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How is ADHD
usually diagnosed?

Many of the symptoms of ADHD occur from time to time in everyone. In those with ADHD, the frequency or severity of these symptoms impairs functioning both at home and at school or work. Although some computerized "tests of attention" and pen-and-paper tests for ADHD are available, no physical test exists to diagnose ADHD. Therefore, a diagnosis is generally based on the subjective reports of parents, teachers, and/or patients. In the USA, criteria for diagnosis are laid down by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders (DSM-IV ), 4th edition.

According to DSM-IV, Attention Deficit Hyperactivity Disorder (ADHD) or one of its subtypes can be diagnosed if the child shows certain characteristics for a period of six months or more, with at least some of the symptoms beginning before age seven. Symptoms must occur in more than one setting - such as at school or work and home. The symptoms are subjective, generally described by a parent, and require:

(A) Six or more symptoms of lack of attention, as paraphrased below:

  1. Fails to pay attention, makes mistakes
  2. Difficulty staying on tasks
  3. Does not seem to listen
  4. Fails to finish things
  5. Trouble organizing things
  6. Does not like homework or schoolwork
  7. Loses things
  8. Easily distracted
  9. Forgetful
~OR~

(B) Six or more symptoms of hyperactivity-impulsivity, as paraphrased below:

  1. Fidgets
  2. Leaves seat in class
  3. Runs around, is restless
  4. Difficulty playing quietly
  5. Acts like "driven by a motor"
  6. Talks too much
  7. Blurts out answers
  8. Can't wait his turn
  9. Interrupts others
For people who don't fit neatly into the categories of ADHD-attentional, ADHD-hyperactive, or ADHD-combined, there is another diagnosis called "ADHD, not otherwise specified." Diagnoses such as ODD (Oppositional Defiant Disorder), Conduct Disorder and Explosive Disorder are descriptive of their major problem symptoms; medical treatment offered is often the same as for ADHD.

Many of the symptoms listed above overlap. For example, how would you separate the symptoms "losing things," "forgetful," and "having trouble organizing?" Are they really three separate symptoms?

It is unfortunate that the DSM-IV does not appear to stress ruling out physical symptoms.

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Last Updated 11/18/13