A simple definition of ADHD
“ADHD” is the abbreviation for “Attention-Deficit/Hyperactivity Disorder.” Sometimes it’s also called ADD (Attention-Deficit Disorder), but for simplicity’s sake, we’ll just use the official name “ADHD” here.
When an ADHD person notices something that his brain finds inherently interesting, he will hyperfocus on it – often to the point that it blocks out all other stimuli. The ADHD person also wants to respond to this stimulus immediately. Restlessness may occur as the person’s brain is telling his body to get up and go find something interesting, but that’s not the case for every person.
What is a medical definition of ADHD?
Attention-Deficit/Hyperactivity Disorder – or ADHD – was so named by the American Psychiatric Association in 1995. (Although it may not include hyperactivity in all patients.) Prior to this, it has been known by many names over the past century, including ADD, Hyperkinetic Disorder, “…and my favorite inaccurate name,” adds Dr. Romereim, “Minimal Brain Dysfunction.”
Although it may present as various attributes in various people, ADHD is primarily a biologically programmed need to monitor the environment for the most interesting stimuli, to hyperfocus on that stimuli, and to respond to it immediately and reflexively.
This trait is a genetic, inherited difference transmitted by several different genes, with the most commonly associated gene a variant of the dopamine receptor known as DRD4. In people with ADHD, it is associated with the allele (variant) of the DRD4 gene known as the 7 repeat allele which is located on chromosome 11.
This gene codes for the dopamine receptors in the brain. Dopamine is one of two neurotransmitters (chemicals) which send messages from one nerve to the next in the prefrontal cortex, the part of the brain that controls attending to and responding to stimuli, and other functions related to learning, decision making and impulse control.
The APA has identified three sub-types of ADHD:
- Predominantly inattentive type;
- Predominantly hyperactive-impulsive type
- Combined type.
The need for a comprehensive evaluation
While our checklists (links below) can help screen for the possibility of ADHD, an accurate diagnosis requires a comprehensive evaluation. This is best done by one or more clinicians who have experience in ADHD and related conditions.
If you’re seeking help with a child, the first step should be an evaluation to see if your child’s struggles are greater than the norm by age and gender.
In both child and adult patients, the examining professional should also explore whether related or similar conditions might account for the learning or behavioral difficulties.
What you can expect from a thorough ADHD evaluation
- It should be conducted by a health professional (or a team of professionals) with experience and expertise in ADHD and related conditions.
- It should not be a brief, quick exam; will usually require one to two hours, minimum.
- There will be a clinical interview surveying past and present ADHD symptoms, including developmental and medical history, medicines prescribed, and prior testing results, if available.
- If possible, information may be collected from various sources (e.g., parents and teachers), to determine if behavior is ongoing and consistent.
- The interview should also cover client’s ability to meet the demands of daily life, whether at home, work or school.
- In some cases, the evaluation may include testing to determine any cognitive or learning weaknesses that may contribute to the client’s difficulties.
ADHD checklists: a screening tool
Symptom checklist for school-age children
This checklist helps identify possible signs of ADHD in children. Mark how frequently each behavior occurs.
How to Use the Checklist
- Never or Rarely – The behavior is almost never observed.
- Sometimes – The behavior happens occasionally.
- Often – The behavior is noticeable and occurs regularly.
- Very Often – The behavior is persistent and happens frequently.
| # | Behavior Description | Never or Rarely | Sometimes | Often | Very Often |
|---|---|---|---|---|---|
| 1 | Struggles to pay close attention to details, frequently makes careless mistakes in schoolwork or daily tasks. | ☐ | ☐ | ☐ | ☐ |
| 2 | Has trouble maintaining focus on activities, especially those that are not personally interesting. | ☐ | ☐ | ☐ | ☐ |
| 3 | Seems to ignore people when spoken to directly. | ☐ | ☐ | ☐ | ☐ |
| 4 | Fails to complete assignments, chores, or responsibilities after receiving instructions. | ☐ | ☐ | ☐ | ☐ |
| 5 | Has difficulty organizing tasks, schedules, or personal belongings. | ☐ | ☐ | ☐ | ☐ |
| 6 | Avoids or dislikes tasks requiring sustained mental effort, particularly those they find uninteresting. | ☐ | ☐ | ☐ | ☐ |
| 7 | Frequently misplaces or loses important items like books, school supplies, or personal belongings. | ☐ | ☐ | ☐ | ☐ |
| 8 | Gets easily distracted by external sounds, sights, or unrelated activities. | ☐ | ☐ | ☐ | ☐ |
| 9 | Often forgets daily tasks, such as homework, responsibilities, or instructions. | ☐ | ☐ | ☐ | ☐ |
| 10 | Fidgets frequently, taps hands or feet, chews on objects, or shifts restlessly in their seat. | ☐ | ☐ | ☐ | ☐ |
| 11 | Has difficulty staying seated when expected, often leaving their seat at inappropriate times. | ☐ | ☐ | ☐ | ☐ |
| 12 | Engages in excessive running, climbing, or other physical activity in settings where it is not appropriate. | ☐ | ☐ | ☐ | ☐ |
| 13 | Struggles to play or participate in quiet activities without excessive movement or noise. | ☐ | ☐ | ☐ | ☐ |
| 14 | Feels the need to be constantly active or seeking stimulation. | ☐ | ☐ | ☐ | ☐ |
| 15 | Talks excessively, often asking questions impulsively without thinking. | ☐ | ☐ | ☐ | ☐ |
| 16 | Speaks or answers without waiting for the question to be completed. | ☐ | ☐ | ☐ | ☐ |
| 17 | Struggles with waiting for their turn, showing impatience or acting impulsively. | ☐ | ☐ | ☐ | ☐ |
| 18 | Interrupts conversations, games, or activities, frequently intruding on others’ space. | ☐ | ☐ | ☐ | ☐ |
ADHD symptom checklist for teens
| # | Behavior Description | Never or Rarely | Sometimes | Often | Very Often |
|---|---|---|---|---|---|
| 1 | Struggles to focus on details, frequently making careless mistakes in schoolwork, chores, or other tasks. | ☐ | ☐ | ☐ | ☐ |
| 2 | Has difficulty maintaining focus on tasks, especially those that are uninteresting or require sustained attention. | ☐ | ☐ | ☐ | ☐ |
| 3 | Appears not to listen when spoken to directly, often requiring information to be repeated. | ☐ | ☐ | ☐ | ☐ |
| 4 | Fails to complete assignments, chores, or responsibilities unless closely supervised. | ☐ | ☐ | ☐ | ☐ |
| 5 | Struggles with organization, managing time, and keeping track of tasks and responsibilities. | ☐ | ☐ | ☐ | ☐ |
| 6 | Avoids or delays tasks requiring mental effort, especially if they are uninteresting. | ☐ | ☐ | ☐ | ☐ |
| 7 | Frequently loses, misplaces, or has trouble finding important items unless kept in the same location. | ☐ | ☐ | ☐ | ☐ |
| 8 | Easily distracted by unrelated noises, activities, or surroundings when working on a task. | ☐ | ☐ | ☐ | ☐ |
| 9 | Often forgets daily tasks, including where things are, instructions given, or responsibilities. | ☐ | ☐ | ☐ | ☐ |
| 10 | Frequently fidgets, taps hands or feet, plays with hair, clothing, or objects while seated. | ☐ | ☐ | ☐ | ☐ |
| 11 | Struggles to remain seated in class or other situations where staying put is expected. | ☐ | ☐ | ☐ | ☐ |
| 12 | Feels restless, especially in situations that require waiting or when bored. | ☐ | ☐ | ☐ | ☐ |
| 13 | Has difficulty relaxing, unwinding, or engaging in quiet activities without excessive movement. | ☐ | ☐ | ☐ | ☐ |
| 14 | Always feels the need to be active, doing something, or seeking stimulation. | ☐ | ☐ | ☐ | ☐ |
| 15 | Talks excessively, loudly, or at inappropriate moments, sometimes annoying or embarrassing others. | ☐ | ☐ | ☐ | ☐ |
| 16 | Interrupts conversations or answers before questions are fully asked, often speaking impulsively. | ☐ | ☐ | ☐ | ☐ |
| 17 | Acts impatiently when waiting, struggles with delays, or makes impulsive decisions without thinking. | ☐ | ☐ | ☐ | ☐ |
| 18 | Frequently interrupts others’ conversations, activities, or personal space. | ☐ | ☐ | ☐ | ☐ |
Adult ADHD checklist
| # | Behavior Description | Rarely or Never | Sometimes | Often | Very Often |
|---|---|---|---|---|---|
| 1 | Struggles to pay attention to details, leading to messy work, careless mistakes, or difficulty completing repetitive tasks. | ☐ | ☐ | ☐ | ☐ |
| 2 | Has trouble maintaining focus on uninteresting tasks or regaining concentration after being interrupted. | ☐ | ☐ | ☐ | ☐ |
| 3 | Finds it difficult to stay engaged in conversations or often misses important details when others speak directly. | ☐ | ☐ | ☐ | ☐ |
| 4 | Frequently starts new projects but struggles to follow through or only completes them at the last minute. | ☐ | ☐ | ☐ | ☐ |
| 5 | Feels disorganized, overwhelmed, or struggles to manage time, tasks, and paperwork efficiently. | ☐ | ☐ | ☐ | ☐ |
| 6 | Avoids or delays tasks that feel tedious or boring, often rushing to finish them at the last moment. | ☐ | ☐ | ☐ | ☐ |
| 7 | Frequently misplaces or loses important items unless they are kept in the same place. | ☐ | ☐ | ☐ | ☐ |
| 8 | Easily distracted from tasks, conversations, or speakers by background noise, movement, or personal thoughts. | ☐ | ☐ | ☐ | ☐ |
| 9 | Often forgets what needs to be done, what was planned, or needs frequent reminders to stay on track. | ☐ | ☐ | ☐ | ☐ |
| 10 | Constantly moving, tapping, or fidgeting with objects when seated, or struggles to stay still. | ☐ | ☐ | ☐ | ☐ |
| 11 | Feels restless or has an urge to get up and move around in situations where sitting is expected. | ☐ | ☐ | ☐ | ☐ |
| 12 | Craves stimulation and struggles with waiting, often feeling restless in slow or boring situations. | ☐ | ☐ | ☐ | ☐ |
| 13 | Has difficulty unwinding, relaxing, or engaging in quiet activities without feeling agitated. | ☐ | ☐ | ☐ | ☐ |
| 14 | Always looking for something to do or staying busy but often feels unproductive or inefficient. | ☐ | ☐ | ☐ | ☐ |
| 15 | Talks excessively, loudly, or at inappropriate times, sometimes embarrassing or frustrating others. | ☐ | ☐ | ☐ | ☐ |
| 16 | Interrupts conversations, finishes others’ sentences, or speaks impulsively without thinking first. | ☐ | ☐ | ☐ | ☐ |
| 17 | Becomes impatient or irritated when waiting, in traffic, or in lines, often acting without considering consequences. | ☐ | ☐ | ☐ | ☐ |
| 18 | Frequently interrupts or intrudes on conversations, activities, or tasks without realizing it. | ☐ | ☐ | ☐ | ☐ |
Interpretation of the results
- Items 1-9 relate to inattention.
- Items 10-15 relate to hyperactivity.
- Items 16-18 relate to impulsivity.
According to DSM-IV-R, ADHD may be suspected if:
✔ At least 6 out of 9 symptoms in inattention or hyperactivity/impulsivity are marked “Often” or “Very Often.”
✔ If 3 or more behaviors in any category are checked, a professional evaluation is recommended.
For an accurate diagnosis and tailored guidance, consult a healthcare provider.
