, check whether there is a fee.
- Find out how the professional prefers the initial session; with only the parents, with the child, or as a family group, etc. Note: Question carefully any treatment professional who doesn’t want to see the child prior to agreeing to treatment. This is less important with an educational evaluator, neuropsychological tester or psychopharmacologist, where expertise is the only critical criteria for selection.
Make the Initial Appointment
- Inquire exactly what will be reviewed at the initial session.
- Ask if you should send copies of any documents you have prior to the interview.
- lf the professional you’re speaking with will be seen regularly over a period of time (psychologist, speech and language or occupational therapist, reading specialist, etc.) and time is extremely limited so you can only schedule regular sessions for specific hours, you should check now to see if the person you would be seeing is there at an acceptable time.
- You should meet with the professional first, without the child. Only after you’ve determined there is a potentially good relationship, but before you’ve made any commitments, should you have the professional meet with the child. (This applies more for therapeutic services.)
- If you’re making the second appointment (for the therapist or evaluator to meet the child), leave time to speak with the professional after he/she meets your child. Do not go in first, as this sets the relationship up in the eyes of the child as primarily between the parent and therapist. If you have a young child, find out if there is some provision for watching the child for part of the session so you can speak privately. Can you bring someone along for that purpose?
- Both parents, if possible, should attend.
- Briefly review with the professional all that was said on the phone.
- Bring copies of all records pertaining to your child. (Although the professional may not wish to read these documents during the session.)
- Discuss in what ways, and with which approach/technique the professional could help your child.
- Specifically determine whether your child’s issues are within that person’s realm of expertise.
- Be prepared to give a child and family background (the nature and extent of this depending upon the type of professional service being sought). Note: The intake interview, where this information is usually discussed in detail, should be scheduled only after you’ve decided this is the professional you want to use.
- Discuss the professional’s experience with ADD/ADHD.
- Ask the professional to offer his/her view on the cause(s) of ADD/ADHD—this gives you some idea of how involved the person is with the topic; whether they know of current neurological studies, etc.
- Ask the percentage of current patients with ADD/ ADHD.
- Ask if the professional is familiar with CHADD or is a member.
- Inquire how quickly he/she will return phone calls.
- Check on references. Ask if you can speak with the parent of a client.
- If more than one professional is involved in your child’s treatment, ask this professional if he/she is:
- Willing to work closely with other professionals who are also working with the child and family, including school staff.
- Will he/she write reports if needed (fee?), attend meetings, have phone discussions, etc.?
- Discuss the specific contact, if any, the professional will have with your child’s teacher
- If the professional is an MD, find out how he/she will work with your child’s psychologist, if any; and if the person you’re interviewing is a psychologist or social worker, ask how they work with the medical doctor.
- One person should be clearly designated the coordinator. This is usually one or both parents, but it can be anyone on the child’s team.
- Review prospective starting date and available hours.
- Check on charges for cancellations.
Summarize the Interview, in case of any misunderstandings, then:
- Ask the professional if, given what he/she has been told about the child and what they’ve seen, do they think this is a good match for his/her services, or could they recommend another professional who might be even more appropriate for this child?
- If the person indicates a desire to work with you and your child, ask them to be specific as to why they think they can help in your particular situation.
- Ask if there are any special issues he/she would like to discuss that might influence your choice of professional.
- Request a day or as long as you need to think about it, make your decision and get back to them.
After the Interview
- Write a brief note to the various professionals you interviewed, thanking them for their time and insights, and for those not selected, a short comment to the effect that you’ve decided to work with someone you feel is more suitable for your child (and/or your pocketbook).
- For the professional you do select, it is a good idea to get a written confirmation of the particulars of treatment(frequency and length of sessions with child, with family, types of tests, costs, etc.)
Following are questions specific to a particular need, be it diagnosis, evaluation, treatment or remediation:
Questions if you are seeking a Diagnosis (Medical, Psychological, Educational, etc.):
- Ask for an outline of the methodology to be used to insure an accurate diagnosis. What criteria will be used? Will other professionals be included?
- What tests will be utilized? Will a school or home visit be necessary? How much time will it take? What additional costs can be anticipated?
- What treatment plan is likely to be recommended if the diagnosis is positive?
- Will the person making the diagnosis be the same person who will do ongoing treatment? Note: This is not necessarily the case. Some professionals specialize in diagnostics; others in treatment.
- Find our whether the evaluation will include a written report, specific recommendations (for the school, tutor, parents, etc.).
- Ask whether the tester is willing to meet with the school and explain test results, and whether he/she will be available in the future for any questions you still may have.
- Questions if the Professional is going to provide Therapy for your child (primarily Psychological); also applies to working with a Coach:
- What is the type of therapy used (“treatment modality”) Le.: individual, group, family, tri-modal?
- Review what the therapy “should” accomplish, from your perspective and from that of the professional.
- Ask how often the sessions will take place.
- Discuss if the professional sees this as totally open-ended or if he/she can assign a time frame to length of treatment.
- Ask how he/she (and you) will know the treatment is working. What criteria will be used to measure success? How much time is needed before this judgment can be made?
- Find out how you would be kept appraised of your child’s progress (Le., occasional phone calls, once a month meetings, etc.)
- Find out how the professional views the confidentiality of his/her meetings with your child—will they alert you to critical issues or consider it patient confidentiality?
- Inquire how frequently the treatment professional would like the child followed up by a psychopharmacologist.
Questions regarding Medication (primarily for the Psychopharmacologist):
- Discuss the pros and cons of medication and how monitoring is accomplished if medication is indicated.
- Ask what medications he/she is familiar with and has successfully used with ADD/ ADHD children; how long he/she has been prescribing each; personal preferences and reasons for them.
- Ask how each medication works and what are its side effects and contraindications.
- Ask how the medication is administered and adjusted.
- Ask the psychopharmacologist how he/she (and you) will know the medication is working? How will he/she/you know if is isn’t working? How long will it take to make this judgment?
- Ask how often the doctor needs to see the child and what will occur at these visits.
Questions about Testing (primarily for the Psychological/Educational Evaluator):
- Ask what tests will be administered to your child, at what location and by whom -Request specific names and forms.
- Ask why these tests are included in the test battery. What does each test show? How will each relate to your child’s specific diagnosis?
- Ask how many test sessions will be needed.
- Check that the evaluation includes a written report and specific recommendations (for the school, tutor, parents, etc.) Ask how long it will take for the test report to be ready. Specify if you have a time deadline.
- Ask how test results will be explained to you; how will further questions be answered?
- Ask whether the consultant is willing to meet with the school and explain test results, and whether he/she will be available in the future for any questions you still may have.
- State who should receive copies of the test report.
- Check on additional fees for reports, etc., if any.
Questions to ask the Educational Consultant/Advocate:
- Ask about the advocate’s experience with public, private and special education schools.
- Ask about his/her philosophy of appropriate educational placement for ADD/ADHD children.
- Ask about his/her knowledge of due-process rights for ADD/ADHD children in your school district.
- What is the person’s usual course of action with ADD/ADHD children? How much time is usually needed (and what outlay of money) to achieve the results you desire? Is there a retainer fee or an hourly rate?
- What is the typical cost of the service? Clarify your financial obligations for known items (i.e., school visit) and future possibilities (school board hearing).
- Ask how much parental participation is required? What will you be expected to do? What will the consultant/advocate do for you?
- Be clear as to what meetings he/she will attend, and with whom? Are there any meetings the advocate would want to instigate?
Questions for the Tutor/Educational Therapist:
- Ask about the tutor’s professional background (teaching experience, training, professional affiliations).
- Ask specifically about the tutor’s experience with working with children with ADD/ ADHD and the age range of those children.
- Ask about his/her philosophy of teaching children with ADD/ADHD. Does he/she have any negative feelings about medication as part of the treatment plan?
- Ask if the tutor is familiar with your child’s school and/or has ever worked with children from the school.
- Describe any academic difficulty your child is having. How might she/he approach this problem?
- Does the tutor work primarily on skills development, compensatory learning strategies or homework help?
- Is the tutor willing to maintain regular contact with the school if parent and school request it. Is there an additional fee for school visits?
- Ask how much parental involvement in the tutoring process is expected. Will the child be expected to complete homework from tutoring as well as assignments from school?
- Ask if the tutor will administer his/her own battery of tests before beginning instruction or will those administered by the educational evaluator be sufficient to begin.
- Ask how progress will be monitored.
- Ask about additional fees for written reports, missed sessions, etc.
- If you have additional tips or suggestions, please send them to us at the address below.
With special thanks to the following:
|Arlene Landes, CSW||Susan Luger, MSEd, CSW|
|Harold Meyer, MBA, BCC, SCAC||Susan Lasky, M.S., BCC, SCAC|
|Eileen Marzola, EdD||Virginia Sterling, Academic Language Therapist|
ADD and ADHD are used interchangeably for Attention-Deficit/Hyperactivity Disorder.
Any information or suggestions in this article are solely the opinion of the author(s) and should not replace the advice of appropriate medical, legal, therapeutic, financial or other professionals. We do not test or endorse any product, link, author, individual or service listed within.