Attention Deficit Disorder (ADD)/ADHD diagnosis deferred?


Our child has recently completed psychological testing as we had school concerns related to paying attention, sitting still, and completing written assignments.  He is in kindergarten and 5 years old

The tests show that he is capable of the work (IQ - 115) but the tests also show weak Working Memory.  The parent and teacher questionnaires (Conner and others) show very elevated concerns for hyperactivity and impulsivity.   We agreed with the school to provide some support services so he can improve his academics.

Now the psychologist who did the testing has deferred on the ADHD diagnosis until a sleep study is done.  Based on light snoring and limb movement on the sleep screening index, the score is cautious for possible sleep disorders.  Since we returned the sleep screening tool to the psychologist around 7 weeks ago, why wouldn't we be notified that we need a sleep study to aid in diagnosis?  As a parent if I wanted to know as soon as possible if you think my child could have sleep apnea rather than hear almost 2 months later.

The deferral sets us back on getting accommodations or support at the school since we don't have the ADHD diagnosis. He currently has Unsatisfactory in all subjects and his teacher refuses to remind him to bring his homework.  He really needs some support to continue to be a productive and happy learner. Is this common to defer a ADHD diagnosis  based on sleep alone?  

Please advise on the best way forward,


Your description of the child is typical of ADHD. As such this condition is a genetically inherited Neurological condtion, not a Psychological one. Thus, as a medical condition, you need to see a medical doctor who specializes in these conditions, not a psychologist in my  opinion.
     I have not assessed him but I cannot see a need for a sleep assessment. A full and complete accurate diagnosis is possible in a doctors consulting room without any other tests all within a 2 hour consultation.   Even at 5 years of age the sequence of involvement is, first diagnosis, then  medication to make him teachable, then  motivation to make him want to learn, and education to catch up any backlog by a sympathetic teacher. Thereafter  remediation if required.
    The doctor must educate both the parents and teacher what is required and what to do and to understand the Conners.
      If medication is given a regular monthly reassessment using Conners rating scales  from both the teacher and parent is vital to obtain an optimal effective dose. The Conners changes as success begins to show.  The Conners can also show if remediation is needed.
   New research suggestd one does not have to wait until the child is 6 and at school to start safe effective medical treatment. Results can often be seen  within 10 to 20 days but success might take longer.  

Attention Deficit Disorder (ADD)

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Dr Billy Levin


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