ADHD Diagnosis in DSM-5 | Cadabams CDC

1. What the DSM-5 Says About ADHD

Quick Definition of ADHD in DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines ADHD as a neurodevelopmental disorder characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning or development. You can learn more about the ADHD meaning here.

Main DSM-5 Changes from DSM-IV

• Onset age raised from 7 to before 12 years
• Symptom threshold lowered for adults (now 5 instead of 6)
• Examples added to reflect adult life (meetings, driving, relationships)
• Autism spectrum comorbidity explicitly allowed

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2. DSM-5 ADHD Criteria Table (Checklist)

Inattentive Presentation Symptoms (9 Items)

Check each that has been present for ≥6 months:

• Fails to give close attention to details
• Difficulty sustaining attention in tasks or play
• Does not seem to listen when spoken to directly
• Does not follow through on instructions
• Difficulty organizing tasks and activities
• Avoids or dislikes tasks requiring sustained mental effort
• Loses things necessary for tasks (toys, homework, phone)
• Easily distracted by extraneous stimuli
• Forgetful in daily activities

Hyperactive-Impulsive Presentation Symptoms (9 Items)

• Fidgets or taps hands/feet
• Leaves seat when staying seated is expected
• Runs about or climbs in inappropriate situations, a common symptom in ADHD in kids
• Unable to play quietly
• “On the go” or acts as if “driven by a motor”
• Talks excessively
• Blurts out answers before questions completed
• Difficulty waiting turn
• Interrupts or intrudes on others

Combined Presentation Requirements

• Six (or five for adults) inattentive and six/five hyperactive-impulsive symptoms must be met.

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3. Age-Specific Symptom Count Rules

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4. Additional DSM-5 Conditions for Diagnosis

• Symptom Duration: ≥6 months
• Onset: Several symptoms present before age 12
• Settings: Observable in two or more environments (home, school, work, social)
• Impairment: Clear evidence that symptoms reduce social, academic, or occupational functioning, which may be seen as poor school performance.
• Exclusion: Symptoms not better explained by another disorder (e.g., anxiety, trauma, or oppositional defiant disorder)

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5. Step-by-Step ADHD Diagnosis Process

The ADHD diagnosis process is thorough and multi-faceted.

Initial Screening Questionnaires

Parents and teachers complete standardized forms (e.g., Conners, Vanderbilt) to rate frequency and severity of symptoms. These are part of official ADHD assessments.

Comprehensive Clinical Interview

A trained clinician:

• Reviews developmental, medical, and family history
• Clarifies when and where symptoms occur
• Rules out other conditions, such as learning disabilities

School & Home Behavior Reports

• Teacher checklists (academic performance, peer relations)
• Parent diaries (morning routine, bedtime, chores)

Medical & Psychosocial Evaluation

• Vision/hearing screening
• Sleep, diet, and medication review
• Family stressors or trauma check This often involves a comprehensive psychological assessment.

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6. Special Considerations by Age Group

Diagnosing ADHD in Preschoolers

• Rely on parent & daycare observations, for which an ADHD parent guide can be useful.
• Emphasize hyperactivity-impulsivity symptoms
• Rule out normal developmental exuberance

School-Age Children vs. Adolescents

• Elementary: Teachers see inattention in reading and math tasks. Educational support for ADHD can be crucial here.
• Middle/High School: Impairment shifts to homework, driving, risky behaviors. These are key ADHD symptoms in teens.

Adult ADHD Diagnosis Nuances

• Retrospective childhood history gathered from parents or school records
• Focus on work performance, relationships, financial management