Diagnosing ADHD in children
What you should know:
In school-aged children, inattentive symptoms often interfere with classwork. Impulsive symptoms may lead to breaking social and school rules. And hyperactivity may make it hard for a child to sit still in class.
The diagnostic criteria for ADHD in the DSM-IV-TR® were developed to diagnose ADHD in children.
It’s important to remember: ADHD doesn’t just affect children. In most cases, ADHD is thought to be inherited and can run in families — so symptoms may also affect adults. Learn more about ADHD and adults.
Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder1
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
- 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.
