Our Diagnostic Test For ADHD

ADHD is a behavioral disorder that affects the concentration and impulse control. Finding a proper diagnosis for ADHD is essential for many reasons, including the distribution of medication. ADHD has been falsely diagnosed and many patients, usually children, are unnecessarily medicated. To prevent this, we decided to look into the current diagnosis and we found that it was based on observation of behavior which is a highly inaccurate approach to a diagnosis. Instead of a set of accurate and biological tests, usually children are taken to a specialists by a teacher's recommendation and then medicated if the specialists deem necessary. This aspect of the diagnostic process was what we wanted to address and fix.

ADHD is a very complex disorder, which explains why many researchers shy away from devoting their time, money, and expertise towards this research. According to aboutkidshealth.ca, ADHD patients have smaller frontal lobes, more temporal grey matter, their caudate nucleus is affected, and their cerebellum is affected, which are all directly correlated with their concentration, impulse control, inhibition, and motor activity.

Our Diagnostic Test:

Grey Matter:

In order to test the amount of grey matter in their brain, our test will consist of language based reasoning and memory measures.

More specifically, we will test auditory memory by reading to our subjects sets of words and numbers to remember within 1 minute.

Then we will test visual memory by visually giving our subjects different words and numbers to remember, also within 1 minute.

In addition to memory, we will test their ability to analyze literature and language through the already created standardized tests for each grade level. Their ability to not only focus and concentrate throughout the test but also their ability to do well on the test will be a factor into the diagnostic test.

Caudate Nucleus:

The Caudate Nucleus is practically a feedback processor, meaning that it uses past experiences and knowledge to make decisions. In order to test how well this part of the brain is functioning, the patient will play the game memory.

Rules of the game:

• Shuffle a deck of cards.
• Place them face down arranged in a table of rows and columns.
• The players try to match pairs until all the cards have been matched.

Prefrontal Cortex, Cerebellum, and the Oculomotor Nerve:

In order to know if the Prefrontal Cortex, the Cerebellum and the Oculomotor Nerve has been affected, we will use our modified test based off of the visual field test that has been proven to work by a published study with the title of “Oculomotor Anomalies in Attention-Deficit/Hyperactivity Disorder: Evidence for Deficits in Response Preparation and Inhibition” by researchers Dr. E. Mark Mahone, Ph.D., Dr. Stewart H. Mostofsky, M.D., Dr. Adrian G. Lasker, M.S., Dr. David Zee, M.D., and Dr. Martha B. Denckla, M.D.

This study directly tests the Oculomotor nerve, which is responsible for eye movement, but the motor skills and the reflexes aspect of the test has a correlation with the Cerebellum, and the processing of information, meaning telling the eye to move to the light, is the Prefrontal Cortex’s responsibility.

Procedure for test 1 (tests motor skills):

Patient’s head movement is restricted with a chin rest and a bite bar. The patient will look into an instrument that takes away all distractions visually and leaves the patient staring into only a screen that is completely blank. Then an LED (light-emitting diodes) will light up 10° from the center. Exactly when the light was illuminated, the patient will have to move their eye to the light which is 10°. Once the light turns off, the patient moves their eye back to the center. This same procedure is repeated 20°, 30°, and 40° from the center, along with -10°, -20°, and -30°, and -40° from the center. The faster speed at which the patient is able to recognize the light and move their eye towards the light provides an indicator that they have an intact and pretty well functioning Prefrontal Cortex, Cerebellum, and Oculomotor Nerve.

Procedure for test 2 (tests memory and processing ability):

Similar to procedure 1, patient’s head movement is restricted with a chin rest and a bite bar. The patient will look into an instrument that takes away all distractions visually and leaves the patient staring into only a screen that is completely blank. Then an LED (light-emitting diodes) will light up 10° from the center. The light is illuminated for 0.5 seconds but then turns off. Once the light turns off, the patient moves their eye to where the light used to be shining and then moves their eye back to the center. This same procedure is repeated 20°, 30°, and 40° from the center, along with -10°, -20°, and -30°, and -40° from the center. The more accurate the person is with moving their eye to the designated location, the more it indicates that they have an intact and pretty well functioning Prefrontal Cortex, Cerebellum, and Oculomotor Nerve.

We came into this project asking the question, “Can a test be created to more accurately diagnose ADHD?” Based on our extensive research, we have concluded that yes, a test can be created to more accurately diagnose ADHD. Throughout this project, we have compiled many different and unrelated tests to come up with a diagnostic test of ADHD.

Researchers have been shying away from ADHD research, and more specifically research towards a more accurate ADHD diagnosis. However what we found was that there are so many tests out there — standardized tests, memory games, visual field tests from your regular eye appointments, etc. All we have to do is tweak those tests a little and broaden the purpose of those tests. Instead of limiting visual field tests to those at risk for glaucoma damage, administer these tests to everyone, and it can be used to diagnose ADHD and possibly other disorders and diseases.

Looking back at this project, we are both immensely proud and we have become even more passionate about this disorder. We started this project off as just a 20 time project, but what it has turned into has been beyond what we even thought it could be. We have learned such a great amount about the nervous system and ADHD. We have created a test that, when coupled with the current surveys, can be an extremely effective and more accurate diagnostic test.

We not only answered “yes, a test can be created,” regarding our initial question, but we answered, “yes, a test, which is a compilation of auditory and visual memory, a standardized test for analyzing literature, the game memory, and the modified visual field test, can be created. Based on this we deserve an A+, because we have gone above and beyond what we set out to do. We worked diligently and used our times very well during class and we learned so much. But more than anything, we are just so incredibly proud of the work we have done.

Although part of this project is giving ourselves a grade and justifying why we should get that grade, this project is much more than a grade. This project has become our passion. This project truly shows people the importance of research on ADHD and why there should be more research. This project has inspired us to not only share this research but continue our study on ADHD.

We have made a test that will change the system, change the perception, and hopefully inspire others to work towards bettering the diagnosis and treatment of ADHD.

Link to Ananya's reflection on her 20 time experience
Link to Veda's reflection on her 20 time experience

Bibliography:

"ADHD Educational Institute." ADHD Neurobiology - ADHD Neural Activity | ADHD Institute. Web. 01 Mar. 2017.

"ADHD Is Biological." ADDitude Magazine. Web. 01 Mar. 2017.

"ADHD Is Biological." ADDitude Magazine. Web. 01 Mar. 2017.

AboutKidsHealth, and About.kidshealth@sickkids.ca. "Brain Differences in ADHD." AboutKidsHealth. AboutKidsHealth, 24 Jan. 2011. Web. 01 Mar. 2017.

Anderson, Fiona S., Alicia S. Kunin-Batson, Joanna L. Perkins, and K. Scott Baker. "White versus Gray Matter Function as Seen on Neuropsychological Testing following Bone Marrow Transplant for Acute Leukemia in Childhood." Neuropsychiatric Disease and Treatment. Dove Medical Press, Feb. 2008. Web. 07 Mar. 2017.

"Brain Differences in ADHD." AboutKidsHealth. AboutKidsHealth. Web. 02 Feb. 2017.

"Checklist: Signs and Symptoms of Attention-deficit/hyperactivity Disorder (ADHD)." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 03 May 2016. Web. 07 Mar. 2017.

"Eye Movement Task Related to Frontal Lobe Functioning in Children with Attention Deficit Disorder." Journal of the American Academy of Child and Adolescent Psychiatry. U.S. National Library of Medicine. Web. 01 Mar. 2017.

Mahone, E. Mark, Stewart H. Mostofsky, Adrian G. Lasker, David Zee, and Martha B. Denckla. "Oculomotor Anomalies in Attention-Deficit/Hyperactivity Disorder: Evidence for Deficits in Response Preparation and Inhibition." Journal of the American Academy of Child & Adolescent Psychiatry 48.7 (2009): 749-56. Print.

"Medscape Log In." Medscape Log In. Web. 07 Mar. 2017.

National Institutes of Health. U.S. Department of Health and Human Services. Web. 01 Mar. 2017.

"Secrets of Your ADHD Brain." ADDitude Magazine. Web. 01 Mar. 2017.

"Secrets of Your ADHD Brain." ADDitude Magazine. Web. 01 Mar. 2017.

"Special Education." Ministry of Education. Web. 18 May 2017.

"Visual Field Testing." Cleveland Clinic. Web. 03 June 2017.

ADHD: A problem that needs addressing

Throughout our research on how to test ADHD, we found that people with the Attention Deficit Hyperactivity Disorder had more grey matter in their brains as well as unstable of dopamine. Children with severe ADHD had smaller frontal lobes, or the part of the brain that makes decisions. Being a biological trait passed down from your parents, if anyone in your immediate family has ADHD and you as a child show symptoms, you would be diagnosed with Attention Hyperactivity Deficit Disorder. While judging a child by their personality, sometimes improper diagnosis occurs and children who do not have ADHD are often medicated. ADHD needs awareness as it is a disorder that is often pushed to the side because of the lack of sufficient tests leading to many misdiagnosis's. Our project has been going fairly well as we are still in the process of making the diagnostic test. We can confidently say that we are on our way to changing the system one blog post at a time.

Progress Update

Throughout the past few weeks, we have been doing additional research and also we have started the construction of the diagnostic test for ADHD. ADHD is one of the most complex disorders, and as a result is lacking a proper diagnostic test. As a result of the complexity of the disorder, we have been struggling with the content of the test as there is such a wide range of skills and parts of the brain affected by ADHD. The hardest part about creating this test is that if we forget to include one aspect of the brain affected by ADHD or a skill that is a marker for those that have ADHD, it no longer becomes a diagnostic test. This is why the extensive research we have been doing is extremely necessary.

However, although researching for ADHD has been very time consuming, our next steps include more research but also continuing to work on the designing of our project. Throughout the entire process, we will probably never find ourselves satisfied with the research we have done and move on from research because of the bulk of the disorder being unknown. The research will only make our diagnostic test more accurate.

It has been already a couple of weeks since we have started this project we are very passionate, making a proper diagnostic test for ADHD, and we have been making progress. We are well on our way towards changing the system one blog post at a time.

Changing the Current System

20-Time is a project we were introduced to where, in a school environment, students use 20% of their class time working towards a goal they are passionate about. Attention-deficit/hyperactivity disorder, also referred to as ADHD, has not gotten the awareness or adequate research, allowing for multiple misdiagnoses as a result of its ineffective diagnostic tests. Through this 20-time project, we truly hope we can make a difference in the way the patients are diagnosed but also spread awareness about ADHD.

ADHD is a behavioral disorder that causes the patients to become less focused, less organized, and hyperactive, as stated in the name of the disorder. Even though, according to the CDC, more than 6.4 million children across the nation are diagnosed with ADHD before the age of 17, it still lacks the proper attention and research. The current system has the diagnosis based on an evaluation of the patient’s personality which allows for inaccuracies and thereby an unjustly diagnosed and medicated patient but also allows for cases where medication and treatment are necessary but no diagnosis is provided.

The purpose of our project is to create a test that tests the cognitive resources and responses to assess the likelihood of the disease based on whether the ADHD symptoms are indicated, answering the question of, “Can a test be created to more accurately diagnose ADHD?” In addition, we hope to spread awareness of this disorder as  the current stereotypes of ADHD play a major role in the lack of medical advancements made for this disorder. Through these diagnostic tests, we hope to provide a means for a preliminary diagnosis to be made, allowing for an increased amount of accuracy in the secondary and tertiary diagnoses.

Since accuracy is one of the most important aspects of our project, we plan on testing the accuracy of our diagnostic test on patients with ADHD and those that currently don’t have it.

Moving forward, we plan on continuing our research so we can plan out all of the details of our test and hopefully start making our diagnostic test.

Throughout this entire process, we will work towards our main goal of making the diagnostic process of ADHD more accurate but to also spread awareness of a disorder (ADHD) that has not gotten a sufficient amount of attention, hopefully working towards changing the system one blog post at a time.