ADD/ADHD

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is among the most prevalent mental health conditions affecting children.

Its symptoms typically include:

  • Inattention: Difficulty maintaining focus or being easily distracted.

  • Hyperactivity: Excessive or inappropriate levels of movement relative to the situation.

  • Impulsivity: Acting hastily without considering the consequences.

ADD, or attention-deficit disorder, is an old term, now out of date, for the disorder we call ADHD, or attention-deficit hyperactivity disorder.

Symptoms & Diagnosis

ADHD is categorized into three primary types:

  • Predominantly Inattentive Presentation: Characterized primarily by difficulties with focus and attention.

  • Predominantly Hyperactive/Impulsive Presentation: Defined by excessive activity and impulsive behaviors.

  • Combined Presentation: A mixture of both inattentive and hyperactive/impulsive symptoms.

Diagnosis is based on the consistent presence of symptoms over an extended period, typically observed for at least six months. Although ADHD can be diagnosed at any age, it originates in childhood.

Inattentive Type

The inattentive presentation of ADHD involves significant challenges with maintaining focus, staying organized, and completing tasks. To receive a diagnosis for this type, individuals must frequently exhibit six (or five for those aged 17 and older) of the following symptoms:

  • Fails to pay close attention to details or makes careless mistakes in schoolwork, job tasks, or other activities.

  • Has difficulty sustaining attention on tasks or activities, such as during lectures, conversations, or extended reading.

  • Appears not to listen when spoken to directly, seeming mentally elsewhere.

  • Struggles to follow through on instructions, often failing to finish schoolwork, chores, or workplace responsibilities (may start tasks but lose focus quickly).

  • Has trouble organizing tasks and activities (e.g., poor time management, messy work, missed deadlines).

  • Avoids or dislikes tasks that require sustained mental effort, such as preparing reports or completing forms.

  • Frequently loses items necessary for tasks or daily life, such as school papers, books, keys, wallets, cell phones, or eyeglasses.

  • Is easily distracted by external stimuli or unrelated thoughts.

  • Forgets daily responsibilities, like chores, errands, or appointments (older teens and adults may forget to return phone calls or pay bills).

Hyperactive/Impulsive Type

The hyperactive/impulsive presentation of ADHD is characterized by excessive energy, difficulty sitting still, and impulsive behaviors. To receive a diagnosis for this type, individuals must frequently display six (or five for those aged 17 and older) of the following symptoms:

  • Fidgets with hands or feet, or squirms in their seat.

  • Struggles to remain seated in appropriate settings (e.g., classrooms or workplaces).

  • Runs or climbs in situations where it is inappropriate.

  • Finds it difficult to engage in leisure activities quietly.

  • Acts as if “driven by a motor,” seeming constantly on the go.

  • Talks excessively.

  • Interrupts or blurts out answers before questions are completed (e.g., finishes others’ sentences or interrupts conversations).

  • Has difficulty waiting their turn, such as in lines or group activities.

  • Frequently interrupts or intrudes on others (e.g., cutting into conversations, games, or activities, or using others’ belongings without permission). Older teens and adults may take over tasks that others are performing.

Combined Type

The combined presentation of ADHD is diagnosed when an individual meets the criteria for both inattentive and hyperactive/impulsive types.

Diagnosis and Evaluation

ADHD is typically diagnosed by mental health or primary care providers through a comprehensive evaluation process, which may include:

  • A detailed description of symptoms from the individual and caregivers.

  • Completion of questionnaires and rating scales by the individual, caregivers, and teachers.

  • A thorough review of the individual’s psychiatric, medical, and family history.

  • Gathering information about the person’s education, environment, and upbringing.

  • Referrals for medical evaluations to rule out other potential medical causes.

It is important to note that several conditions can mimic ADHD symptoms, including:

  • Learning disorders

  • Mood disorders

  • Anxiety

  • Substance use

  • Head injuries

  • Thyroid conditions

  • Side effects of certain medications, such as steroids (Austerman, 2015).

ADHD can also co-occur with other mental health conditions, such as:

  • Oppositional defiant disorder or conduct disorder

  • Anxiety disorders

  • Learning disabilities

Since no specific blood tests or routine imaging can diagnose ADHD, additional psychological assessments (e.g., neuropsychological or psychoeducational testing) or computer-based tests may be recommended to evaluate the severity of symptoms further. A thorough psychiatric evaluation remains essential to ensure an accurate diagnosis and to rule out other conditions.