Attention deficit hyperactivity disorder - diagnosis

The current debate around attention deficit hyperactivity disorder (ADHD) centres on whether it is a formal disorder or a cluster of symptoms. The number of behavioural and developmental disorders that affect young children with symptoms of ADHD is increasing. This means it is important to properly assess the causes of their symptoms. Their symptoms can include:

• Difficulty paying attention
• Impulsivity
• Overactivity.

• Fail to give close attention to details or make careless mistakes in school work, work or other activities.
• Have difficulty sustaining attention in tasks or play activities.
• Not seem to listen when spoken to directly.
• Not follow through on instructions and fail to finish school work, chores or duties in the workplace (but not because they are being wilful or do not understand instructions).
• Have difficulty organising tasks and activities.
• Avoid, dislike or be reluctant to engage in tasks that require sustained mental effort (such as school work or homework).
• Lose things necessary for tasks or activities (for example: toys, school assignments, pencils, books or tools).
• Be easily distracted.
• Be forgetful in daily activities.

• Often fidgets with hands or feet or squirms in seat.
• Often leaves seat in classroom or in other situations in which remaining seated is expected.
• Often runs about or climbs excessively in situations in which it is inappropriate.
• Often has difficulty playing or engaging in leisure activities quietly.
• Is often ‘on the go’ or often acts as if ‘driven by a motor’.
• Often talks excessively.

• Often blurts out answers before questions have been completed.
• Often has difficulty waiting in turn.
• Often interrupts or intrudes on others (for example, ‘butts into’ conversations or games).

• Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before the age of seven years.
• Some impairment from the symptoms is present in two or more settings, such as at school and at home.
• There must be clear evidence of clinically significant impairment in social, academic or occupational functioning.
• The symptoms do not occur exclusively during the course of a developmental disorder, a mental illness like schizophrenia or other psychotic disorder, and are not better accounted for by another disorder (for example: mood disorder, anxiety disorder, dissociative disorder or a personality disorder).

• ADHD combined type - if both criteria for inattention and hyperactivity-impulsivity are met for the past six months.
• ADHD predominantly inattentive type - if criteria for inattention are met but the criteria for hyperactivity-impulsivity are not met in the past six months.
• ADHD predominantly hyperactive-impulsive type - if criteria for hyperactivity-impulsivity are met but the criteria for inattention are not met in the past six months.

• Neurophysiology - including differences in brain anatomy, electrical activity and metabolism.
• Genetics - some research suggests possible gene mutations may be present.
• Drugs - drug use (nicotine and cocaine) by the mother during pregnancy may contribute.
• Lead - chronic exposure to low levels of lead may influence behaviour and brain chemistry.
• Lack of early attachment - if a baby does not bond with a parent or caregiver, or has traumatic experiences related to the attachment, it can contribute to inattention and hyperreactivity.
• Childhood post traumatic stress disorder - this may present with features of ADHD, yet require different treatment.

• Your doctor
• Paediatrician
• The Specialist Children’s Services, Department of Human Services Victoria Tel. (03) 9096 0000
• The Resource Centre for Child Health and Safety (CHAS) Tel. (03) 9345 6429
• Attention Deficit Disorder Victoria (ADDVic) Tel. 1800 233 842
• Hyperactive Children’s Association of Victoria (ACTIVE) Tel. (03) 9650 2570

• Attention deficit hyperactivity disorder (ADHD) is one of a number of behavioural and developmental disorders that affect young children.
• A child with ADHD has three main problems: inattention, impulsivity and overactivity.
• There is no single test, and a diagnosis can only be made after a range of information is collected, especially from the parents.

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