Diagnostic Testing for ADHD With Laurie Harwood Peter
I had the honor of speaking to Laurie Harwood Peterson from Diagnostic Learning on our podcast about diagnostic testing for ADHD. Laurie is the owner and director of Diagnostic Learning Services.
Laurie and her husband have five offices across the state of Texas and conduct ADHD diagnostic testing for children. She spends every day helping kids get identified and then teaching parents how to help them.
Lori has a bachelor's degree in special education. She spent eight years teaching students with learning disabilities in grades K through 12. She has a master's degree in special education with an emphasis on assessment, and a second master's degree in professional counselling.
In this blog, I share the highlights of Episode 61 as we talk about diagnostic testing, her business, and how this all works. But before we do that, I'd love to talk about ADHD.
Now, I know you have ADHD and that it's widespread in your family. Let's hear about your experience with the diagnostic testing process that you all went through.
So, I was diagnosed sometime in my 20s. It was before I had kids - and it's vague, I don't remember it very well.
I don't even remember what prompted me to finally go see somebody, but I went and saw a psychiatrist. She had me answer, you know, like a paper-pencil questionnaire kind of thing. By the time I left her office, I had a prescription for medication but this was before I knew as much as I know today about ADHD.
And so, I thought, well, it makes sense. But the more I've worked on it, and the more I've dealt with it, and the more I've lived with it, the more I look back over my past and I realized, oh gosh, this explains so much.
And I feel like everything that I went through as a high school student, everything I experienced in college, everything I've experienced afterward, it just makes sense now.
With the benefit of hindsight, what are some of the symptoms you now recognize as ADHD?
Well, impulsivity is one. I was a chatty Cathy, I would do stupid things. And then you know that feeling of like, ‘Why did I just do that?’.
And not just thinking like, how dumb Am I like, I know I shouldn't do that. But I did it anyway, going back through really, I think the clearest piece for me.
I did terribly in school, I hated school. It was stupid. It was boring. I didn't know when I'd ever use it again. I had terrible grades. I was lazy. I didn't apply myself, you know, all the typical stuff. But then I got to college.
And found a sorority that I wanted to stay in. And so I made my GPA stay. I got to finally the classes about the stuff that I was interested in. And I had like a 4.0 in those classes.
And then I got to work. My resume is embarrassing prior to starting my business. Because I'm not a rule follower. I think your rules don't make any sense.
But I would go from job to job because I would get bored. I didn't like it. And that's when I finally realized, you know, I'm so much better off working for myself.
I just, love what I do, which for anybody with ADHD makes all the difference in the world. But I get to make my own rules. And you know what, sometimes they're not great.
Okay, so tell me then how you went from hating school to end up with two masters and how did that kind of metamorphosis into diagnostic testing for ADHD?
So, I taught special education, and I loved it.
You know, when I was in high school - and this is probably the most not ADHD thing about me - I knew in high school I wanted to work with kids, and child psychology was kind of where I was at in high school, which I've kind of ended up there.
I love to work with kids that learn differently, it just fascinated me. I am the most impatient person unless I have a child in front of me who's struggling. And my patients just increased by a million. I loved it.
But I also wanted to know more like why are you struggling? Why is this hard for you, and not hard for this other kid? What is going on in your brain that's making you struggle? And so that is where I went back to the state of Texas. We have what's called educational diagnosticians.
You go back and it's through the school, through your state education agency, you get certified to be a diagnostician.
So, I went back, got my master's, took my education course, took my assessment courses, and then went back to the school district. And now I'm testing these kids to see if they qualify to get help through special education. And again, I loved it, I loved getting in there and cracking up in their head.
Oh my gosh, I love it. And every person that comes in here and works for me that comes from the schools are like: ‘this is amazing’. Because we get to help kids, we get to help families.
How is ADHD Diagnostic Testing different from neuropsychological testing or IQ testing?
So, a psychologist or a psychiatrist calls it neuro-psych testing. I call it psycho-educational testing. It's a full IQ, cognitive test. It's a full achievement test. It's emotional, behavioral surveys, and whatnot.
Now, I think that, in my experience, I think that psychologists and psychiatrists are more clinical, so they focus more on the clinical stuff, and they focus a lot more on the scores.
I'll give you an example, I had a student come in and he is so smart. And he went through psychologists for testing. And the psychologist did the testing and said, Nope, no, ADHD. And one of the reasons he said was because his working memory was above average.
So, I had him come in, I talked to him, this poor kid is just, he's like: ‘I cannot focus and nobody will listen to me. And I'll think I'm just bored.’ And I'm like, well, you are bored. But not because you're so smart, because you just can't focus. And what I ended up trying to explain to the parents was like these working memory tests, for a really smart kid.
They've got compensatory skills, they've got strategies, and they can spit numbers backward all day long. Tell him to get do three things at home, go to his room, get his jacket, don't forget your shoes turn off the light, not happening.
Because they're not sitting there thinking, Oh, I'm being tested over this, I must come up with a strategy on how to remember these three things. So in a testing situation, those kids blow processing speed out of the water because their brains going on nothing and their working memory is off the charts. But tell them a story and ask them to tell it back to you can't remember anything they just heard.
Who commonly asks for ADHD diagnostic testing? Is it the teacher, pediatrician, or parent?
So I will tell you that it depends on the pediatrician, most parents come to us first, some will go to their pediatrician and he says, Okay, do the Vanderbilt, you know, send it to the teacher, you fill it out, boom, you've got ADHD?
I also think doctors have gotten a lot better informed. And they that they need a comprehensive evaluation to rule out any other reason why this kid might not be focusing so that they can make sure they're calling it what it is. And I think that's how the overdiagnosis thing happened.
What are the signs that parents should look for to consider ADHD Diagnosis testing?
It depends on the age and where they're at. But you know, if they're getting in trouble for behaviors, if they're forgetting to turn in work, if they're not understanding concepts, to me, the big thing is when it starts to interfere academically or emotionally, right?
And then if academically, they're going to school all day, and then they come home to do homework, and they don't understand the homework, then you want to know, are they not paying attention?
Because attention, or the lack thereof, will cause academic gaps? And so if someone's struggling in math in middle school, well, a lot of times, that's because they haven't been there for all the instruction for the last however many years because they check out they lose interest.
How does testing for giftedness and ADHD differ from standard ADHD testing?
We will do a full IQ test. I do a reading evaluation, just reading comprehension and math problem solving because I like for them to see where they fall academically, not just cognitively with those skills.
But do you want to maybe just pursue this, we could do a little bit more. And we can kind of either rule that out or rule it in. But we're seeing a lot of, you know, off-task kind of behaviors.
Now, in a traditional setting, you know, if the pediatrician is doing the ADHD evaluation, then you don't ever find out if a child's gifted, you just know where they can and can't focus. So, you know, I think it depends on who's doing it. But for us, that all fall under the same kind of test.
Can you talk about the disproportionate number of brown and black girls that are misdiagnosed, and the lack of research, we all know, there's little research for ADHD and women. It makes the testing process so difficult and long.
I agree with you on that. As far as the disparity among, you know, different types of different races, I think there are lots of reasons for that.
When we have families from that are that are Asian families or Indian families those families with ADHD can sometimes culturally be looked upon as very negative, like the parents have failed in some way.
So, when those families come in, they do not like to pursue an ADHD diagnosis. They don't necessarily want to hear there's something wrong and that the labels bother them.
I also think that this testing is not cheap. Yeah, covered by insurance, you know, so that's going to have an impact.
I don't think that tests are biased. Some people will say that some of the tests like the Wechsler are more verbally loaded, or I mean, there's all kinds of things, but at the end of the day, again, you're never just using one test, you've got to look at the whole picture. Okay, so I think it does rely more on who does the testing. And then the test that you use?
Do you ever have kids that are diagnosed, and the parents won't tell the kids?
The younger ones? Yep. They feel that their child doesn’t understand ADHD. Right?
So again, we go through the whole piece about you have to educate yourself and
understand this could be a really good thing. You know, this is this doesn't have to be a bad thing.
I had a parent come in a couple of years ago, a husband and wife, and they were not prepared for the ADHD diagnosis. But the minute we sat down, the dad was shaking his leg the entire time. The entire time.
I looked at him I'm like: ‘okay. Since you sat down, you have not stopped moving. That tells me how this is a surprise to you.’
You know, and then we all kind of laughed and the parents are like: ‘Well, you're right!’
You can catch up on the whole interview with Laurie in Episode 61 about ADHD Diagnostic Testing of ADHD for smart-ass Women.