Diagnosing ADHD

June 18th, 2009 at 03:16pm Mitchell F. Davenport

In my last blog, I concluded that “ADHD is a debilitating disorder causing trouble for the child, the parents, and the teachers.”  I also promised to address the issue of how ADHD is diagnosed.  To make a formal diagnosis of a mental disorder in the USA, the Diagnostic and Statistical Manual of Mental Disorders, IV (DSM IV) is the most often used standard in diagnosing.  It is published by the American Psychiatric Association and groups symptoms under certain labels that we call a diagnosis.  In the medical field, you might go to the doctor with a stomach ache and the doctor tells you that you have appendicitis.  “Appendicitis” is the diagnosis.

In the DSM there are 3 types of ADHD:

·         ADHD, Inattentive Type

·         ADHD, Hyperactive/Impulsive type

·         ADHD, Combined Type

Whenever diagnosing children, it is important to keep their developmental stage in mind.  Behaviors that are “normal” for one developmental stage may not be “normal” for another.  According to the DSM, in order to have ADHD, Inattentive Type, the child must have at least six of the following: 1) often fails to give close attention to details or makes careless mistakes in schoolwork; 2) has difficulty sustaining attention in tasks or play activities; 3) often does not seem to listen when spoken to directly; 4)Often does not follow through on instructions and fails to finish things; 5) has difficulty organizing tasks and activities; 6)avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort;  7) often losing things; is easily distracted; 9) is forgetful  during daily activities.

Besides having six of the nine symptoms listed above, these behaviors must cause impairment in the child’s daily functioning and be present in two or more environments.  For example, a child who displays the above symptoms at school but not in other environments would not be diagnosed with ADHD.  The assumption being that since ADHD is a brain based disorder, if present, it should manifest in most or all of the child’s environments.   If it only manifests in one environment then there is probably something particular to that environment that needs to be adjusted as opposed to diagnosing (and medicating) a child with ADHD.

We will look at the other two forms of ADHD in my next blog.

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