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How is ADD diagnosed?

by Dr.James Lawrence Thomas, Director, The Brain Clinic, New York, NY
In the mental health fields of psychiatry and psychology, there are "official" criteria for the diagnosis of ADD. The 18 symptoms are broken into three parts—the Inattentive, Hyperactive and Impulsive symptoms, and these are below, simplified from the official diagnostic manual. The person, child or adult, can exhibit the following problems worse than others the same age:

Part A: Inattentiveness
  1. Fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
  2. Has difficulty sustaining attention in tasks
  3. Does not seem to listen to what is being said to him/her
  4. Does not follow through on instructions and fails to finish schoolwork, chores, or workplace duties
  5. Has difficulties organizing tasks and activities
  6. Avoids or strongly dislikes tasks (such as schoolwork or homework) that require sustained mental effort
  7. Loses things necessary for tasks or activities (e.g., school assignments, pencils, books, tools, or toys)
  8. Is easily distracted by extraneous stimuli
  9. Is forgetful in daily activities

    Part B: Hyperactivity

  10. Fidgets with hands or feet or squirms in seat
  11. Leaves seat in classroom or in other situations in which remaining seated is expected
  12. Often runs about or climbs excessively in situations where it is inappropriate. In adolescents or adults, may be limited to subjective feelings of restlessness
  13. Has difficulty playing or engaging in leisure activities quietly
  14. Often "on the go" or often acts as if "driven by a motor"
  15. Often talks excessively

    Part C: Impulsivity

  16. Blurts out answers to questions before the questions have been completed
  17. Has difficulty waiting in lines or awaiting turn in games or group situations
  18. Often interrupts or intrudes on others
If you have 6 of the first nine symptoms, then you qualify for being the Inattentive type. If you have six of the second nine (10-18), then you qualify as the Hyperactive-Impulsive type. Having six of each of these groups, you are the combined type.

There are some other criteria necessary in order to have the diagnosis of ADD. These include the idea that these symptoms started before the age of seven years old, and that there are problems in more than one environment (such as work/school and home). In addition, the symptoms should not be due to some other psychiatric disorder. For this reason, it is recommended that psychological and neuropsychological testing be done so that the diagnosis can be clarified. It is worth keeping in mind that these diagnostic categories are not perfect, and there are many variations between people—as many people as have this diagnosis.

There is another issue worth mentioning, and which will become the topic of another complete article, and that is the topic of co-morbidity. This sounds worse than it is. All it means is that the person has another disorder along with ADD. The most common are obsessive-compulsive disorder, learning disabilities, depression, and anxiety. Treatment is available for ADD and these other problems, so never give up hope. Help is available. Never give up.

Dr. James Lawrence Thomas is the director of The Brain Clinic in New York City. He can be reached at: (212) 268-8900 or See the Brain Clinic online here.

Disclaimer: Internet Special Education Resources (ISER) provides this information in an effort to help parents find local special education professionals and resources. ISER does not recommend or endorse any particular special education referral source, special educational methodological bias, type of special education professional, or specific special education professional.
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