Diagnosis

In order to meet diagnostic criteria, ADD/ADHD behaviors must be excessive, long-term, and pervasive. The behaviors must appear before age 7, and continue for at least six months. A crucial consideration is that the behaviors must create a real handicap in at least two areas of a personís life -- school, home, work, or in social settings. These criteria set ADHD apart from the ěnormalî distractibility and impulsive behavior of childhood, or the effects of the hectic and overstressed lifestyle prevalent in our society.

Over the past twenty years research, diagnosis and treatment options for ADHD have grown enormously. However, treatment for a person with ADD varies greatly, ranging from a brief office visit to a thorough, multi-disciplinary evaluation. Because of the varying levels of care, ADHD is both over-diagnosed and under diagnosed. It is both over-treated and under-treated.

A number of disorders mimic ADD/ADHD symptoms or may accompany ADD/ADHD. Such disorders include Oppositional Defiant Disorder, Bipolar Disorder (manic depression), lead poisoning, Hyperthyroidism, Post Traumatic Stress Disorder, or Sleep Apnea/sleep deprivation.

Comprehensive evaluations are extremely important and should include a complete individual medical, academic, and family history, ability tests, achievement tests, and the collection of observations from people who are close to the person who is being assessed. It is also extremely important to use a combination of assessment tools that can uncover co-existing conditions such as learning disabilities and behavior, mood or anxiety disorders, food allergies, sleep disorder or sleep apnea, or any other problems that could be causing symptoms that resemble ADHD.

In its Guiding Principles, the National Attention Deficit Disorder Association, a consumer advocacy organization, has outlined what it considers to be the essential and critical components of high quality diagnosis/assessment and treatment.

  1. Evaluate and treat the whole person
  2. ADHD should be suspected but not presumed
  3. ADHD may present across the life span
  4. A comprehensive assessment is necessary for an accurate diagnosis
  5. The evaluation and treatment of ADHD should be conducted by a qualified professional including appropriately trained and experienced psychiatrists, pediatricians, internists, family physicians, psychologists, social workers, professional counselors and psychiatric nurses.
  6. Response to medication should not be used as the basis to diagnosis ADHD
  7. Diagnosis should be based primarily upon the DSM-IV ADHD criteria.
  8. Diagnosis and treatment of ADHD should involve others familiar with the person undergoing the evaluation
  9. Treatment should often involve more than one discipline working cooperatively.
  10. Practitioners should become familiar with current research and diagnostic tools.

Click ADDA Guiding Principles to read the complete text accompanying the principles.