Evaluation and Assessment of ADD/ADHD

Evaluation and Assessment of ADD/ADHD

The symptoms of ADD (attention deficit disorder) and ADHD (attention-deficit hyperactivity disorder) include inattention and/or hyperactivity and impulsivity. ADD/ADHD are common in children and teens. But adults also can have these disorders. In adults, symptoms may vary, as they may experience restlessness, instead of hyperactivity. Adults with ADD/ADHD have problems with social relationships and in the workplace, while children have problems in school and home life.

Even though science has made great strides to evaluate and treat ADD/ADHD in the general population, there is still no single definitive test available to help doctors assess this increasingly common condition. Usually doctors get a better picture of the problem after talking to the patient, family or teachers, in the case of children. Behaviors, moods, productivity level, nutrition and lifestyle habits are key to attention span issues. A physical examination can assess the adult patient’s, or child’s, overall health. But specific signs and symptoms should be evaluated before an accurate diagnosis and subsequent treatment of ADD/ADHD can occur.

How is ADD/ADHD assessed?

The American Psychiatric Association publishes a set of criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Doctors use this criteria to evaluate patients who may have ADD/ADHD or other mental or behavioral disorders. The patient needs to meet either the first or second set of criteria in order to receive a diagnosis of ADD/ADHD.

The first set of criteria focuses on inattentiveness. A patient with six or more of these symptoms, for at least six months, that are inconsistent with their developmental level, would receive an ADD/ADHD diagnosis. These include:

  • Appearing not to listen when spoken to
  • Avoiding tasks that require sustained mental effort
  • Being easily distracted by extraneous stimuli
  • Being forgetful in daily activities
  • Difficulty in organizing tasks and activities
  • Misplacing or losing things that necessary for tasks or activities
  • Not following through on instructions, not finishing schoolwork, chores or work duties
  • Not giving close attention to details, making careless mistakes in schoolwork or work
  • Problems with paying attention in tasks or activities

The second set of criteria focuses on hyperactivity-impulsivity. Again, the patient would have to have six or more of these symptoms, for at least six months, and are inconsistent with the person's level of development. These include:

  • Being "on the go" or appearing to be "driven by a motor"
  • Difficulty playing in leisure activities quietly
  • Fidgeting with hands or feet or squirming in seat
  • Leaving his or her seat in the classroom or at work
  • Running around or climbing during inappropriate situations
  • Talking excessively

Impulsivity symptoms include:

  • Blurting out answers before questions are completed
  • Difficulty waiting turns
  • Interrupting or intruding on others

After the symptoms criteria are met, additional criteria are evaluated, such as whether these symptoms were present before the age of seven. To obtain a diagnosis of ADD/ADHD, impairment should be present in two or more settings, and would interfere with the person's performance at school/work and home. The impairment needs to be clinically significant impairment with regards to social, academic or occupational functioning.

How is ADD/ADHD evaluated?

  • Behavior rating scales or questionnaires
  • Evaluation of learning disabilities
  • Patient history
  • Physical exam
  • Review of developmental level as well as academic, social and emotional functioning
  • Talk with parents or spouse to obtain health and behavior history

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