Determining if a child has Attention-Deficit/Hyperactivity Disorder (ADHD) is a detailed process that requires careful evaluation. It’s important to understand that there isn’t a single, definitive test for ADHD. Many conditions, such as sleep problems, anxiety, depression, and certain learning disabilities, can present symptoms that overlap with ADHD, making accurate diagnosis crucial.
When to Seek Professional Advice
If you have concerns about your child exhibiting symptoms of ADHD, the initial step is to consult with a healthcare professional to assess whether these symptoms align with an ADHD diagnosis. This evaluation can be conducted by a mental health specialist, such as a psychologist or psychiatrist, or by a primary care physician, like a pediatrician. Early identification and intervention are key to supporting children with ADHD.
The Diagnostic Process for ADHD in Children
Healthcare providers will conduct a thorough assessment to rule out other potential conditions that might better explain the observed symptoms or co-exist with ADHD. For children, the American Academy of Pediatrics (AAP) guidelines recommend1 healthcare providers to gather information from various sources, including parents, teachers, and other caregivers, about the child’s behavior across different settings such as home, school, and social interactions. This comprehensive approach ensures a holistic understanding of the child’s challenges. Learn more about the guidelines for diagnosing and treating ADHD in children and adolescents.
Further Reading: Understanding the Link Between Family Health History, ADHD, and Learning Disorders
Understanding ADHD in Adults
It’s important to recognize that ADHD is not solely a childhood condition; it often persists into adulthood. While symptoms may evolve with age, the core challenges remain. For instance, hyperactivity in adults might manifest as intense restlessness or an inability to relax. Explore more about the presentation of ADHD in adults.
For in-depth information on diagnosis and care across the lifespan, resources like the National Resource Center on ADHD and the National Institute of Mental Health websites offer valuable insights.
DSM-5 Diagnostic Criteria for ADHD
Healthcare professionals rely on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5),[2](#cdcreference_2] as the standard guidelines for diagnosing ADHD. These criteria ensure accurate diagnosis and appropriate treatment planning. Consistent application of these standards across different settings also allows for better understanding of ADHD prevalence and its public health impact.
Symptom Thresholds for ADHD Diagnosis by Age
The DSM-5 outlines specific symptom thresholds for diagnosis based on age:
- For children up to 16 years old: Six or more symptoms of inattention and/or hyperactivity-impulsivity.
- For adolescents 17 years and older and adults: Five or more symptoms of inattention and/or hyperactivity-impulsivity.
Individuals with ADHD demonstrate a persistent pattern of inattentionA and/or hyperactivityB–impulsivityC that significantly impacts their daily functioning and development.
Detailed DSM-5 Criteria for ADHD Diagnosis
The following are the DSM-5 criteria for ADHD, presented in a summarized format for informational purposes. It is crucial to remember that only qualified healthcare providers can diagnose and manage ADHD.
Inattention Symptoms
Note: These symptoms must have been present for at least 6 months and be inappropriate for the child’s developmental level.
- Frequently overlooks details or makes careless errors in schoolwork, work, or other activities.
- Struggles to maintain attention in tasks or play.
- Appears not to listen when directly spoken to.
- Fails to follow through on instructions and doesn’t complete schoolwork, chores, or workplace duties (e.g., loses focus, gets sidetracked).
- Has difficulty organizing tasks and activities.
- Avoids, dislikes, or is reluctant to engage in tasks requiring sustained mental effort (like schoolwork or homework).
- Loses necessary items for tasks or activities (e.g., school supplies, tools, keys, phones).
- Is easily distracted by extraneous stimuli.
- Is forgetful in daily routines.
Hyperactivity-Impulsivity Symptoms
Note: These symptoms must have been present for at least 6 months and be inappropriate for the child’s developmental level.
- Fidgets or taps hands or feet, or squirms in their seat.
- Leaves seat in situations where remaining seated is expected.
- Runs about or climbs excessively in inappropriate situations (in adolescents or adults, this may manifest as restlessness).
- Has difficulty engaging in leisure activities quietly.
- Is often “on the go,” acting as if “driven by a motor.”
- Talks excessively.
- blurts out answers before questions are completed.
- Has trouble waiting their turn.
- Interrupts or intrudes on others (e.g., butts into conversations or games).
Additional Conditions for ADHD Diagnosis
In addition to meeting the symptom criteria, the following conditions must also be satisfied for an ADHD diagnosis:
- Several inattentive or hyperactive-impulsive symptoms were present before the age of 12 years. Learn more about early onset of ADHD.
- Symptoms are evident in two or more settings (e.g., home, school, work, with friends or relatives).
- There is clear evidence that symptoms significantly interfere with or reduce the quality of social, academic, or occupational functioning.
- The symptoms are not better explained by another mental health condition (such as mood disorders, anxiety disorders, or personality disorders) and do not occur exclusively during schizophrenia or another psychotic disorder. Explore other mental health conditions.
For further information on diagnosis and comprehensive care strategies for children and adults with ADHD, please visit the National Resource Center on ADHD and the National Institute of Mental Health websites. Effective care often involves a combination of behavioral therapy, medication, and educational support, tailored to the individual needs of the child and family.
Resources for Care and Support
References
[1] Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. American Academy of Pediatrics. Pediatrics. 2019;144(4):e20192528
[2] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Footnotes
[A] Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.
[B] Hyperactivity means a person moves about constantly and excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with activity.
[C] Impulsivity means a person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm; or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering long-term consequences.
