ADHD Symptoms and Diagnosis

ADHD Symptoms and Diagnosis

The symptoms of ADHD are broadly defined as problems with attention or hyperactive / impulsive behavior, but the presentation of ADHD can be quite complex.

The parents, schoolteachers, or other caretakers of a child with ADHD may experience some of the following situations at home, school, or elsewhere:

  • The child is given a task: “Please gather the dirty clothes from your room and bring them into the laundry room.”  Ten minutes later, the child is found playing in his room, having not retrieved his laundry.  The child is not being defiant.  He began with the intention of gathering his laundry but was quickly distracted and soon forgot about the task altogether.
  • The child completes a task but omits steps or other details (distractibility and forgetfulness).
  • The child fails to complete school assignments, and, despite seeming intelligent and capable of succeeding, he consistently makes poor grades in school (distractibility and forgetfulness).
  • The child seems not to listen when spoken to (distractibility).
  • The child tends to misplace or lose things frequently (distractibility and forgetfulness).
  • The child fidgets, squirms, or cannot stay seated (hyperactivity).
  • The child is constantly moving, running, or climbing (hyperactivity).
  • The child is frequently in trouble for misbehaving at school (hyperactivity and impulsivity).
  • The child blurts out responses when being spoken to, has trouble waiting his turn, or interrupts when others are speaking (impulsivity).

In adolescence and adulthood, hyperactivity symptoms become less prominent, and impulsive behavior becomes the predominant feature, with inattentiveness remaining a problem as well.  The following characteristics are often seen in adolescent and adult ADHD patients:

  • Difficulty completing tasks at work, possibly resulting in firing and frequent job changes.
  • Feelings of restlessness and difficulty relaxing.
  • Frequent missing of appointments, deadlines, and other commitments.
  • Maintaining a messy or disorganized work space.
  • Exhibiting socially inappropriate behavior, such as impulsively blurting out rude or insulting comments.
  • Frequent discipline for irresponsible behavior, such as speeding tickets or even arrests.
  • Impulsive spending and difficulty managing finances.

    The “DSM-IV” reference book has the
    final word in diagnosing mental disorders

Diagnosis of ADHD is made purely on history of ADHD symptoms and documentation of their impact on the day-to-day function of the child or older patient.  There is no diagnostic blood test, and, though researchers have noted differences when the brain is visualized by MRI or PET scanning between patients with and without ADHD, no imaging test is currently used for diagnosis.  However, it is necessary that a qualified medical professional evaluate the history and make the diagnosis, since many of the symptoms of ADHD may also represent such other disorders as depression or anxiety, which require different treatments.

The most commonly used criteria are from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), published by the American Psychiatric Association.  These criteria look for symptoms of inattention and/or hyperactivity / impulsivity.  The symptoms must be present in more than one setting (e.g. home, school, work) and must significantly impair daily functioning.  At least some of the symptoms must have been present before the age of 7, and other psychiatric disorders must be ruled out.  Take our interactive questionnaire (based on the DSM-IV criteria) to see if your child’s or your symptoms are consistent with ADHD.  If so, speak with your physician.  He or she will use these or other criteria combined with clinical judgment to assess whether ADHD is present and whether treatment is warranted.

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