Doctors diagnose attention deficit disorder (ADD ADHD) on the basis of detailed criteria spelled out in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. In its entry on ADHD, the DSM-IV lists nine symptoms that suggest inattention and nine that suggest hyperactivity/impulsivity:
1. fails to give close attention to details or makes careless mistakes
2. has difficulty sustaining attention
3. seems not to listen when spoken to
4. has trouble following through on instructions or finishing tasks
5. has difficulty organizing tasks and activities
6. is reluctant to engage in tasks that require sustained mental effort
7. often loses things
8. is easily distracted
9. is forgetful in daily activities
1. fidgets with hands or feet or squirms in seat
2. leaves seat in classroom
3. runs about or climbs excessively
4. has difficulty playing quietly
5. often seems “on the go” or acts as if “driven like a motor”
6. talks excessively
7. blurts out answers before questions have been completed
8. has trouble taking turns
9. interrupts or intrudes on others
Almost every child will exhibit one or more of these symptoms at some point. A child is diagnosable with ADHD only if he or she exhibits at least six of nine symptoms from one of the above lists, and if the symptoms have been noticeable for at least six months in two or more settings — for example, at home and at school. What’s more, the symptoms must significantly impair the child’s functioning, and at least some of the symptoms must have been apparent before age seven.
A child can meet all the diagnostic criteria for ADHD without actually having the disorder. Perhaps she is just unusually "spirited." Maybe he isn't eating right, or getting enough exercise. Another possibility, of course, is that the child doesn't have ADHD at all — but is affected by one or more "look-alike" conditions.
Physical conditions (such as pinworms, hearing loss, or an allergy) or another medical disorder (such as auditory processing disorder, sensory integration disorder, bipolar disorder, or depression) can present symptoms that look a lot like those of ADHD.