Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Testing for ADHD involves a number of screening tools, full history and
physical, self-tests, observations, and other neurocognitive evaluations. There
is no currently accepted blood test or radiologic test for the disorder, though
recent studies suggest that there may be some biomarkers (lab tests) and
recently the FDA approved the use of an electroencephalogram (EEG) device to
assist in the diagnosis and treatment of ADHD. There is some disagreement
amongst researchers and clinicians regarding the cost-effectiveness of the
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder
associated with difficulties with attentiveness, impulsivity, and hyperactivity.
There are several subtypes of the disorder that include varying expressions of
the symptoms. Attention deficit disorder (ADD) is considered an inattentive
predominant subtype. There is a high frequency (>50%) of comorbid psychiatric
disorders in children and adults with ADHD, including bipolar disorder, mood
disorders, anxiety disorders, and others. The diagnosis and treatment of ADHD is
well established and is based on observations and subjective reports by the
affected children, parents, teachers, and physicians.
Specific Rating Scales Used to Diagnose ADHD in Children
There are a number of assessments that are completed by physicians, parents,
and teachers. No single scale or source should be used to make the diagnosis of
ADHD. It requires information from multiple sources. These include the following:
The Vanderbilt Assessment Scale is a tool which reviews symptoms associated
with ADHD and other psychiatric diagnoses. This is generally completed by a
teacher and a parent.
Behavior assessment system for children assesses
symptoms such as hyperactivity, aggression and conduct problems, as well as
other behavioral problems. Though used originally by psychologists, it is not commonly
used by pediatricians and others involved in evaluating and treating children
with ADHD and other behavioral disorders.
A child behavior checklist/teacher
report form (Achenbach checklist) is completed by parents, teachers, and
the child and is a subjective evaluation of behaviors consistent with ADHD.
Physicians and parents should be aware that schools are federally mandated to perform an appropriate evaluation if a child is suspected of having a disability that impairs academic functioning. This policy was strengthened by regulations implementing the 1997 reauthorization of the Individuals With Disabilities Act (IDEA), which guarantees appropriate services and a free, appropriate public education to children with disabilities from ages 3 to 21.