Diagnosing ADHD

Key points

• Diagnosing ADHD is a process with several steps.
• If you think someone might have ADHD, the first step is to talk with a healthcare provider.

How is ADHD diagnosed?

Deciding if a person has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, such as sleep disorders, anxiety, depression, and certain types of learning disabilities, can also have symptoms similar to ADHD.

When to talk with a doctor‎

If you are concerned about whether someone might have ADHD, the first step is to talk with a healthcare provider to find out if the symptoms fit an ADHD diagnosis. The diagnosis can be made by a mental health professional, like a psychologist or psychiatrist, or by a primary care provider, like a pediatrician.

Diagnosing ADHD in children

The healthcare provider will look to determine whether the child has another condition or conditions that might explain the symptoms better, or that can often occur at the same time as ADHD.

For children, the American Academy of Pediatrics (AAP) recommends1 that healthcare providers ask parents, teachers, and other adults who care for the child about the child’s behavior in different settings, including at home, school, or with peers. Read more about recommendations for the diagnosis and treatment of children and adolescents with ADHD.

Keep Reading: Family Health History, ADHD, and Learning Disorders

Diagnosing ADHD in adults

ADHD often lasts into adulthood. Symptoms might look different at older ages. For example, in adults, hyperactivity may appear as extreme restlessness or wearing others out with their activity. Find out more about ADHD in adults.

For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institute of Mental Health.

DSM-5 criteria for ADHD

Healthcare providers use the guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition (DSM-5),2 to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. Using the same standard across communities can also help determine how many children have ADHD, and how public health is impacted by this condition.

The number of symptoms required for an ADHD diagnosis (by age group) are as follows:‎

■ Six or more symptoms of inattention and/or hyperactivity-impulsivity for children up to age 16 years, OR

■ Five or more symptoms of inattention and/or hyperactivity-impulsivity for adolescents ages 17 years and older and adults.

People with ADHD show a persistent pattern of inattentionA and/or hyperactivityB–impulsivityC that interferes with functioning or development:

DSM-5 criteria for ADHD diagnosis ‎

Included below are the DSM-5 criteria in shortened form. Please note that they are presented just for your information. Only trained healthcare providers can diagnose or treat ADHD.

Inattention

Symptoms

NOTE: Symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level.

• Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
• Often has trouble holding attention on tasks or play activities.
• Often does not seem to listen when spoken to directly.
• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
• Often has trouble organizing tasks and activities.
• Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
• Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
• Is often easily distracted.
• Is often forgetful in daily activities.

Hyperactivity-impulsivity

Symptoms

NOTE: Symptoms of hyperactivity-impulsivity have been present for at least 6 months, and they are inappropriate for the person’s developmental level.

• Often fidgets with or taps hands or feet, or squirms in seat.
• Often leaves seat in situations when remaining seated is expected.
• Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
• Often unable to play or take part in leisure activities quietly.
• Is often “on the go” acting as if “driven by a motor.”
• Often talks excessively.
• Often blurts out an answer before a question has been completed.
• Often has trouble waiting their turn.
• Often interrupts or intrudes on others (e.g., butts into conversations or games).

In addition to the above criteria, the following conditions must also be met:

• Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
• Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).
• There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
• The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institute of Mental Health.