Diagnosis criteria

How is ADHD diagnosed?


There are two systems of international classification criteria for diagnosing ADHD. One system was created by the American Psychiatric Association (APA) and the other by the World Health Organization (WHO). These classification systems are used to determine which conditions and symptoms need to be present for a patient to receive an ADHD diagnosis. According to the “ICD-10 Classification of Mental and Behavioural Disorders” by the WHO, someone needs to show the symptoms of inattention and hyperactivity before the age of six to be diagnosed with ADHD. In the UK, doctors are using the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-V) created by the American Psychiatric Association, which lists the following criteria for ADHD:

Criteria

For someone to be diagnosed, he or she must have suffered at least six (or more) of the following symptoms before the age of 12. The symptoms must also exist for six months or more and to a degree that is different from those considered normal for similarly aged children in an academic environment or extracurricular activity. At least five symptoms are required to make a diagnosis of ADHD in older adolescents and adults (age 17 and older).

Inattention

  • Often fails to pay attention to details or makes careless mistakes in schoolwork, at work, or during other activities
  • Tends to have difficulty sustaining attention during tasks or recreational activities, such as in class, in conversations, or during prolonged reading
  • Does not seem to listen when spoken to directly, and seems to have other things on his or her mind even when there is not an obvious distraction
  • Fails to follow instructions and finish schoolwork, chores, or work duties (may start work but be distracted quickly and easily evade it)
  • Has difficulty organising tasks and activities and putting belongings in order. He or she neglects work, has poor time-management skills, and does not meet deadlines
  • Avoids and dislikes tasks that require sustained mental effort, such as schoolwork or chores
  • Often loses things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallet, keys, working papers, glasses, or mobile phones
  • Easily distracted by external stimuli
  • Forgets daily activities, such as homework or doing errands, or in older teens and adults, returning calls, paying bills, or keeping appointments

NOTE: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.

To be diagnosed with ADHD, a person must also show six or more of the following symptoms of hyperactivity and impulsivity:

  • Fidgets with hands or feet or squirms in seat
  • Frequently gets up in situations where he or she is expected to remain seated
  • Runs around or climbs in situations where It is not appropriate (in teens or adults, this may be limited to fidgeting)
  • Unable to quietly play or engage in leisure activities
  • Typically too “busy”, acting as if he or she has to do things
  • Talks excessively
  • Often responds unexpectedly or before a question is concluded or finishes someone else’s thought
  • Has difficulty waiting his or her turn
  • Interrupts or intrudes on others; distracts others or does not realise he or she is bothering anyone

NOTE: The symptoms are not solely a manifestation of oppositional behaviour, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.

Keep in mind that the symptoms must also meet these criteria:

  • Be present for at least six months
  • Have started before the age of 12
  • Be present in two or more places, such as at school and in the home
  • Negatively affect day to day life
  • Not occur solely due to a psychotic condition
  • Not be better explained by another mental condition