Category Archives: ADHD Awareness

ADHD Diagnostic Criteria: DSMV

  • ADHD Diagnostic Criteria - DSMVThe DSMV, the Diagnostic and Statistical Manual of Mental Disorders, guideline for all psychiatric disorders, was updated in 2013 by the American Psychiatric Association.  The following are the updated criteria for an evaluation for ADHD.

9 Inattention Symptoms (Six or more symptoms present for 6 months or more)

  • Consistently disorganized
  • Problems organizing activities
  • Cannot focus or pay attention to tasks or instruction
  • Forgetful
  • Frequently loses personal items (arrives at class unprepared, loses toys and tools)
  • Begins tasks or assignments, but frequently does not follow through and leaves them uncompleted
  • Appears not to listen, even when directly addressed
  • Makes careless mistakes in school work, professional work, and other activities
  • Avoids taking on tasks that require sustained mental effort for long periods

 9 Hyperactivity-impulsivity Symptoms (Six or more symptoms present for 6 months or more) Note: For individuals 17 and above, only 5 or more symptoms are needed because overtly hyperactive symptoms reduce with age.

  • Talks excessively at home, in class, at work, and other places
  • Has difficulty remaining seated in situations where sitting still is expected
  • Children may move about a room, climb, or run where inappropriate to do so – teens and adults feel restless
  • Cannot sit still when seated and frequently squirms, fidgets, or moves around
  • Difficulty playing quietly (children) or quietly engaging in leisure activities (teens and adults)
  • Seems constantly moving and driven, as if by a motor
  • Impatient and has trouble waiting his or her turn
  • Interrupts others’ conversations or games
  • Blurts out answers to questions before the speaker has completed the question

If you or your child exhibits six or more of the symptoms on either or both of these lists, you should consider having a professional evaluation for ADHD.

Making the Diagnosis

  • Note:  To make a diagnosis of ADHD, these symptoms should not be better explained by another physical or mental disorder.  Dysfunction or upheaval in  the home, school or work environment can also cause similar symptoms and should be considered.
  • To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age. For adults, symptoms must have been evident in some way by their teen years.
  • Symptoms appear, on average, between 3 and 6 years of age. And a diagnosis requires that some symptoms were evident before the age of 13 years.
  • There are three categories or “presentations” of ADHD; ADHD with Hyperactivity, ADHD/Inattentive type, or ADHD/Combined type. Dr. Daniel Amen proposed even more types. For more information, see Recognizing the Types of ADHD on Everyday Health.

Don’t expect a quick diagnosis

“According to developmental pediatrician, Mark Bertin,

“An initial evaluation includes a detailed history along with physical and neurological examinations. These appointments explore psychological, family and educational factors that may be triggering concerns.  Developmental tests are used to observe your child’s cognitive, language, motor, and academic abilities, or specific aspects of behavior.” (1)

“An evaluation should also identify strengths as well as the likely causes of any difficulties.
The goal is to create as comprehensive picture as possible of skills and to provide practical information for planning accommodations.” (1)

Unfortunately, primary care pediatricians are failing to meet the standards of care set forth by the American Pediatric Association on many levels. (See results of a 2014 study reported by David Rabiner in “Pediatric care for children with ADHD – Discouraging new findings.”) Your doctor is doing you a disservice if all he provides is a 15 minute visit followed by a prescription and maintains that is sufficient for the diagnosis and treatment of ADHD.

Serious impairment

“Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD,” states Russell Barkley, PhD. “ It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. ”(2) It’s important to keep in mind that not every high-energy or impulsive child has ADHD. Children and adults are diagnosed with ADHD only if they demonstrate these symptoms so often that they are causing real difficulty. Impairment in two areas of life, playground, classroom, home, social, or the workplace, is crucial.

Developmental delays in Executive Function and control of emotions are also problematic. (2, 3) The inability to regulate attention stalls building self-regulation, or self-control, a mark  of growth and maturity. These will show up in everyday situations as chronic disorganization, memory problems, procrastination, a lack of motivation or follow through in situations when interest or the pressure of deadlines isn’t high.  Frustration is a common response and invites overwhelm and anger at the situation as well as at themselves.

Take ADHD seriously!

There’s still a lot of misunderstanding and moral judgment that those with ADHD are PURPOSEFULLY not living up to expectations. The extent of these difficulties permeates how those with ADHD think of themselves, as “less than” others.  According to a 2006 study, “Children with a history of ADHD were 6 times as likely as those without ADHD to have a high level of overall difficulties including emotional, conduct, and peer problems and were 9 times as likely to manifest a high level of impairment including interference with home life, friendships, classroom learning, and leisure activities.”(4)  Early diagnosis and effective treatment, preferably combining medications and behavior changes for parent, child, and adults, is the key to building self-awareness and skills that can change many of the negative outcomes.

 

Note: Basic symptoms checklist is taken from “New Diagnostic Criteria for ADHD: Subtle but Important Changes” by Ravid Rabiner, Ph.D.

1) Evaluation Process from Developmental Pediatrician, Mark Bertin, MD. – author of The Family ADHD Solution: A Scientific Approach to Maximizing Your Child’s Attention and Minimizing Parental Stress From ADHD: Does my Child Have it? https://breezymama.com/2011/04/11/adhd/#more-15443  Harvested January 29, 2021

2) Russell Barkley’s ADHD Fact sheet –  http://www.russellbarkley.org/factsheets/adhd-facts.pdf Harvested 2/28/2016

 

3) The validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Willcutt, EG, Doyle, AE, Nigg, JT, et al. http://www.ncbi.nlm.nih.gov/pubmed/15950006 Harvested 10/22/2014

4) Emotional and Behavioral Difficulties with Impairments in Everyday Functioning among Children with a history of Attention-Deficit/Hyperactivity Disorder – Tara W. Strine, MPH, Catherine A Lesenesne, PhD, Catherine A Okoro, MS, et al. http://www.cdc.gov/pcd/issues/2006/apr/05_0171.htm Harvested March 2, 2015

 

“Image courtesy of Stuart Miles/FreeDigitalPhoto.net” Modified on Canva.com

 

7 Facts You Need To Know About ADHD

7 Facts You Need to Know about ADHDBy the ADHD Awareness Month Coalition
Citations

1) ADHD is Real.
Nearly every mainstream medical, psychological, and educational organization in the United States long ago concluded that Attention-Deficit/Hyperactivity Disorder (ADHD) is a real, brain-based medical disorder. These organizations also concluded that children and adults with ADHD benefit from appropriate treatment. (1, 2, 3, 4, 5, 6, 7)

2) ADHD is a Common, Non-Discriminatory Disorder.
ADHD is a non-discriminatory disorder affecting people of every age, gender, IQ, religious and socio-economic background. In 2011, the Centers for Disease Control and Prevention reported that the percentage of children in the United States who have ever been diagnosed with ADHD is now 9.5%.(8) Boys are diagnosed two to three times as often as girls. Among adults, the Harvard/NIMH National Comorbidity Survey Replication found 4.4% percent of adults, ages 18-44 in the United States, experience symptoms of ADHD and some disability.(9) ADHD, AD/HD, and ADD all refer to the same disorder. The only difference is that some people have hyperactivity and some people don’t.

3) Diagnosing ADHD is a complex process.
In order for a diagnosis of ADHD to be considered, the person must exhibit a large number of symptoms, demonstrate significant problems with daily life in several major life areas (work, school, or friends), and have had the symptoms for a minimum of six months. To complicate the diagnostic process, many of the symptoms look like extreme forms of normal behavior. Additionally, a number of other conditions resemble ADHD. Therefore, other possible causes of the symptoms must be taken into consideration before reaching a diagnosis of ADHD. What makes ADHD different from other conditions is that the symptoms are excessive, pervasive, and persistent. That is, behaviors are more extreme, show up in multiple settings, and continue showing up throughout life. No single test will confirm that a person has ADHD. Instead, diagnosticians rely on a variety of tools, the most important of which is information about the person and his or her behavior and environment. If the person meets all of the criteria for ADHD, (10, 11) he or she will be diagnosed with the disorder.

4) Other Mental Health Conditions Frequently Co-Occur with ADHD.
• Up to 30% of children and 25-40% of adults with ADHD have a co-existing anxiety disorder.(12 )
• Experts claim that up to 70% of those with ADHD will be treated for depression at some point in their lives. (13)
• Sleep disorders affect people with ADHD two to three times as often as those without it. (14)

5) ADHD is Not Benign. (15)
Particularly when the ADHD is undiagnosed and untreated, it contributes to:

• Problems succeeding in school and successfully graduating. (16, 17)
• Problems at work, lost productivity and reduced earning power. (18, 1,9 20, 21)
• Problems with relationships. (22, 23)
• More driving citations and accidents. (24, 25, 26, 27)
• Problems with overeating and obesity. (28, 29, 30, 31)
• Problems with the law. (32, 33) According to Dr. Joseph Biederman, professor of psychiatry at Harvard Medical School, ADHD may be one of the costliest medical conditions in the United States: “Evaluating, diagnosing and treating this condition may not only improve the quality of life, but may save billions of dollars every year.” (34)

6) ADHD is Nobody’s FAULT.
ADHD is NOT caused by any moral failure, poor parenting, family problems, poor teachers or schools, too much TV, food allergies, or excess sugar. Instead, research shows that ADHD is both highly genetic (with the majority of ADHD cases having a genetic component), and a brain-based disorder (with the symptoms of ADHD linked to many specific brain areas). (35)The factors that appear to increase a child’s likelihood of having the disorder include gender, family history, prenatal risks, environmental toxins, and physical differences in the brain. (36)

7) ADHD Treatment is Multi-Faceted.
Currently, available treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, behavioral interventions, education or training, and educational support. Usually, a person with ADHD receives a combination of treatments. (37, 38)

7 Facts You Need To Know About ADHD
Copyright: ADHD Awareness Month Coalition – Content may be reproduced, in whole or in part, with attribution and a link to www.ADHDAwarenessMonth.org

Citations

“Photo courtesy of Vlado/FreeDigitalPhoto.net” Modified on Canva.com