ADD/ADHD Treatment Services

1. Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
   • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities
   • Often has trouble holding attention on tasks or play activities
   • Often does not seem to listen when spoken to directly
   • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked)
   • Often has trouble organizing tasks and activities
   • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework)
   • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones)
   • Is often easily distracted
   • Is often forgetful in daily activities

2. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
   • Often fidgets with or taps hands or feet, or squirms in seat
   • Often leaves their seat in situations when remaining seated is expected
   • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless)
   • Often unable to play or take part in leisure activities quietly
   • Is often “on the go” acting as if “driven by a motor”
   • Often talks excessively
   • Often blurts out an answer before a question has been completed
   • Often has trouble waiting his/her turn
   • Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:

• Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
• Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).
• There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
• The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

Based on the types of symptoms, three kinds (presentations) of ADHD can occur:

• Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months
• Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months
• Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months.

Because symptoms can change over time, the presentation may change over time as well.

Diagnosing  ADHD in Adults

ADHD often lasts into adulthood. To diagnose ADHD in adults and adolescents age 17 or older, only 5 symptoms are needed instead of the 6 needed for younger children. Symptoms might look different at older ages. For example, in adults, hyperactivity may appear as extreme restlessness or wearing others out with their activity.

The most recent revision, DSM-5, breaks Attention-Deficit/Hyperactivity Disorder into three subtypes: Predominantly Inattentive Presentation, Predominantly Hyperactive/Impulsive Presentation, and Combined Presentation, to more accurately reflect the most common forms of the condition. Though using the term ADD may in some cases refer more specifically to ADHD of the Inattentive Presentation, the term is just as often used as a substitute for ADHD – with the unspoken assumption that “type” or presence of particular symptoms like hyperactivity would have to be specified on a case by case basis.

Hyperactivity

Excessive activity is the most visible sign of AD/HD [ A.D.D. OR ADHD ]. The hyperactive toddler/preschooler is generally described as “always on the go” or “motor driven.” With age, activity levels may diminish. By adolescence and adulthood, the overactivity may appear as restless, fidgety behavior (American Psychiatric Association, 1994).^*

Symptoms of hyperactivity are:

• often fidgets with hands or feet or squirms in seat
• often leaves their 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 (in adolescents or adults, may be limited to subjective feelings of restlessness)
• often has difficulty playing or engaging in leisure activities quietly
• is often “on the go” or often act as if “driven by a motor”
• often talks excessively