ADD/ADHD

For more detailed information regarding ADD/ADHD and its causes/symptoms, click here.

The evaluation process is complex because there are many reasons for attention, behavior, and school difficulties with learning.

Your pediatrician will evaluate any medical basis for your child’s problem and explore the emotional, behavioral, and learning aspects.

Following evaluation, your child may be referred for additional consultations from a child neurologist, child psychologist, or child psychiatrist.

The Diagnostic Process

There are three initial visits spaced about two weeks apart.

First Visit

The first visit is with our ADHD care coordinator, Tonya Primeau, RN, and your child does not need to be present.

In this visit, we will gather a general idea of the problem, discuss what evaluations have already been done by the school, mental health or other health care providers, and review some history of your child and family.

You will receive:

• Information regarding the diagnosis and treatment options for Attention Deficit Hyperactivity Disorder.
• Answers to questions that you may have about the diagnostic process.
• Questionnaires that you and your child’s teacher must complete before we can further evaluate your child.

During the first visit, Tonya will review:

1. Understanding ADHD written by the American Academy of Pediatrics. This discusses the diagnostic criteria, evaluation process, and treatment of ADHD. We recommend that you read this carefully before the second visit.
2. NICHQ Vanderbilt Assessment Scale – PARENT Informant. A behavioral rating scale designed for the parents or guardian of the child. There is a separate behavioral rating scale designed for your child’s teacher. Because the diagnosis of ADHD is dependent on the evaluation of the child in two different settings, we will need both the parent and the teacher rating scale completed and returned before the second appointment.
3. Patient Authorization for Use and Disclosure of Protected Health Information. You will need to sign this form giving your child’s teacher permission to share the information asked in the behavior rating scale with your pediatrician. We will need ongoing communication with your child’s teacher in order to evaluate your child’s progress.You will be given a copy of this authorization and one will be kept in your child’s office chart.

For Your Child’s Teacher

At the initial visit you will receive information that you must give to your child’s teacher:

1. A letter of introduction and instruction from the physicians at Forest Hills Pediatric Associates. This letter explains the importance of their role in the diagnosis of your child’s learning or behavior problem.
2. Patient Authorization for Use and Disclosure of Protected Health Information. A copy of this form must be given to your child’s teacher in order for them to return the behavior rating scale to our physicians.
3. NICHQ Vanderbilt Assessment Scale—TEACHER Informant. This behavior rating scale has been developed specifically for teachers. This must be completed and returned to us before the second visit. We can either send an electronic copy via email or provide a paper copy for you to give to the teacher. Please stress that we need this form returned as soon as possible so that our evaluation may proceed. An envelope with our address is included for convenience. Alternatively, your teacher may fax the information back to us at (616) 949-6191.

Next Step

The next step in the diagnostic process is taken when we have received these completed documents:

• NICHQ Vanderbilt Assessment Scale—PARENT Informant
• NICHQ Vanderbilt Assessment Scale—TEACHER Informant

If the school or another professional has done any other evaluations on your child please forward those to us before the second visit. Report cards from the past two years are also helpful in our evaluation.

Tonya and your pediatrician will review all of the information before you and your child return for the second visit to help anticipate diagnostic tests or specialty referrals your child may need.

Often there is no need for further testing. Tonya will contact you once we have all the information and schedule the next two visits with your child’s pediatrician as well as a phone consultation with her.

Second Diagnostic Visit

• Your child must be present for the second diagnostic visit.
• A physical examination will include vision, hearing, blood pressure and neurological testing.
• Your pediatrician will discuss the results of the comprehensive history, behavior rating scales and the physical exam.
• At that visit, the most likely diagnoses will be discussed.
• Treatment options will be reviewed, including medication and behavioral therapy. If your pediatrician feels that further testing or consultation is indicated that will be set up at this visit.
• It is most helpful if both parents can be present at this visit without siblings.

Medication Review Appointments

• If we prescribe a medication for your child’s problem, then we must see him/her frequently until we have determined that your child is on an effective medication and dosage without side effects.
• At a minimum, Tonya will do a phone consultation after your child has been on medication for one week, then the pediatrician will see your child in two weeks.
• At the second physician visit, if things are going well, a plan for further rechecks will be established. Your child will then be seen at a minimum of every 4 months.

Guidelines for ADD/ADHD Medications

If your child has been diagnosed with ADD or ADHD and we prescribe him/her medication, we require that your child be evaluated in the office at least every 4 months.

We ask that at least one parent be present at your child’s visit. Prior to each visit, we ask that at least one parent, and, if during the school year, one teacher, complete a Vanderbilt Follow-up questionnaire, available on your patient portal several days prior to your visit.

Teacher questionnaires will be emailed directly to them.

Most ADD/ADHD medications are closely monitored by the State of Michigan and there are very stringent rules regarding their availability.

• No phone orders can be made to the pharmacy.
• Starting June 15th, 2016 we will be able to send your child's medication to the pharmacy electronically.
• Please give us at least a 48-hour notice when you need a new prescription so that we may have it ready for you.
• We can provide you with two prescriptions at one time; one to fill now, and one that can be filled in three to four weeks. You have 59 days to fill it from the date signed or it becomes void.

Resources and Forms

• Assessment Follow-up—Parent Informant
• Assessment Scale—Parent Informant
• Assessment Follow-up—Teacher Informant
• Assessment Scale—Teacher Informant
• Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
• Behavioral Health Coordination of Care Consent

ADHD Coordinator

Tonya has worked in pediatrics for 8 years; she obtained her nursing degree from Northwestern Michigan College in Traverse City. Tonya and her family moved to  the Grand Rapids area in 2017.  In her spare time Tonya enjoys many outdoor activities.

Request an Appointment

Online through our patient portal or call (616) 949-4465

To reach Tonya , call (616) 949-4465