Aimee- I think the differences in the ADD brain are visible on an MRI but there isn't anyone using them diagnostically right now. That's the most common medical "So there" response to people who don't accept that ADD is something other than a behavior problem. I've gone through the diagnostic process twice-- once at an ADD center and once with a psychologist where I live now. My daughter was diagnosed by her pediatrician.
The test done at the ADD center, I think has fallen into disfavor. It's almost like a computer game with flashing letters, where you're to hit the space bar each time you see the "s". People with ADD will make specific errors relating to impulsivity and distractibility etc, and then they do the test again with medicine. At the end of that first test, I was hysterical, because I did well for about 15 seconds and then the test went all to h***. I begged him for a chance to try it again- and the doctor laughed and said that people with ADD are supposed to have a hard time with that test. They gave me 10mg ritalin and I retook the test and did much better- The scale was 1-100, and anything above 60 being abnormal. I scored 99 the first time w/o meds, and then 61 the second with meds. I think it's fallen into disfavor because not all people with ADD will respond to stimulant meds, though it is true that more people with "pure" ADD (ADD with no co-morbid disorder-- up to 40% of people with ADD will also have another issue) respond better and more quicly to stim meds.
Now, when I moved, I had to go through the process again- because, for the most part, if you walk into a doctor's office and say I have ADD, and I need Stimulant meds, they'll regard you as a drug-seeker. To cover their rears, I had to do the testing again. The second time was a battery of psychological tests (mostly check here if you___) to screen specifically for ADD and other "problems" "I rush through things to get them over with" "I like to harm myself" "I sometimes feel that I don't have a conscience" etc. to screen out other stuff. I came out with an ADHD with no accompanying disorder.
When my daughter went through the process, I already knew what the inventory for evaluation was looking for, and though I mentioned it as a potential concern at her 4 and 5 year annual exams, I waited until she started school, we had an opportunity to compare her with her peers and we had another adult on board who thought there was a problem. I'm going on a limb here, but I don't think they pay much attention unless the teacher's on board. I spoke with her teacher about three weeks after school started and I saw the "deer caught in headlights" look when she heard instructions-- and we decided to wait until mid-year to have time to observe. By Xmas, it was very, very obvious, and I had a half-year's worth of work to bring in to the doc to show.
She did the inventory, and diagnosed my DD and started her on meds and then her work began to improve almost immediately.
Through my battles I'd just say a couple of things- I KNOW how awful it is not knowing if there's something wrong with your child. I know it, know it, know it. But ADD is not a disorder like any other. You may just hit a peach who can help you with compassion on your first try- but after 12 years of dealing with this personally and one year with DD- I've never seen it be that easy. It was a painful process, because even with all the backup info I had in hand- I came under question, our homelife and parenting, her ability because of the mythical "overdiagnosis" of ADD, nobody wants to be the one to give stimulant meds to a poorly parented child, and unlike PE, nobody's going to die if they drop the ball, so they hedge and hemm and haw.
So I say- go slow. You don't want Nicky to come to you in 15 years and say, there was nothing wrong with me, why did you drug me, everyone says that Ritalin's just speed. You don't want your family or friends (all who think this diagnosis is the opening salvo in a debate over your ability to rear a child) to be able to bully you into thinking that you jumped the gun (and I still have friends telling me "maybe if you only tried ____ vitamin" she wouldn't have a problem since ADD is from allergies- etc. etc.) I've heard it all, from everyone- so much so that I don't really talk about it much. Just have your ducks in a row so you don't feel like you have to explain yourself.
If there's a problem with Nicky, when he hits school, you'll probably see it. Watch for impulsivity, and distractibility. Impulsive- when the kid has the scissors in the hand, and you say, "don't cut that" and then they convulsively start cutting like they can't help it... that's impulsivity. Watch in the classroom- I have just sort of intuitively started speaking in a tone and structure that gets my kid's attention. Other people won't be doing that, and if he looks like his teacher has suddenly spouted out in Latin when while issuing instructions- that's inattention. I was helping at an Art Center- and working with other kids (Because I lack the patience to work with mine) and saw another mom struggling to communicate with my kid and the stricken look on her face- and I just knew.
I made them make copies of her before and after work for her medical chart, I made them make copies of the inventories that the teacher and I filled out, because I wanted to make sure- 10 years from now, there's no doubt why we came to the decisions that we did. I knew three weeks into the school year that she "had" it, but I kept my mouth shut and bided my time, and I'm very, very happy that I did it that way. And the other thing- I just wanted to confirm the dx- but when the doctor did, (unexpectedly, uncharacteristically) started crying- because it hit me that this is something that my child is going to have to deal with and accomodate for the rest of her life. I wish that I hadn't been such a hurry to finalize that diagnosis. Sorry for the book! you just touched a nerve because I know you are where I was, and that isn't a great place to be. Good luck to you guys...
Mom to Alicia (severe PE) 5/98 and Camille (htn, oligo) 4/03