Diagnostic Criteria for Attention Deficit Disorder

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Note: The information below is intended to familiarize you with the diagnostic criteria for ADHD/ADD. Making this diagnosis correctly requires a comprehensive evaluation, however, and should only be made by a qualified health care provider.

In the United States, ADHD is diagnosed according to criteria specified in the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV). ADHD symptoms are divided into two groups: symptoms of inattention and symptoms of hyperactivity/impulsivity. These groups of symptoms are shown below:

In the United States, Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder is diagnosed according to criteria specified in the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV). ADHD/ADD symptoms are divided into two groups: symptoms of inattention and symptoms of hyperactivity/impulsivity. These groups of symptoms are shown below:

· often has difficulty sustaining attention in 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 school work, chores, or duties in the work place (this failure is not due deliberately refusing to do it or not understanding instructions);

· often has difficulty organizing tasks or activities;

· often avoids or is reluctant to engage in tasks that require sustained mental effort;

· often loses things necessary for tasks or activities;

· is often easily distracted by extraneous stimuli;

· is often forgetful in daily activities;

· often leaves seat in classroom or in other   situations in which remaining seated is expected;

· often runs about or climbs excessively in which it is inappropriate (in adolescents and adults, may be limited to subjective feelings of restlessness;

· often has difficulty playing or engaging in 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 difficulty awaiting turn;

· often interrupts or intrudes on others (e.g. butts into conversations or games)

To avoid diagnosing individuals who show only isolated difficulties, at least 6 inattentive symptoms and/or 6 hyperactive/impulsive symptoms must be present to possibly qualify for an ADHD/ADD diagnosis. In addition, these symptoms must have been present for at least 6 months to a degree that is considered inappropriate for the individual's age.

If 6 or more inattentive symptoms are present the diagnosis of ADHD/ADD, Predominantly Inattentive Type may apply. This is what people mean when they refer to ADD.  Technically, this term is no longer correct.

If 6 or more hyperactive/impulsive symptoms are the diagnosis of ADHD, Predominantly Hyperactive/Impulsive Type may apply;

When 6 or more of both types of symptoms are present, the diagnosis of ADHD, Combined Type may apply.

For example, it is not uncommon for children with inattentive symptoms, but not the hyperactive/impulsive symptoms, to do okay in the early grades when the academic demands are not very rigorous. This is especially likely for a bright child who catches on despite not attending very well. In later grades, however, when the work becomes more demanding, the child's problems with attention may begin to create real problems. Thus, although it may appear that the child's problems with attention emerged "suddenly", a careful investigation often reveals the presence of attentional difficulties earlier on.

In cases where there truly is no indication of ADHD symptoms, even at a reduced level, than ADHD would not be an appropriate diagnosis. Instead, it is likely that some other type of problem such as a mood disorder or anxiety disorder is responsible for the symptoms.

It is important to emphasize that the intensity of ADHD symptoms can vary considerably across settings and it is not necessary that the degree of impairment from symptoms be equivalent in different settings. For example, it is not uncommon for a child's difficulties to be more prominent at school than at home. When this occurs, it is often because the demands to sustain attention and inhibit activity level are greater at school than at home. Thus, in order to satisfy the dual setting criteria, there just needs to be some indication that the problems are not exclusively confined to a single context.

In reality, the first 3 disorders listed (i.e. pervasive Developmental Disorder, Schizophrenia, or some other Psychotic Disorder) are quite rare, and impair an individual's functioning to such an extent that it should be clear that something besides a simple case of ADHD is present. The remaining disorders are most likely to be the cause of ADHD symptoms when the symptoms emerged after age 7, and there was no indication of ADHD symptoms earlier on.

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