Diagnosing ADHD

Signs of ADHD

The three symptoms or signs of ADHD are inattention, hyperactivity, and impulsivity. Symptoms that many children with or without the disorder experience at times. In order to be diagnosed with ADHD these symptoms should be inappropriate for the child's age or developmental level. 


It can be difficult to diagnose a child with ADHD. There is no one test doctors can use to diagnose the disorder, and its symptoms are similar to other problems or learning disabilities. Since it is a disorder and not a disease (see Disorder NOT Disease section), blood work, x-rays, or other medical tests can not determine a diagnosis for it. Instead, doctors rely on the presence or absence of symptoms.


The DSM-IV (Diagnostic and Statistical Manual) was developed by the American Psychiatric Association to provide mental health examiners help with diagnosing ADHD.  It gives doctors a standard for assessing their patients' symptoms. For a free symptoms checklist visit the Symptoms Checklist section.

DSM-IV Criteria for ADHD

I. Either A or B:

1. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level: 
   Inattention

1. 1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
   2. Often has trouble keeping attention on tasks or play activities.
   3. Often does not seem to listen when spoken to directly.
   4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
   5. Often has trouble organizing activities.
   6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
   7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
   8. Is often easily distracted.
   9. Is often forgetful in daily activities.

2. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:  
   
    Hyperactivity

1. 1. Often fidgets with hands or feet or squirms in seat when sitting still is expected.
   2. Often gets up from seat when remaining in seat is expected.
   3. Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
   4. Often has trouble playing or doing leisure activities quietly.
   5. Is often "on the go" or often acts as if "driven by a motor".
   6. Often talks excessively.

1. Impulsivity
   
2. 7. Often blurts out answers before questions have been finished.
   8. Often has trouble waiting one's turn.
   9. Often interrupts or intrudes on others (e.g., butts into conversations or games).

II. Some symptoms that cause impairment were present before age 7 years.

III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).

IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.

V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder). 

Based on these criteria, three types of ADHD are identified:

IA. ADHD, Combined Type: if both criteria IA and IB are met for the past 6 months

IB. ADHD, Predominantly Inattentive Type: if criterion IA is met but criterion IB is not met for the past six months 

IC. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion IB is met but Criterion IA is not met for the past six months.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000


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