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DIAGNOSTIC CRITERIA

ADHD SYMPTOMS IN
CHILDREN & ADOLESCENTS

An estimated 11% (6.4 million) of US school-aged children have been diagnosed with ADHD in their lifetime*1

*Based on the 2011/12 National Survey of Children’s Health, in which parents were asked if a healthcare practitioner had ever told them their child had ADD or ADHD.

ADHD Symptoms and DSM-5®diagnostic criteria for ADHD in children and adolescents (less than 17 years of age)2

ADHD is characterized as a persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development.

To be diagnosed with ADHD, individuals must meet the following criteria adapted from the DSM-5®:

  • Six or more symptoms of inattention and/or 6 or more symptoms of hyperactivity/impulsivity must have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities. For older adolescents and adults (ages 17 and older), at least 5 symptoms are required.

ADHD symptoms of inattention†

  • Makes careless mistakes/lacks attention to detail 
  • Lacks sustained attention
  • Poor listener 
  • Fails to follow through on tasks and instructions 
  • Exhibits poor organization
  • Avoids tasks requiring sustained mental effort 
  • Loses things necessary for tasks/activities 
  • Easily distracted (may include unrelated thoughts) 
  • Forgetful in daily activities

†Symptoms must occur often.

ADHD symptoms of hyperactivity/impulsivity†

  • Fidgets with or taps hands/feet or squirms in seat 
  • Leaves seat in situation when remaining seated is expected 
  • Runs about/climbs in situations where it is inappropriate or experiences feelings of restlessness
  • Has difficulty engaging in leisure activities quietly
  • Is “on the go” acting as if “driven by a motor” 
  • Talks excessively 
  • Blurts out answers 
  • Has difficulty waiting their turn 
  • Interrupts or intrudes on others

†Symptoms must occur often.

DSM-5® diagnostic criteria for ADHD in children and adolescents (cont.)2

  • Several inattention or hyperactive/impulsive symptoms were present before age 12 years
  • Several inattention or hyperactive/impulsive symptoms must be present in 2 or more settings (e.g., at home, school, or work; with friends or relatives; in other activities)
  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
  • Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

These are not the complete diagnostic criteria.

Diagnosis should be based on a complete history and evaluation of the patient.

DSM-5® is a registered trademark of the American Psychiatric Association. All rights reserved.

Tips to help assess for ADHD in children and adolescents

Because children may struggle with the complexity of open-ended questions, it can help to use more close-ended questions and to assess their condition from several points of view.3

  • Talk with their parents and caregivers, teachers, and other school professionals about potential onset of core symptoms in a variety of settings, how old they were, how long symptoms lasted, and how their symptoms affected them4,5
  • Collect information about their family history, including ADHD and/or other significant mental disorders, perinatal history, developmental milestones, medical history, and mental health history5
  • Rule out alternative causes of symptoms or behavior problems4,5

Educational resources for you and your caregivers of pediatric patients.

These educational resources are available to help you faciliatate a more meaningful and informed discussion about ADHD with caregivers.

ADHD in Children and Adolescents Symptom Checklist

Consider using this symptom checklist for discussing ADHD with your pediatric patients.

Proper Use of Stimulant Medication Brochure

Help your patients understand the proper use of stimulant medications for ADHD.

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Hypoithetical patient portrayal

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References
  1. Visser SN, Danielson ML, Bitsko RH, et al. Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. J Am Acad Child Adolesc Psychiatry. 2014;53(1):34-46.
  2. American Psychiatric Association. Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). 5th ed. (DSM-5®). Arlington, VA: American Psychiatric Association; 2013.
  3. Irwin LG, Johnson J. Interviewing young children: explicating our practices and dilemmas. Qual Health Res. 2005;15(6):821‐831.
  4. Wolraich M, Brown L, Brown RT, et al.: Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007‐1022.
  5. Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894‐921.
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