Diagnosing Attention Deficit Hyperactivity Disorder

NYU Langone doctors are experienced at diagnosing attention deficit hyperactivity disorder (ADHD), a psychiatric condition that affects a person’s focus, behavior, and ability to pay attention. It is often diagnosed in childhood, when symptoms may affect a child’s social interactions and performance in school.

However, sometimes a diagnosis of ADHD is missed in childhood altogether, or a child’s symptoms may be attributed to conditions such as depression or anxiety, which are often present along with ADHD. Even with treatment in childhood, ADHD can persist into adulthood and continue to cause difficulty with a person’s ability to concentrate, work efficiently, and interact socially. About 50 to 60 percent of children with ADHD continue to have symptoms into adulthood.

ADHD is diagnosed equally as often in men and in women. Its exact cause is unknown, although researchers suspect there is some genetic component. The disorder often runs in families: About 85 percent of people with ADHD have a family member with the condition. Many adults may have been labeled as daydreamers, slackers, troublemakers, or bad students in childhood only to be diagnosed with ADHD in adulthood—often after their own child receives this diagnosis.

Depending on the symptoms, an adult or child may be diagnosed with one of three presentations of ADHD—predominantly inattentive type, predominantly hyperactive-impulsive type, or combined type ADHD. Children are more likely than adults to show hyperactive symptoms, because hyperactivity tends to wane as a person reaches adulthood.

Adults with ADHD are more likely than children to show inattentive symptoms. Adults with all forms of ADHD are more likely than adults without the condition to have a history of poor educational performance, to perform inadequately at work, to lose jobs or to change employers frequently, and to have relationship or marital problems.

Both adults and children with predominantly inattentive type ADHD may often be distractible and forgetful, have difficulty sustaining attention or listening, and have trouble attending to detail. They may have poor organizational and study skills, easily lose things, and have difficulty managing time.

People with the predominantly hyperactive-impulsive type ADHD may seem to be restless or in constant motion. They often talk excessively, interrupt or intrude, and have difficulty waiting in professional and social situations. However, people with this type may have few or no problems with attention or concentration. Less than 5 percent of people with ADHD are estimated to have this subtype of the condition.

Combined type ADHD is the most common subtype. People with this type of the condition have a combination of the inattentive and hyperactive-impulsive symptoms.

Evaluation and Diagnostic Tests

For an adult to be diagnosed with ADHD, symptoms must be present since childhood and affect your ability to function daily. The experts at NYU Langone use certain rating scales to determine if an adult meets the diagnostic criteria for ADHD. In fact, the psychiatrists at NYU Langone, working in collaboration with the Harvard School of Public Health, the World Health Organization, and other institutions, helped to create a questionnaire called the ADHD Self-Report Scale Screener, also known as the ASRS-v1.1, to better identify at-risk adults in the general population.

This screening tool takes less than five minutes to complete and can provide supplemental information that is critical to the diagnostic process. Filling out the questionnaire also helps you to better recognize the signs and symptoms of adult ADHD.

During an evaluation for ADHD, a psychologist or psychiatrist asks you to recall your childhood behavior and school experiences and to describe current difficulties caused by your symptoms. You may also be asked about any stressors. Our specialists may speak with you spouse or partner, parents, or close friends to obtain a complete picture of your symptoms and a better understanding of how they affect your everyday life. In order to be diagnosed with ADHD, an adult must have persistent symptoms that affect the ability to function daily, and the symptoms must date back to childhood.

Adults with ADHD are likely to have one or more coexisting mental health condition, such as anxiety or depression, which may contribute to additional emotional distress and difficulty meeting the demands of everyday life. During an ADHD evaluation, an NYU Langone specialist asks about your mood, thoughts, and behavior patterns to determine if your symptoms may be caused by one of these conditions.

After an evaluation is complete, your doctor meets with you to review his or her findings and to discuss treatment recommendations.