Assessing Attention-Deficit/Hyperactivity Disorder
Because Attention-Deficit/Hyperactivity Disorder is often a “quick diagnosis,” it’s subject to misdiagnosis. AD/HD symptoms can be confused with symptoms of other psychiatric or physiological disorders (e.g., bipolar spectrum disorder or hyperthymia). Allergic reactions and certain foods or ingredients can also cause classic AD/HD-like symptoms, thus, it’s important to not automatically assume that a child who’s experiencing academic, emotional, or social problems has AD/HD.
An accurate diagnosis requires careful evaluation by a trained mental health professional.
DSM-IV-TR Criteria for Attention-Deficit/Hyperactivity Disorder
I. Either A or B:
A. For at least 6 months, 6 or more of the following symptoms of inattention have been present to an extent that is disruptive and inappropriate for the person’s developmental level:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
- Often has difficulty sustaining attention on tasks or play activities
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish schoolwork, chores, or workplace duties. (And is not defiant or oppositional behavior or a failure to understand the instructions.)
- Often has difficulty organizing activities
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
- Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools)
- Is often easily distracted by extraneous stimuli
- Is regularly forgetful in daily activities
B. Hyperactivity-Impulsivity Symptoms. For at least 6 months, 6 or more of the following symptoms of hyperactivity-impulsivity have been present to an extent that is disruptive and inappropriate for the person’s developmental level:
- Often fidgets with hands or feet or squirms in seat when sitting still is expected
- Often gets up from seat when remaining in seat is expected
- Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless)
- Often has trouble playing or doing leisure activities quietly
- Is often “on the go” or often acts as if “driven by a motor”
- Often talks excessively
- Often blurts out answers before questions have been completed
- Often has trouble awaiting turn
- Often interrupts or intrudes on others (e.g., butts into conversations or games)
C. Some symptoms that cause impairment were present before age 7.
D. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and home).
E. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
F. 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).
What are the different forms of AD/HD?
A diagnosis of AD/HD includes one of these subtypes:
Attention-Deficit/Hyperactivity Disorder, Combined Type. For 6 months, the person meets the above criteria for both Inattention and Hyperactivity-impulsivity. (Most children have symptoms of Combined Type.)
Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type. For 6 months, the person meets the criteria for Inattention, but not Hyperactivity-mpulsivity.
Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type. For 6 months, the person meets the criteria for Hyperactivity-impulsivity, but not Inattention.