Week 11, Spring 2008

In honor of the Bellis presentation that we all attended this week & the subsequent cancellation of all of my clinic slots, my post this week relates to APD.

The following article, Can We Differentially Diagnose an ADD without Hyperactivity from a CAPD?, addresses an issue that is a core concern of my client's mother ... differentiating ADD from APD. The article describes a case study about a boy named Corey. Corey was having difficulty in school. He was not staying on task, he was asking his teachers to repeat instructions, he was acting out, and he had a history of phonological delays and OM. Corey underwent a full psychoeducational evaluation.

During an interview with Corey, the investigators found that he had skewed social competence. Specifically, he blamed others for his difficulties and didn't understand why he kept getting in trouble and getting rejected from same-age friends. Both a speech-language pathologist's and a school psychologist's interpretations of results were given. Both professionals cited similiar difficulties, such as inability to maintain attention, difficulty processing complex sentences and directions, and weak figure-ground scores. However, the two professionals suggested two different diagnoses: APD and ADD. This article provides a real-world example of a child who may not fall neatly into a diagnostic category. It emphasizes that APD and ADD can be mistaken for each other and can also occur concurrently. Significantly, the authors also advised multiple case histories and interviews with the children in order to arrive at more accurate diagnoses.

As we've learned in our APD class, a test like the ACPT would be useful in differential diagnosis as well. Still ... very tricky!

http://web.ebscohost.com.www.libproxy.wvu.edu/ehost/pdf?vid=39&hid=101&sid=5077a623-7531-4b3a-a840-604f8d099f9b%40sessionmgr106