Attention Deficit Hyperactivity Disorder ADD/ADHD
(contd.)

Diagnosis of Attention Deficit Disorder

In the most current assessment guidelines published by the American Psychiatric Association, Diagnostic and Statistical Manual for Mental Disorders IV (DSM4), the disorder is known as Attention Deficit Disorder and has several types including: (1) predominantly inattentive; (2) predominantly impulsive or (3) combined. Individuals with this condition usually have many (but not all) of the following symptoms:

Inattention:

• often fails to finish what he starts
• doesn’t seem to listen
• easily distracted
• has difficulty concentration or paying attention
• doesn’t stick with a play activity

Impulsivity:

• often acts without thinking & later feels sorry
• shifts excessively from one activity to another
• has difficulty organizing work
• needs a lot of supervision
• speaks out loud in class
• doesn’t wait to take turns in games or groups

Hyperactivity:

• runs about or climbs on things excessively
• can’t sit still and is fidgety
• has difficulty staying in his seat and bothers classmates
• excessive activity during sleep
• always on the "go" and acts as if "driven"

Emotional Instability:

• angry outbursts
• social loner
• blames others for problems
• fights with others quickly
• very sensitive to criticism

The diagnosis can be made by "ruling out" other medical or psychiatric causes for the symptoms and by then determining that the patient meets the DSM4 criteria for Attention Deficit Disorder. In some cases psychological testing is also used to help determine the diagnosis. The testing may be in the form of questionnaires such as the Conners Rating Scale or the Child Behavior Check List. Sometimes, a computerized neuropsychological test such as the TOVA, IVA or Gordon Diagnostic System may be used. These tests are known as continuous performance tests and measure a person’s ability to pay attention, tune out distractions and their impulse control while performing a repetitive task over a period of time ( 6 to 15 minutes). This type of testing can be helpful. More extensive batteries may be offered by various practitioners but are not necessary to provide the necessary data to make a diagnosis.

True Attention Deficit Disorder patients usually start showing symptoms by the time they start school. Some very impulsive children are diagnosed as early as 2 or 3 years old. Another group appears to develop more severe symptoms around the fourth grade. These children may have always had Attention Deficit Disorder but were able to compensate for the condition. As school requires more work and more organization skills, these children may reach a point where they become unable to compensate and exhibit "full blown" Attention Deficit Disorder symptoms. Some children may remain undiagnosed until they are in their teens. More recently adults have been diagnosed as having Attention Deficit Disorder. These individuals had the disorder as children but were not properly identified during their childhood.

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