Diagnosing ADHD in adolescents
What you should know:
The diagnostic criteria for ADHD in the DSM-IV-TR® were evaluated primarily with children in mind. However, as children mature, ADHD symptoms can become less conspicuous. For example, hyperactivity becomes less overt and may be expressed instead as fidgetiness or an inner restlessness.
It’s important to remember: The symptoms of ADHD can evolve throughout a patient’s life. ADHD doesn’t just affect children and adolescents. In most cases, ADHD is thought to be inherited and can run in families1 — so symptoms may also affect adults. Learn more about ADHD and adults.
Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder3
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development
Either (1), (2), or Combined Type:
(1) six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with 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 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 schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
- often has difficulty organizing tasks and activities
- often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
- often loses things necessary for tasks or activities (eg, toys, school assignments, pencils, books, or tools)
- is often easily distracted by extraneous stimuli
- is often forgetful in daily activities
(2) six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity
- often fidgets with hands or feet or squirms in seat
- often leaves seat in classroom or in other situations in which remaining seated is expected
- often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or 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
Impulsivity
- often blurts out answers before questions have been completed
- often has difficulty awaiting turn
- often interrupts or intrudes on others (eg, butts into conversations or games)
- Some hyperactive-impulsive or inattentive symptoms that cause impairment must have been present before age 7 years
- Some impairment from the symptoms must be present in at least 2 settings (eg, at home and at school)
- There must be clear evidence of interference with developmentally appropriate social, academic, or occupational functioning
- The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and is not better accounted for by another mental disorder
- ADHD, Combined Type should be used if 6 (or more) symptoms of inattention and 6 (or more) symptoms of hyperactivity-impulsivity have persisted for at least 6 months
Reference: 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR®). 4th ed, Text Revision. Washington, DC: American Psychiatric Association; 2000;85-93.
