Diagnosing ADHD
To be diagnosed with attention-deficit/hyperactivity disorder (ADHD), individuals must meet the following criteria, adapted from DSM-5.1,2
An update to the defining criteria:
ADHD-RS-5 vs ADHD-RS-4
The ADHD-RS-5 is a rating scale specifically for children and adolescents with ADHD that has been updated to correspond with the DSM-5. The ADHD-RS-5 has several versions which correspond to different age groups (5-10 and 11-17) as well as different settings (home and school) and can also measure how ADHD symptoms can affect behavior such as hyperactivity/impulsivity, restlessness, and inattention.1,2
The diagnosis of ADHD in pediatrics
In order to be diagnosed with ADHD, 6 or more symptoms of inattention and/or hyperactivity/impulsivity must have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities.1
What to look for
Symptoms of inattention1
- Makes careless mistakes/lacks attention to detail
- Lacks sustained attention in tasks or play activities
- Poor listener, even in the absence of obvious distraction
- Fails to follow through on tasks and instructions
- Difficulty with organization, time management, and deadlines
- Avoids tasks requiring sustained mental effort
- Loses things necessary for tasks or activities
- Easily distracted (including unrelated thoughts)
- Forgetful in daily activities
Symptoms of hyperactivity/impulsivity1
- Fidgets, taps hands, or squirms in seat
- Leaves seat in situations when remaining seated is expected
- Excessive running/climbing or feelings of restlessness
- Difficulty with quiet, leisure activities
- Often “on the go”; acting as if “driven by a motor”
- Excessive talking
- Blurts out answers before questions are even completed
- Difficulty waiting turn
- Interrupts or intrudes on others
Several ADHD symptoms must be present in 1 or more settings1
In order to diagnose ADHD, symptoms must be persistent; confirmation of substantially impacting symptoms across settings typically cannot be accurately assessed without consulting observers who have seen the individual in the setting.
Symptoms may vary depending on setting/context. Below, you will find some examples of how ADHD may affect children and adolescents at home, at school, and in social settings:
At home1
- Is forgetful doing chores
- Has difficulty keeping materials and belongings in order
- Reluctant to engage in tasks that require sustained mental effort, such as homework
- Several inattentive or hyperactive impulsive symptoms are present in one or more settings (e.g., at home, school, or work; with friends or relatives; in other activities)
At school1
- Does not follow through on instructions and fails to complete assignments
- Overlooks or misses details in homework or schoolwork
- Often squirms in seat and leaves seat in classroom inappropriately
- There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning
In social settings1
- Does not seem to listen when spoken to directly
- Cannot wait for turn in conversation
- May intrude into, or take over, what others are doing during play activities
These are not the complete diagnostic criteria. Please see DSM-5 for full diagnostic criteria. It is important to note that diagnosis should be based on a complete clinical history of the patient.