Types of ADHD: Making the Diagnosis
How Did Amen Come Up With His Types of ADHD?
Amen has performed and analyzed thousands of single photon emission computed tomography (SPECT) brain scans on people with psychological problems. SPECT uses a radioactive dye to create a three-dimensional image of the blood flow and activity in the brain. It is typically used to diagnose medical conditions such as Alzheimer's disease, Parkinson's disease, and head injury. Amen says this type of scan also can provide doctors with more thorough information about ADHD and other psychological conditions.
SPECT scans don't themselves diagnose ADHD, but they can help fine-tune the diagnosis when considered together with the patient's medical history and psychiatric evaluation, according to Amen. He says these scans measure whether areas of the brain are working correctly, too much, or not enough. Knowing which areas of the brain are problematic in children with ADHD can help doctors focus treatments on those areas. SPECT also can identify how well a child's medication is working, according to Amen.
Criticism of Amen's Approach to Diagnosing ADHD
Although some psychologists and psychiatrists hail Amen as a pioneering ADHD researcher, others are vocally opposed to his methods. Critics argue that his tests are very expensive (scans can cost upwards of $3,000), and have not been proven to be helpful by scientific studies in peer-reviewed medical journals.
In 2005, the American Psychological Association (APA) Council on Children, Adolescents and Their Families released a position paper stating that brain imaging for the purpose of diagnosing psychiatric disorders in children and adults is still experimental, and there isn't enough evidence to support its general use. The report also raised concerns about the long-term effects on children who are exposed to the radiation used in SPECT and other brain scans.
Although he claims to have had great success with his patients, currently Amen's techniques for diagnosing ADHD are not widely accepted in the medical community. However, the APA Council did acknowledge that refinements in brain imaging techniques might make these scans more useful in the future.