Unlocking ADHD writer Chia Shu Min explores the differences between an ADHD Diagnosis and Assessment for children and adults.
The symptoms of ADHD in a child and ADHD in an adult present differently. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ADHD symptoms usually follow the 3 main criteria: Inattention, Hyperactivity, and Impulsivity.
For instance, you might see a child with ADHD fidgeting on the chair in class, while an adult with ADHD may feel very restless in a very important meeting. Both symptoms mentioned above are signs of hyperactivity, but present themselves in different ways.
Criteria for ADHD Diagnosis in Children and Teenagers
The DSM-5 diagnostic criteria for ADHD in children (16 and younger) include:
- Six or more symptoms mentioned in each of the two criteria – inattention and hyperactivity & impulsivity
- Symptoms should last for more than 6 months
- There should be functional impairment
Criteria for ADHD Diagnosis in Adults
The DSM-5 diagnostic criteria for ADHD in adults (17 and older) are listed below. Adults have a lower diagnostic requirement because adults with ADHD might develop coping mechanisms to mask their symptoms compared to children.
- Five or more symptoms from the two criteria mentioned above
- Symptoms should last for more than 6 months
- There should be functional impairment
- The onset of several symptoms before the age of 12
- Symptoms manifest in more than two settings: home, school, work, interactions with friends and relatives, or other activities
- Symptoms are independent of other comorbid disorders
Since the presentation of ADHD symptoms vary between children and adults, the assessments used to diagnose ADHD also differs. The main objective of ADHD assessments is to identify ADHD symptoms present, rule out other possible disorders, develop future intervention plans, and determine any other comorbid disorders.
Types of Assessments used for ADHD Diagnosis in Children & Teenagers
Behaviours are observed mainly by parents/caregivers and/or school teachers.
The following are a list of assessments that clinicians may use to assess ADHD in children:
- Achenbach System of Empirically Based Assessment (ASEBA)
- Behavior Assessment System for Children, Second Edition (BASC-2)
- Behavior Rating Inventory of Executive Function® (BRIEF)
- Brown ADD scales for Children
- Conner’s rating scales
- Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS) and Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS)
- Wechsler Intelligence Scale for Children (WISC)
Types of Assessments used for ADHD Diagnosis in Adults
The diagnosis of ADHD in adults involves ruling out whether the ADHD symptoms are present during childhood and adulthood. Moreover, as some adults may have learnt to manage their ADHD symptoms, the assessment method differs from that used for children/adolescent ADHD.
The following are a list of assessment that clinicians may use to assess ADHD in Adults:
- Adult ADHD Self-Report Screener (ASRSv1.1)
- Brown Attention-Deficit Disorder Scale (BADDS)
- Conners Adult ADHD Rating Scale (CAARS)
- Wechsler Adult Intelligence Scale (WAIS)
A definitive diagnosis for ADHD would benefit from more than one person’s assessment or test. The results obtained by self-reported scales or caregiver/teacher report scales may also be skewed and/or subjective.
Interviews and assessments used to diagnose ADHD should obtain information from more than one person and in different settings. Commonly, parents, siblings, or school friends may be able to provide further information on whether certain patterns of behaviour (i.e. ADHD symptoms) were present in the person’s past, especially if they have known the person in childhood.
Using various assessments could also mean testing in various areas like inattention, hyperactivity, and impulsivity, intellectual abilities and executive functioning to rule out any other disorders or comorbidity and develop future intervention plans.