Diagnosing ADHD

There are two major classificatory systems for diagnosing ADHD, one is DSM-IV/DSM-IV-TR and another is ICD-10. The first is published by APA and the second one by World Health Organization (WHO)

DSM-IV Criteria for ADHD is as follows- 
 
Inattention

1.      Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.

2.      Often has problem in focusing attention on tasks or play activities.

3.      Often does not seem to listen when spoken to directly.

4.      Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (should not be because of oppositional behavior or failure in understanding the instructions).

5.      Often has problem in organizing the tasks or activities.

6.      Often avoids, dislikes, or doesn't want to do things that require a good deal of mental effort for a sufficiently long period of time (such as schoolwork or homework).

7.      Often loses or forgets the things that are needed for tasks/activities (e.g. toys, school assignments, pencils, books, or tools).

8.      Is often easily distracted or attentions gets diverted easily.

9.      Is often forgetful in daily activities.

Hyperactivity

1.      Frequently fidgets with hands or feet or squirms in seat.

2.      Frequently leaves the seat when remaining seated is expected as per norms.

3.      Frequently runs about or climbs when and where it is inappropriate (adolescents or adults may feel very restless or unable to relax).

4.      Frequently has trouble in playing or enjoying leisure activities without making noise.

5.      Frequently "on the go" or Frequently acts as if "driven by a motor".

6.      Frequently talks excessively that is situational inappropriate.

Impulsivity

1.      Frequently provide or speaks answers before questions have been finished.

2.      Frequently has trouble in waiting for his/her turn.

3.      Frequently interrupts or intrudes on others’ conversation or games

How to diagnose:

Ø      For the diagnosis of ADHD, Predominantly Inattentive Type six or more symptoms should be there from the inattention area.

Ø      For the diagnosis of ADHD, Predominantly Hyperactive-Impulsive Type six or more symptoms should be there from the hyperactive and impulsive areas.

Ø      The symptoms should be disruptive and inappropriate for the developmental level.

Ø      The symptoms should be there for at least six months.

Ø      The symptoms related impairment should be there before the age of 7 years.

Ø      The symptoms should be present in at least two settings.

Ø      There should be significant impairment in the functioning of the child.

Ø      For differential diagnosis, Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder, Mood Disorder, Anxiety Disorder, Dissociative Disorder, Personality Disorder should be considered.

In ICD-10 it is classified as Hyperkinetic Disorder and it requires meeting the criteria for both- inattentive and hyperactive-impulsive areas. Thus it gives low prevalence of the disorder.

There are several psychological tests that help in the diagnosis of ADHD. Some of these measure attention and executive functions and others are rating scales. The rating scales are very frequently used and these are filled by parents, teachers and by the self.
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