Diagnosing ADHD
Online ADHD Self-Test
Diagnosing ADHD
Online ADHD Self-Test
Table of Contents
What is Attention Deficit Hyperactivity Disorder (ADHD)?
Commonly known by its acronym, ADHD, attention deficit hyperactivity disorder is a neurodevelopmental disorder that typically occurs in children but can also be diagnosed in adulthood. The symptoms or characteristics for diagnosing ADHD include:
- Difficulty concentrating or staying focused
- Difficulty staying organized
- Forgetfulness about completing tasks
- Difficulty sitting still
- Short attention span
Statistics About ADHD
How Many Children Have ADHD?
- According to a national 2016 parent survey, the number of children diagnosed with ADHD in the U.S. is 6.1 million (9.4%).1
388,000 of these children were aged 2 – 5, 2.4 million were aged 6 – 11 and 3.3 million were aged 12-17.1 - 12.9% of boys have been diagnosed with ADHD versus 5.6% of girls.1 Males are almost three times as likely to be diagnosed with ADHD than females.
- The average age for diagnosing ADHD diagnosis is 7 years old.2 Symptoms of ADHD in children typically tend to appear between the ages of 3 and 6.2
How Many Children Have ADHD?
In terms of diagnosing ADHD amongst adults, approximately 2.8% of adults worldwide have an ADHD diagnosis.3 Estimates within the U.S. vary between 0.96% to 4.4% of adults having an ADHD diagnosis.3 Men are more likely to be diagnosed with ADHD at a 5.4% diagnosis rate compared to a 3.2% rate in women.3
Has ADHD Been Increasing or Decreasing?
Cases of ADHD have been increasing over the past few years. Between 2003 and 2011, there was a 42% increase in the number of ADHD diagnoses. One factor that could account for this increase is a greater understanding and willingness to diagnose ADHD in children in the medical community. Additionally, with today’s children growing up in a world of technology, social media, and constant over-stimulation, it is no surprise that children may be struggling to stay focused on tasks for long periods. Because many of the symptoms for diagnosing ADHD are typical behaviors seen in children, ADHD can be difficult to diagnose and tell apart from normal behaviors that children grow out of.
Risk Factors for ADHD
While it is not entirely clear what causes ADHD, some of the risk factors include:4
- Gender: Boys are more likely to be diagnosed with ADHD than girls
- Genes: ADHD and similar disorders run in families
- Age: Children aged 3-6 are most likely to start experiencing symptoms
- Substance Use: Smoking, drinking, or drug use during pregnancy
- Toxins: A mother's exposure to environmental toxins during pregnancy
- Preterm Labor
- Mental Health: Mothers with mental health issues
- High Blood Pressure
- Environmental Toxins: A child's exposure to environmental toxins at a young age
- Low Birth Weight
- Head Injuries: Brain injuries or an other head injuries at a young age
Diagnosing ADHD with the DSM-5 Criteria
The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5), outlines the diagnostic criteria for ADHD.5 People with ADHD show persistent patterns of inattention and or hyperactivity/impulsivity that interferences with regular functioning and development.5 It is important to look at behavior in multiple settings when diagnosing ADHD. This includes school, home, work, with family or friends, and while doing other activities.
Inattention Symptoms and DSM-5 Criteria for Diagnosing ADHD
Symptoms of Inattention:5
- Failure to give close attention to detail, making careless mistakes in schoolwork, at work, or with other activities
- Trouble holding attention on tasks or activities
- Not listening when spoken to directly
- Not following through on instructions or failing to finish schoolwork, chores, or duties in the workplace
- Trouble organizing tasks and activities
- Avoiding, disliking, or being reluctant to do tasks that require mental effort over a long period of times (e.g. schoolwork or homework)
- Often losing items necessary to complete tasks and activities (such as school materials, pencils, books, tools, wallets, keys, paperwork, glasses, cellphone, etc.)
- Easily distracted
- Forgetful in daily activities
Criteria for Diagnosis:5
- 6 or more symptoms of inattention for children up to the age of 16
- 5 or more symptoms for adolescents over the age of 17 and for adults
- Symptoms of inattention must have been present for at least 6 months
- Symptoms are impeding development or quality of life
Hyperactivity and Impulsivity Symptoms and DSM-5 Criteria for Diagnosing ADHD
Symptoms of Hyperactivity and Impulsivity:5
- Fidgeting with or tapping hands/feet, squirming in seat
- Leaving seat in situations where remaining seating is expected
- Running around or climbing things in inappropriate situations (restlessness)
- Inability to play or take part in leisure activities quietly
- Often “on the go” and acting as if “driven by a motor”
- Talking excessively
- Blurting out answers before the question has been completed
- Trouble waiting their turn
- Interrupting or intruding on others
Criteria for Diagnosis:5
- 6 or more symptoms of hyperactivity/impulsivity in children up to the age of 16
- 5 or more symptoms in adolescents over 17 and adults
- Symptoms of hyperactivity/impulsivity have been present for at least 6 months
- Symptoms are disruptive and inappropriate for the person’s developmental level
Additional Conditions that Must Be Met When Diagnosing ADHD
- Several inattentive or hyperactive-impulsive symptoms were present before the age of 12
- Several symptoms are present in two or more settings (home, school, work, with friends or relatives, during other activities)
- There is clear evidence that the symptoms interfere with or reduce the quality of social, school or work functioning
- Symptoms are not better explained by another mental disorder and symptoms do not occur only during the course of schizophrenia or another psychotic disorder5
Three Types of ADHD
Based on the symptoms listed above, three kinds of ADHD can be diagnosed:
- Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months
- Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months
- Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months
Diagnosing ADHD with the ICD-10 Criteria
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) labels ADHD as hyperkinetic disorder (HDK).6 The ICD-10 defines HKD as “a persistent and severe impairment of psychological development, characterized by “early onset; a combination of overactive, poorly modulated behavior with marked inattention and lack of persistent task involvement; and pervasiveness over situations and persistence over time of these behavioral characteristics.”6 The criteria used by the ICD-10 to diagnose HKD are:6
- The main symptoms of HKD are impaired attention and over-activity. Both are necessary for diagnosing ADHD.6
- Impaired Attention: manifested by a lack of persistent task involvement and a tendency to move from one activity to another without completion
- Over-activity: characterized by restlessness, talkativeness, noisiness, and fidgeting, particularly in situations requiring calm
- Early onset: behavioral symptoms present prior to 6 years of age, and are of long duration
- Settings: the impairment must be present in two or more settings (e.g. home, classroom, clinic)
- Exclusions: diagnosis of anxiety disorders, mood affective disorders, pervasive developmental disorders and schizophrenia must be excludedAdditional symptoms that the ICD-10 has recognized but are not necessary nor sufficient for a HKD diagnosis are:6
- Disinhibition in social relationships
- Recklessness in dangerous situations
- Non-adherence to social norms (interrupting, intruding on others, prematurely answering questions, difficulty waiting your turn)
The ICD-10 also notes that impaired attention should be considered in comparison to what is expected at that child’s age and IQ and over-activity should be considered in the context of what is expected in a situation and comparison to other children of the same age and IQ.6
What Makes ADHD Worse?
While ADHD can’t be cured, there are ways that improve and manage ADHD and there are activities that can trigger and make ADHD worse.
Ways to make ADHD worse include:
Stress
Stress can be particularly triggering for adults with ADHD. ADHD can also increase stress since people with ADHD might have trouble focusing, may feel over-stimulated, and have a harder time winding down and relaxing. For children, family stress can make symptoms of ADHD worse as children may have trouble processing the stress.
Poor Sleep
A lack of sleep can worsen ADHD symptoms such as inattention, drowsiness, and lack of concentration. It can also decrease performance at work or in school and increase hyperactivity if substances are used to stay awake.
Foods and Additives
Certain foods and additives can make ADHD symptoms worse in some people. These includes:
- Foods that are high in sugar
- High-fat foods
- Foods with additives such as:
- Sodium benzoate
- MSG
- Red and yellow dyes
Foods that may help with ADHD symptoms have nutrients such as:
- Proteins
- Fatty acids
- Calcium
- Magnesium
- Vitamin B
Overstimulation
Overstimulation such as bright or flashing lights, loud sounds, and crowded areas can worsen ADHD symptoms and lead to feelings of being overwhelmed and overstimulated. Avoiding these triggers can help get in front of ADHD symptoms.
Technology
Technology and excess screen time can cause overstimulation and make ADHD symptoms worse. Children balance technology use and active activities such as going outside and playing sports.
Trauma
Studies show that repeated exposure to trauma at a young age can increase a child’s risk of toxic stress which can exacerbate symptoms of ADHD.
Complications from ADHD
Although most people can function fairly normally with ADHD, it can create complications and lead to other issues. These include:
Academic Difficulties
Children with ADHD may struggle to stay focused in school and on school work. They might have a harder time paying attention and staying seated during class.
Poor Work Performance
Adults with ADHD may struggle in the workplace when trying to concentrate on tasks and stay focused.
Unemployment
ADHD may make it harder to maintain employment or to find employment for some people.
Low Self-Esteem
People who live with ADHD symptoms may deal with low self-esteem due to feeling like they’re not good enough or smart enough simply because they may struggle with things that other people do not struggle with. Children who have ADHD may have a harder time at school or may be made fun of, which can lead to low self-esteem.
Coexisting Conditions
Approximately two-thirds of children with an ADHD diagnosis also have at least one other coexisting condition.3 This could be:
- Learning differences
- Conduct disorder
- Anxiety disorder
- Depression
- Bipolar disorder
- Tourette’s Syndrome
- Substance use disorders
- Bed-wetting
- Sleep disorders
- Anti-social behavior
Statistics surrounding coexisting conditions are:3
- 51.5% of children with ADHD have a behavioral disorder
- 32.7% have an anxiety disorder
- 16.8% have depression
- 13.7% have an autistic spectrum disorder diagnosis
- 1.2% have Tourette syndrome
- 45% have a learning disorder
Children with ADHD are 12 times more likely to have a Loss of Control Eating Syndrome which is an eating disorder like binge eating.3
What Can Parents Do?
Learn
In addition to different forms of ADHD treatment, parenting is an important part of your child’s success. It is important first and foremost for parents to understand ADHD and how it affects their child. Every child is different and has different symptoms. It’s best to know exactly what triggers your child and how to navigate that. It can be easy to become frustrated with children when they are hyperactive, don’t finish tasks you assigned them, or don’t pay attention well. Understanding ADHD can also help you communicate with your child more effectively and help them to manage their symptoms.
Be Involved
It is also important for parents to be involved. As a parent, you have a right to be involved in treatment, medication, dosage, doctor’s appointments, and in your child’s schooling. Parent advocacy at school may be necessary to ensure your child is receiving the resources and help to succeed.
Support Groups
Lastly, there are many support groups that parents can join where they can find tools and resources to help their children succeed. Other parents who have had similar experiences can also be a great community where you can lean on the support of others.
When to See a Professional?
If you suspect that your child may be struggling with ADHD, it may be time to see a doctor. Once you receive a diagnosis for ADHD, professionals such as therapeutic educational consultants, case managers, and therapists can help in your child’s treatment and academic success.
- Therapeutic educational consultants can help create an educational plan that works best for your child
- Case managers can help you to stay on top of your child’s appointments and connect you with the correct professionals and treatments in the medical field
- Therapists take part in ADHD counseling to help manage the symptoms and support your child’s success in school
- Professionals can help you with this process. You don’t have to do this alone
Resources
- https://www.cdc.gov/ncbddd/adhd/data.html
- https://www.healthline.com/health/adhd/facts-statistics-infographic#fast-facts
- https://www.additudemag.com/statistics-of-adhd/#footnote5
- https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
- https://www.cdc.gov/ncbddd/adhd/diagnosis.html
- https://adhd-institute.com/assessment-diagnosis/diagnosis/icd-10/
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