What Qualifies as Attention Deficit Disorder? ADHD Symptoms Explained
What behaviors qualify as attention deficit disorder? To receive an ADHD diagnosis, children or adults must demonstrate six of these nine symptoms of inattention and/or hyperactivity-impulsivity in at least two settings over six months or more.
Doctors diagnose attention deficit disorder (ADHD or ADD) using detailed criteria spelled out in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). In its entry on attention deficit, the DSM-V lists nine symptoms that suggest ADHD – Primarily Inattentive and nine that suggest ADHD – Primarily Hyperactive-Impulsive.
ADHD Symptoms in Children and Adults
A child may be diagnosed with ADHD only if he or she exhibits at least six of nine symptoms from one of the lists below, and if the symptoms have been noticeable for at least six months in two or more settings — for example, at home and at school. What’s more, the symptoms must interfere with the child’s functioning or development, and at least some of the symptoms must have been apparent before age twelve. Older teens and adults may need to consistently demonstrate just five of these symptoms in multiple settings.
ADHD – Primarily Inattentive Type (Formerly Known as ADD)
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
- Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
- Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
- Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
- Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
- Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
- Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
ADHD – Primarily Hyperactive-Impulsive Type
- Often fidgets with or taps hands or feet or squirms in seat.
- Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
- Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
- Often unable to play or engage in leisure activities quietly.
- Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
- Often talks excessively.
- Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).
- Often has difficulty waiting his or her turn (e.g., while waiting in line).
- Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
ADHD Symptoms in Girls
ADHD symptoms can present quite differently in girls and women. As such, psychologist Kathleen Nadeau, Ph.D. has devised an ADHD symptoms checklist specifically for girls. It should be filled out by girls themselves, not parents and teachers, because girls experience ADHD more internally than do boys, who get attention with unruly behavior.
Many of Nadeau’s questions apply to boys, since they pertain to problems with productivity, general distractibility, impulsivity, hyperactivity, and sleep problems. The following statements, however, are particularly oriented toward girls, and each one should be answered with Strongly Agree, Agree, Uncertain, Disagree, or Strongly Disagree:
Anxiety and Mood Disorders
- I often feel like I want to cry.
- I get a lot of stomachaches or headaches.
- I worry a lot.
- I feel sad, and sometimes and I don’t even know why.
- I dread being called on by the teacher because, often, I haven’t been listening carefully.
- I feel embarrassed in class when I don’t know what the teacher told us to do.
- Even when I have something to say, I don’t raise my hand and volunteer in class.
- Sometimes, other girls don’t like me, and I don’t know why.
- I have arguments with my friends.
- When I want to join a group of girls, I don’t know how to approach them, or what to say.
- I often feel left out.
- I get my feelings hurt more than most girls do.
- My feelings change a lot.
- I get upset and angry more than other girls do.
A child can meet all the diagnostic criteria for ADHD without actually having the disorder. In order to deliver a definitive diagnosis, a clinician must see clear evidence that the symptoms reduce the quality of social, academic, or job-related functioning.
If a child meets the diagnostic criteria, but doesn’t have ADHD, parents should explore other possible explanations for her symptoms. Perhaps she is just unusually “spirited.” Maybe she isn’t eating right, or getting enough exercise. Or the child may be affected by one or more “look-alike” conditions such as anxiety disorder, oppositional defiant disorder, or learning disabilities.
Physical conditions (such as food allergies, hearing loss, or an environmental allergy) or another medical disorder (such as auditory processing disorder, sensory integration disorder, or a mood disorder) can present symptoms that closely resemble those of ADHD.