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Content reviewed and updated: 06/29/20

Diagnosing ADHD

Attention deficit hyperactivity disorder (ADHD) is a complex neurological condition that primarily affects the frontal lobe, which is the part of the brain that enables us to organize, plan, focus, and complete tasks. Although the full name of the condition implies that a person has an attention deficit, ADHD actually involves an inability to regulate attention.

Sometimes people with ADHD have difficulty remaining focused on specific tasks. Other times, ADHD can lead individuals to hyperfocus on tasks and lose track of time.

According to Jason Meisel, a psychiatric nurse practitioner at Ahead, ADHD affects not only focus and attention, but also memory recall. Some individuals with ADHD have a tendency to misplace necessary items. Others regularly interrupt conversations, answer questions out of turn, and blurt out their thoughts, feeling that if they do not express them immediately, they will be lost.

Hyperactivity is another eponym of ADHD. The expression “driven by a motor” is often used to describe children with ADHD who are always on the go or have a lot of energy. Adults with ADHD, however, more often exhibit restlessness or fidgeting.

If you show similar signs and symptoms and think that ADHD may be affecting you and your life, consider undergoing an ADHD evaluation by a board-certified practitioner. An ADHD evaluation is the best way to establish a diagnosis and determine whether treatment is necessary.


During an ADHD evaluation, many aspects of your daily life will be analyzed, including: During an ADHD evaluation, many aspects of your daily life will be analyzed, including:

  • Learning
  • Long-term memory
  • Reasoning
  • Cognitive functioning
  • Executive functioning
  • Social functioning
  • Verbal and nonverbal communication

Cognitive functioning is associated with things like short-term memory, problem solving, decision making, and attention. Executive functioning involves your ability to manage your thoughts, time, and productivity and consider the long-term consequences of your actions. Social functioning involves your ability to work, engage in social relationships, and participate in community and recreational activities.


There are many symptoms of ADHD, which can be broken down into 3 subtypes: inattentive, hyperactive-impulsive, and combined type. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) lists 9 symptoms for the inattentive subtype and 9 for the hyperactive-impulsive subtype.

For children to be diagnosed with ADHD, 6 of the 9 symptoms must be present consistently for at least 6 months in more than one area of life (e.g., at home and at school), with some symptoms exhibited before 12 years of age. On the other hand, for older teens and adults to be diagnosed with ADHD, 5 of the 9 symptoms must be present consistently in multiple settings (e.g., at home and at work), with some symptoms exhibited during childhood.

The DSM-V lists the following inattentive and hyperactive-impulsive ADHD symptoms.

Inattentive ADHD Symptoms

  1. Lacks sustained attention on tasks
  2. Fails to pay close attention, leading one to make careless mistakes
  3. Does not seem to listen when spoken to directly, leading one to appear as though their mind is elsewhere despite no obvious distraction
  4. Does not follow through on tasks at home, at work, and/or in relationships
  5. Has trouble organizing tasks and activities, making sequential tasks difficult and leading to poor time management and disordered work
  6. Avoids or dislikes tasks that require sustained mental effort
  7. Misplaces everyday items such as keys, eyeglasses, or cell phones
  8. Is easily distracted
  9. Is forgetful in daily activities

Hyperactive-Impulsive ADHD Symptoms

  1. Fidgets, taps hands or feet, and/or squirms in seat
  2. Leaves seat when expected to remain seated such as in the classroom, at work, or in church
  3. Experiences feelings of restlessness (leading to excessive running or climbing in children)
  4. Has difficulty engaging in quiet, leisurely activities
  5. Is unable or uncomfortable being still for an extended time
  6. Talks excessively
  7. Blurts out answers or comments and/or completes sentences for others
  8. Has difficulty waiting their turn such as while waiting in line
  9. Interrupts and/or intrudes on others, including taking over what others are doing

Sleep problems, oppositional behavior, mood swings, anxiety, social awkwardness, and behavioral immaturity are often associated with ADHD, as well. ADHD symptoms may vary in severity, and they overlap with symptoms inherent to other conditions, which complicates the diagnosis of ADHD, and therefore treatment.


ADHD is one of the most common childhood disorders. Symptoms can appear as early as 3 years of age. However, only a small fraction of children with ADHD exhibit the bouncing-off-the-walls stereotype. More often, children with ADHD stare out windows, are quietly distracted, and lose track of time. These symptoms in children are often overlooked because they are not recognized as related to ADHD. Children showing these under-recognized symptoms, then, typically do not receive an ADHD diagnosis and the subsequent treatment that could benefit them.

According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), more than 75% of children with ADHD continue to experience significant symptoms as adults. With the increased structure of work and home life that accompanies adulthood, ADHD symptoms can interfere with daily activities more frequently and more noticeably.


ADHD can manifest differently in children and adults. Hyperactivity in children is often replaced by impulsivity and restlessness in adults. Inattention-related symptoms are the most prevalent symptoms in adult ADHD.

“Adults with ADHD often … lose track of conversations or zone out in meetings without realizing they are distracted and not paying attention,” Meisel says.

According to the Attention Deficit Disorder Association (ADDA), ADHD affects nearly 5% of adults in the U.S. ADHD can often coexist with other conditions such as depression, mood or conduct disorders, and substance abuse disorders in teens and adults. Additionally, ADHD often occurs alongside personality disorders, which can result in further complications in personal and work relationships.


ADHD is biological, which Meisel says many people do not realize. The symptoms are not voluntary, and the condition cannot be resolved through willpower. The condition is also not associated with one’s intelligence. Meisel notes that the problem actually exists in the wiring of the brain.

Diagnosis is the first step in managing ADHD. Certain medications have been proven to enhance focus and memory, and in combination with education and therapy, one can learn to embrace their unique qualities and develop skills to manage areas of concern, which can lead to a more fulfilling life, Meisel says.

ADHD diagnosis requires a comprehensive evaluation by a clinician, psychiatrist, or psychologist with ADHD expertise. These specialists are trained to obtain a comprehensive medical, emotional, and behavioral history, which is necessary in establishing a correct diagnosis.

“ADHD is not something people need to avoid or struggle with alone,” Meisel says.

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