Diagnosis of ADHD

ADHD is diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The process involves:

Clinical Interview:

A psychologist gathers a detailed history, including symptoms, medical background, medications, family history, and social/environmental factors.

• Symptom Assessment: Use of standardised ADHD rating scales or questionnaires (e.g., Vanderbilt, Conners-4) filled out by the patient, parents, teachers, or others who know the individual well.
• Ruling Out Other Conditions: Screening for other medical, psychological, or learning disorders that could explain symptoms (like anxiety, depression, sleep disorders, or learning disabilities), other questionnaires may be assigned for screening.
• Diagnostic Criteria: Evaluation of symptoms against DSM-5 criteria for ADHD, considering factors like age of onset, duration, and settings in which symptoms occur.
• Collateral Information: Gathering observations from multiple sources (parents, teachers, caregivers) to confirm symptoms are present in more than one setting.
• Functional Impairment Assessment: Determining whether symptoms significantly impair academic, occupational, or social functioning.

Subtypes & Symptoms of ADHD

According to the DSM-V, there are three subtypes of ADHD: 

1. ADHD, Predominantly Inattentive Subtype.

A child with inattentive ADHD may not pay attention to details or make careless mistakes. This child may have difficulty sustaining attention in tasks and play and may listen when spoken to directly. Often this child does not follow requests, complete schoolwork, and chores. They may have organisational difficulties or be forgetful – losing necessary things like pencils and books. They may be reluctant to engage in tasks that require sustained mental effort. Family life could be filled with arguments about homework.

2. ADHD, Predominantly Hyperactive-Impulsive Subtype.

This subtype is diagnosed if there are symptoms of hyperactivity-impulsivity along with fewer symptoms of inattention.
Symptoms include frequent fidgetiness with hands and/or feet or squirming when required to sit still. This child is likely to have difficulty playing or engaging in activities quietly. They may be constantly on the go or talk excessively. Often this child gets up from their seat in class or in other situations where remaining seated is expected. They may run and climb at inappropriate times. As they move into adolescence and adulthood, these ‘active’ behaviours often subside, but their restlessness usually remains. The impulsive child blurts out answers before the question has been finished and has difficulty waiting their turn. Consequently, they interrupt and disrupt games and conversations, and they often act without thinking.

3. ADHD, Combined Subtype.

This subtype is when the symptoms of both inattention and hyperactivity-impulsivity co-occur.

Caution. Because we all show some of these behaviours across the lifetime, the DSM-V contains specific guidelines for determining whether ADHD is present. The behaviours must appear early in life, before age 7, and continue for at least 6 months. The behaviours must be more frequent and/or severe than others of the same age. The behaviours must cause significant functional impairment in at least two areas of the person’s life (school, work, home or social life).

ADHD treatment for Adults & Children

Pharmacological Treatment: Stimulant medications, including methylphenidate and dexamphetamine and Vyvanse are recommended as first-line pharmacotherapy due to their strong evidence of efficacy and safety in reducing core ADHD symptoms. Medication should be carefully titrated and monitored, considering potential side effects and coexisting conditions such as anxiety (AADPA, 2022).
Psychosocial Interventions: Behavioural therapies, particularly cognitive-behavioural therapy (CBT), parent training, and school-based support, are essential components of comprehensive ADHD management. These interventions address emotional regulation, oppositional behaviours, and functional impairments, complementing medication benefits (AADPA, 2022).
Lifestyle and Nutritional Considerations: The guidelines highlight the role of lifestyle factors, recommending regular physical activity, sleep hygiene, and nutritional assessment to support symptom management and overall well-being. Dietary interventions should focus on balanced nutrition and correction of deficiencies but are adjunctive rather than primary treatments (AADPA, 2022).
 

Updated on:  24/02/2026 by: Dr. Jacques Duff – BA Psych; Grad Dip Psych; PhD; MAPS; MECNS; MAAAPB; MISNR; FANSA
Reviewed on: 25/02/2026 by: Bernard Ferriere - BA; Grad Dip App Psych; Dip Clinical Hypnosis; FCCP; MAPS; MASH; Clinical Psychologist