All children exhibit some behaviors consistent with ADHD at some point. Inability to sit still and pay attention for extended periods of time is typical in young children. However, when these behaviors persist and begin to affect the child’s ability to function and socialize, ADHD may be the culprit. A doctor or mental health professional can provide insight into whether your child’s behaviors are typical, or if they might be indicative of ADHD.
DSM-IV Diagnostic Criteria
The American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) outlines specific criteria for an ADHD diagnosis. According to these guidelines, ADHD symptoms fall into three categories, applicable to ADHD in children as well as ADHD in adults:
- Begins tasks without waiting for instruction
- Has trouble waiting for a turn
- Interrupts others in conversation.
- Appears to “zone out” or not pay attention
- Avoids tasks requiring sustained attention
- Frequently forgets directions or leaves items behind
- Has trouble organizing and executing tasks
- Makes careless mistakes.
- Feels compelled to keep moving
- Frequently moves or fidgets
- Moves, walks or runs when expected to stay still or seated
- Has difficulty waiting
- Talks constantly.
To be diagnosed as ADHD, these symptoms must appear before the age of seven. Symptoms must last for at least six months in a variety of contexts (e.g., at home, with peers and in the classroom), and the symptoms must be disruptive to everyday routines.
Three ADHD Types
ADHD cases can be classified in three categories, based on a person’s most prominent symptoms. These types are:
- Combined type (signs of all three types of symptoms)
- Predominantly hyperactive/impulsive type
- Predominantly inattentive type.
How is ADHD Diagnosed?
Like many other neurobiological conditions, no specific medical test exists to diagnose ADHD; therefore, diagnosing ADHD can be challenging. A qualified mental health professional can complete a comprehensive battery of tests to examine intelligence and language skills. Observation of behavior during testing appointments, as well as a parent’s reports about behavior in different contexts, can help make a diagnosis.
Doctors will also discuss risk factors with you; the presence of these factors increases the odds that your child is presenting with ADHD. Risk factors include:
- Exposure to toxins in utero or during early childhood
- Family history of ADHD
- Maternal smoking or drug use during pregnancy.
Differential diagnosis involves identifying a person’s specific condition and ruling out other conditions that may have similar symptoms. Your child’s pediatrician can help rule out a medical basis for your child’s symptoms. He may order and analyze blood tests or other physical examinations to rule out problems such as metabolic disorders, thyroid problems or toxin exposure.
Interviews with mental health professionals can also help to differentiate ADHD from other conditions affecting mental health. Conditions that can resemble ADHD include:
- Autism spectrum disorders
- Child abuse
- Mood disorders (such as bipolar disorder, anxiety and depression)
- Oppositional defiant disorder or conduct disorder
- Tourette’s syndrome.
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Centers for Disease Control. (2010). Facts about ADHD. Retrieved August 11, 2010, from http://www.cdc.gov/ncbddd/adhd/facts.html.
Centers for Disease Control. (2010). ADHD symptoms and diagnosis. Retrieved August 11, 2010, from http://www.cdc.gov/ncbddd/adhd/diagnosis.html.
Mayo Clinic. (2009). Attention-deficit/hyperactivity disorder (ADHD). Retrieved August 10, 2010, from http://www.mayoclinic.com/health/adhd/DS00275/.
Medline Plus. (2010). Attention deficit hyperactivity disorder (ADHD). Retrieved August 10, 2010, from http://www.nlm.nih.gov/medlineplus/ency/article/001551.htm.