Diagnosing ADHD

11_0036_Layer 66

Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms.

The American Psychiatric Association’s Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR) is used by mental health professionals to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. Using the same standard across communities will help determine the prevalence and public health impact of ADHD.

The criteria are presented here in modified form in order to make them more accessible to the general public. They are listed here for information purposes and should be used only by trained health care providers to diagnose or treat ADHD.

DSM-IV Criteria for ADHD

I. Either A or B:

A. 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. 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.

B. 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. 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.

Impulsivity

  1. Often blurts out answers before questions have been finished.
  2. Often has trouble waiting one’s turn.
  3. 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.

References

  1. American Psychiatric Association: Diagnostic and Statistical Manual of mental disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.
  2. Bagwell, Catherine L.; Molina, Brooke SG; Pelham, Jr., William E.; and Hoza, Betsy. Attention-Deficit Hyperactivity Disorder and Problems in peer Relations: Predictions From Childhood to Adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, November 2001, 40(11):1285-1292.
  3. Barkley RA., et al. Driving related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3-to5 year follow up survey, Pediatrics, August 1993; 92(2):212-218
  4. DiScala, C., et al. “Injuries to children With attention deficit hyperactivity disorder,” Pediatrics, December 1998, 102(6):1415-1421.
  5. Green M, Wong M, Atkins D, et al. Diagnosis of Attention Deficit/Hyperactivity Disorder: Technical Review 3. Rockville, MD: US Department of Health and Human Services, Agency for Health Care Policy and research; 1999. Agency for Health Care Policy and research publication 99-0050.
  6. Guevara, J., et al. “Utilization and Cost of Health Care Services for children With Attention-Deficit/Hyperactivity Disorder,” Pediatrics, July 2001, 108(1):71-78.
  7. Hann, Della M. and Borek, Nicolette, Eds. Taking Stock of Risk Factors for Child/Youth Externalizing Behavior Problems. Department of Health and Human Services, Public Health Service, National Institute of mental health/NIH, 2001.
  8. Hodgens, J. Bart; Cole, Joyce; and Boldizar, Janet. Peer-Based Differences Among Boys With ADHD. Journal of Clinical Child Psychology, 2000, 29(3):443-452.
  9. Leibson, C., et al. Use and Costs of Medical Care for children and Adolescents With and Without Attention-Deficit/Hyperactivity Disorder, JAMA, 3 January 2001, 285 (1):60-66.
  10. National Institutes of Health/National Institute of mental healthDecade of the Brain-attention deficit hyperactivity disorder. U.S government Printing Office, Washington, DC, NIH 96-3572.
  11. New York University Child Study Center. I.M.P.A.C.T. (Investigating the Mindset of Parents about ADHD & Children Today) Survey, 2001.
  12. Woodward, Lianne J. and Ferguson, David M. Childhood Peer relationship Problems and Psychosocial Adjustment in Late Adolescence. Journal of Abnormal Child Psychology, February 1999.

1 Comment

  1. Pingback: 5 Common ADHD Myths! | Mental Health Matters

Leave a Reply

Your email address will not be published. Required fields are marked *