• Knowledgebase: ADHD (Attention Deficit Disorder)

    Questions about ADHD and its diagnosis and management.

    14. How is ADHD Diagnosed? - Top

    Not everyone who is overly hyperactive, inattentive, or impulsive has an attention disorder. Since most people sometimes blurt out things they didn't mean to say, bounce from one task to another, or become disorganized and forgetful, how can specialists tell if the problem is ADHD?

    To assess whether a person has ADHD, specialists consider several critical questions: Are these behaviors excessive, long-term, and pervasive? That is, do they occur more often than in other people the same age? Are they a continuous problem, not just a
    response to a temporary situation? Do the behaviors occur in several settings or only in one specific place like the playground or the office? The person's pattern of behavior is compared against a set of criteria and characteristics of the disorder. These criteria appear in a diagnostic reference book called the DSM (short for the Diagnostic and Statistical Manual of Mental Disorders).

    According to the diagnostic manual, there are three patterns of behavior that indicate ADHD. People with ADHD may show several signs of being consistently inattentive. They may have a pattern of being hyperactive and impulsive. Or they may show all three types of behavior.

    According to the DSM, signs of inattention include:

    becoming easily distracted by irrelevant sights and sounds
    failing to pay attention to details and making careless mistakes
    rarely following instructions carefully and completely
    losing or forgetting things like toys, or pencils, books, and tools needed for a task

    Some signs of hyperactivity and impulsivity are:

    feeling restless, often fidgeting with hands or feet, or squirming
    running, climbing, or leaving a seat, in situations where sitting or quiet behavior is expected
    blurting out answers before hearing the whole question
    having difficulty waiting in line or for a turn

    Because everyone shows some of these behaviors at times, the DSM contains very specific guidelines for determining when they indicate ADHD. The behaviors must appear early in life, before age 7, and continue for at least 6 months. In children, they must be more frequent or severe than in others the same age. Above all, the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work, or social settings. So someone whose work or friendships are not impaired by these behaviors would not be diagnosed with ADHD. Nor would a child who seems overly active at school but functions well elsewhere.
    - Updated: March 6, 2001

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    • James L Horwitz, MD

    David C. Thomas, MD

    Barbara Lindberg, PNP