ADHD & Executive Functioning Evaluations

ADHD can look very different from one child to another.

Some children are noticeably active, impulsive, and constantly on the go. Others are quiet, daydreamy, forgetful, or chronically overwhelmed. Some perform very well academically but require an extraordinary amount of time, effort, parental support, or stress to keep up.

Parents may notice difficulties with:

• Sustaining attention
• Getting started on tasks
• Following through and completing work
• Remembering instructions or assignments
• Organization and time management
• Losing or misplacing belongings
• Planning multi-step tasks
• Procrastination
• Distractibility
• Impulsivity
• Hyperactivity or restlessness
• Keeping track of deadlines
• Regulating emotions
• Completing routines independently

For some children, these difficulties are apparent everywhere. For others, concerns become most visible when demands increase—often as schoolwork becomes more complex and children are expected to manage more independently.

ADHD can be missed when a child doesn't fit the stereotypical picture.

Children with predominantly inattentive symptoms may not be disruptive or noticeably hyperactive. Instead, they may appear quiet, forgetful, disorganized, internally distracted, slow to begin work, or dependent on reminders and external structure.

Bright and academically capable children can also compensate for attention and executive functioning difficulties for years. Strong reasoning abilities, supportive parents, highly structured environments, or significant effort may help them maintain good grades even when everyday functioning is much harder than it appears.

This is one reason an ADHD evaluation should consider how a child functions and what it takes for them to succeed, rather than relying solely on grades or whether they create problems in the classroom.

Difficulty concentrating is real—but it doesn't necessarily mean ADHD.

Attention and executive functioning can be affected by anxiety, OCD, depression, autism, learning disabilities, sleep difficulties, stress, environmental demands, and other factors. More than one condition may also be contributing at the same time.

For example, a child who is consumed by worry may appear distracted. A child who spends excessive time checking, second-guessing, or trying to make something "just right" may appear unable to complete work efficiently. A child with an unidentified learning disability may avoid or lose focus during academic tasks because the work requires substantially more effort.

Simply documenting that a child has difficulty paying attention isn't enough.

A comprehensive evaluation should help determine why.

One of the most common misconceptions about ADHD is that a child with ADHD should be unable to focus.

Attention isn't an all-or-nothing ability.

A child may struggle significantly to regulate attention for routine, repetitive, lengthy, or effortful tasks while becoming deeply engaged in activities that are novel, stimulating, rewarding, or personally interesting.

The important question isn't simply "Can my child focus?"

It's how consistently and independently your child can regulate their attention and executive functioning when everyday life requires it.

Sometimes, children and adolescents are capable of focusing during an individual appointment with a psychologist. The testing environment is structured, distractions are limited, tasks change frequently, and an adult is providing continuous one-on-one interaction. That can look very different from managing six hours of school, completing homework independently, organizing belongings, remembering responsibilities, or getting through a morning routine.

For this reason, we don't determine whether ADHD is present based solely on how a child performs during testing. We integrate standardized testing with developmental history, everyday functioning, parent and teacher reports, clinical observations, academic information, and other available evidence to understand how attention and executive functioning operate in real life.

Families who complete an evaluation at TLC have access to ongoing consultation with Dr. Savaiano at a reduced rate of $200/hour, including help implementing recommendations and navigating school supports.