Do I have ADHD? Does my child have ADHD? Simple words, but the answer to this question can be life changing for people and/or parents who are unsure as to whether or not they or their child have attention deficit hyperactivity disorder (ADHD). It amazes me in this age of advance science, technology and media, how misunderstood ADHD still is. On a daily basis I talk to medical professionals, teachers and parents, who are still confused about the symptoms, terminology, diagnoses and treatment of ADHD. If I might be so bold…I have a dream…that one day in my lifetime, the treatment and understanding of ADHD will be no more mysterious than other natural health disorders.

Being diagnosed properly is important and includes multiple steps, input from several different people and the presence of specific problems or symptoms consistent with ADHD. I believe knowledge equals choice, which is why I am writing this week’s article about how the diagnosis of ADHD is made. I hope it will explain the initial diagnostic process in understandable language, so you can make an informed choice as to what your next steps might be. In essence I am going to try and do what my grandmother always said was not possible…make a silk purse out of a sows ear!

Simply, ADHD is a medical disorder caused by insufficient or inefficient amount of the neurotransmitter, dopamine, getting to the frontal lobe of the brain which impairs the full functioning of that part of the brain. Because it involves the brain and mental health it falls under the medical specialty of psychiatry. Just like cardiologists specialize in heart related conditions, a psychiatrist specializes in the diagnosis and treatment of mental disorders. Psychiatrists and other mental health professionals licensed to diagnose ADHD (psychologists, family doctors, nurse practitioners, neurologist, master level counselor, social worker with an MSW or LCSW) are guided in their mental health diagnoses by a standardized manual, called the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).

This manual was published in 1994 (DSM IV) and since then science and research has helped us to understand much more about ADHD. For instance, in 1994 it was thought that ADHD was outgrown in adolescence. We now know that ADHD is a lifelong disorder. A new updated edition of the Diagnostic and Statistical Manual of Mental Disorders is scheduled to be published in 2013 and will reflect these new understandings of ADHD. Until then, diagnosing ADHD in Adults is complicated because the current standard does not necessarily include the option of being first diagnosed with ADHD as an adult…unless someone can remember back to when they were under seven years old which is not always possible for people with ADHD. So, using the standards and criteria currently available, this article will explain how ADHD is diagnosed. I will talk next time about what currently is being used (despite the limitations of the DSM IV) to help diagnose ADHD in adults.

So here goes…remember sow’s ear…silk purse….after one final note of clarification!

“ADHD” is the correct overall umbrella term used for all of the attention-deficit disorders. The diagnosis is further broken down to three sub types of ADHD; inattentive, hyperactive or a combined type of ADHD. Correctly stated, a diagnosis of inattentive type of ADHD would be something like,” I have ADHD, inattentive type”, or for someone who has inattentive and hyperactive type, a person would correctly say, “I have ADHD, combined type”. Or finally, for someone who has fits the criteria for the hyperactive type of ADHD, they might say, “I have ADHD, hyperactive type”. Make sense? Over the years, the acronym “ADD” has become synonymous with “ADHD” even though correct terminology does not include the term “ADD” at this time.

So…Do I have ADHD? Or does my child have ADHD? Let’s look at the DSM IV criteria:

The essential part of having attention deficit hyperactivity disorder is the continual problem individuals have with inattention and/or hyperactivity-impulsivity that is more consistent and severe than is typical for someone of the same age. In addition, these challenges or symptoms need to have been present for the person before the age of seven, even though many people are diagnosed after many years of struggling. Finally, the inattention and/or hyperactivity-impulsivity need to be causing problems in at least two different areas of their lives (e.g., academics, work, home, or social ).
As an overview, to be diagnosed with “inattentive” type of ADHD, an individual needs:

1.To have experienced six or more of the following symptoms, and
2.The symptoms have to have significantly impaired their functioning in at least two different areas of their life (school, home, work, social). This means that even though a parent may notice these symptoms and suspect a diagnosis, a medical diagnosis cannot be made until it is collaborated by someone from a different “life setting” such as a teacher.
3.To be diagnosed with ADHD , the problems need to have lasted for more than six months, and
4.The behavior noticed before the person was seven years old and
5.Be more severe or problematic compared to others of their age level
Diagnostic Criteria for Attention Deficit Hyperactivity Disorder, Inattentive type:

•Fails to give close attention to details or makes careless mistakes
•Difficulty sustaining attention on things that are not as interesting
•Does not seem to listen
•Failure to follow through
•Difficulty organizing
•Avoids tasks that require sustained mental effort
•Often loses things
•Easily distracted
•Forgetful in daily activities

Diagnostic criteria for Attention Deficit Hyperactivity Disorder, Hyperactive-Impulsive type: with “hyperactive” type of ADHD, someone needs to have experienced six or more of:

•Fidgets, squirms
•Leaves seat
•Often runs about
•Difficulty playing or engaging in leisure activities
•Always “on the go”
•Talks excessively
•Blurts out answers before question completed
•Difficulty awaiting turn
•Often interrupts

To be diagnosed with the “combined” type of ADHD, an individual would need to be experiencing six or more of the symptoms in both from the “inattentive” and “hyperactive” areas, the symptoms noticed before the person was seven years old, significantly impair their functioning in at least two major areas of their life and be inconsistent with their developmental level.

Finally, it is important that other medical causes for these symptoms have been ruled out. Common medical conditions that can cause symptoms similar to ADHD include: poor eyesight, thyroid disorders, hearing disorders or allergies.

If after reading this you think you or your child may have ADHD, please contact your medical professional for follow up.

Leave a reply and be looking for next week’s newsletter “Adult ADHD Symptoms” a list of symptoms for adults that might indicate the diagnosis of ADHD.