According to the DSM V
Attention Deficit Hyperactivity Disorder – the diagnosis requires symptoms to be:
- present for 6+ months,
- in 2+ different settings,
- show negative impact on the child’s functioning (in academic/occupational or social realms) and development, and
- not caused by another mental disorder.
- Remember this assessment should be made according to the developmental level of the child.
- Of note, 6+ is for those up to age 16, and 5+ for 17y+ and adults.
- Symptoms must have been present before 12 years of age.
What are the types?
Inattentive (6+ required up to 16, 5+ for 17 and older)
- little or no attention to detail, careless mistakes: schoolwork/work/other activities
- difficulty holding attention on tasks or play activities (must differentiate between something they may find boring and something interesting)
- doesn’t seem to listen when spoken to directly
- does not follow through: schoolwork, chores, work duties
- difficulty organizing tasks and activities
- avoids/dislikes/reluctant to do tasks that require mental effort over long period of time
- loses things necessary for tasks and activities
- easily distracted
- forgetful in daily activities
Hyperactive/Impulsive (6+ if 16 and under, and 5+ of 17 and over)
- fidgeting/tapping hands or feet, squirming in seat
- leave seat in situations where remaining seated is expected
- runs about or climbs in situations where it is not appropriate
- unable to play or take part in leisure activities quietly
- “on the go”, “driven by a motor”
- talks excessively
- blurts out answers before question is completed
- trouble waiting their turn
- interrupts or intrudes on others
- 6+ of both types
They can be graded as mild/moderate/severe, based on the number of symptoms in excess of the ones required to make a diagnosis, and functional impairment within the social or academic/occupational realms.
SNAP IV questionnaire:
Used at the initial visit and also to gauge effectiveness of medication, once started. This is filled out by both the school and the home.
Other things to think about:
- are there comorbidities (i.e., anxiety, depression, learning disability, ASD, other mental health disorder)
- social environment
- suspect in those who are older and depressed, as this may have been an undiagnosed ADHD and compensation with depression, anxiety and low self esteem may result.
- girls tend to be missed more than boys as they tend to have more outbursts at younger ages