diagnosis

Attention Deficit Disorder Diagnosis

SUGGESTED DIAGNOSTIC CRITERIA FOR
ATTENTION DEFICIT DISORDER IN ADULTS

This section is probably of interest to those adults diagnosed with ADD. It maybe be useful for parents of ADD children who may not be aware that maybe they have ADD, Dr. Hallowell is a child psychiatrist at Harvard Medical School who has ADD himself. Attached is a transposed handout from one of his lectures. The handout isn't copyrighted.

Note: These criteria are based on extensive clinical experience but have not yet been statistically validated by field trials.

Note: Consider a criterion met only if the behavior is considerably more frequent than that of most people of the same mental age.

A chronic disturbance in which at least twelve of the following are present:

1. A sense of under achievement, of not meeting one's goals
 (regardless of how much one has accomplished). We put this symptom first because it is the most common reason an adult seeks help. "I just can't get my act together," is the frequent refrain. The person may be highly accomplished by objective standards, or may be floundering, stuck with a sense of being lost in a maze, unable to capitalize on innate potential.

2 difficulty getting organized.
A major problem for most adults with ADD. Without the structure of school, without parents around to get things organized for him or her, the adult may stagger under the organizational demands of everyday life. The supposed "little things" may mount up to create huge obstacles. For the want of a proverbial nail--a missed appointment, a lost check, a forgotten deadline--their kingdom may be lost.

3 chronic procrastination or trouble getting started.
Adults with ADD associate so much anxiety with beginning a task, due to their fears that they won't do it right, that they put it off, and off, which, of course, only adds to the anxiety around the task.

4 many projects going simultaneously; trouble with follow-through.
A corollary of "c". As one task is put off, another is taken up. By the end of the day, or week, or year, countless projects have been undertaken, while few have found completion.

5 tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark.
Like the child with ADD in the classroom, the adult with ADD gets carries away in enthusiasm. An idea comes and it must be spoken, tact or guile yielding to child-like exuberance.

6 an ongoing search for high stimulation.
The adult with ADD is always on the lookout for something novel, something in the outside world that can catch up with the whirlwind that's rushing inside.

7 a tendency to be easily bored.
A corollary of Boredom surrounds the adult with ADD like a sinkhole, ever ready to drain off energy and leave the individual hungry for more stimulation. This can easily be misinterpreted as a lack of interest; actually it is a relative inability to sustain interest over time. As much as the person cares, his battery pack runs low quickly.

h) easy distractibility, trouble focusing attention, tendency to tune out or drift away in the middle of a page or a conversation, often coupled with an ability to hyper focus at times.

The hallmark symptom of ADD. The "tuning out" is quite involuntary. It happens when the person isn't looking, so to speak, and the next thing you know, he or she isn't there. The often extraordinary ability to hyper focus is also usually present, emphasizing the fact that this is a syndrome not of attention deficit but of attention inconsistency.

8 often creative, intuitive, highly intelligent.
Not a symptom, but a trait deserving of mention. Adults with ADD often have unusually creative minds. In the midst of their disorganization and distractibility, they show flashes of brilliance. Capturing this "special something" is one of the goals of treatment.

j) trouble going through established channels, following proper procedure.

Contrary to what one might think, this is not due to some unresolved problem with authority figures. Rather it is a manifestation of boredom and frustration: boredom with routine ways of doing things and excitement around novel approaches, and frustration with being unable to do things the way they're supposed to be done.

k) impatient; low tolerance for frustration.

Frustration of any sort reminds the adult with ADD of all the failures in the past. "Oh no," he thinks, "here we go again." So he gets angry or withdraws. The impatience has to do with the need for stimulation and can lead others to think of the individual as immature or insatiable.

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