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Types of ADHD: Making the Diagnosis

In some people, the signs of ADHD seem obvious -- fidgeting constantly, difficulty paying attention in school or at work, and leaving tasks unfinished. For others, particularly those without behavior problems, ADHD may be more difficult to diagnose.

The symptoms of ADHD may mimic those of other conditions, and sometimes the signs are subtler and harder to distinguish. One psychiatrist, Daniel Amen, MD, believes that to get a truly accurate diagnosis of ADHD, it is necessary to look inside the brain to see how well various areas are functioning. He has developed his own set of ADHD subtypes based on brain scans of children with ADHD, which he says can better target treatment and determine which areas are not working as they should.

How Is ADHD Usually Diagnosed?

Most psychologists, psychiatrists, and pediatricians diagnose ADHD based on a set of inattention and hyperactivity symptoms along with other criteria outlined in the Diagnostic & Statistical Manual for Mental Disorders- Fifth Edition (DSM-V). For someone to be diagnosed with ADHD, the behaviors must have lasted for at least six months, and symptoms must be present in school and in other aspects of the individual's life.

Inattention symptoms of ADHD include:

  • Not paying attention to detail
  • Making careless mistakes
  • Failing to pay attention and keep on task
  • Not listening
  • Being unable to follow or understand instructions
  • Avoiding tasks that involve effort
  • Being distracted or forgetful
  • Losing things that are needed to complete tasks

Hyperactivity-impulsivity symptoms of ADHD include:

  • Fidgeting
  • Squirming
  • Getting up often when seated
  • Running or climbing at inappropriate times
  • Having trouble playing quietly
  • Talking excessively or out of turn
  • Interrupting

Based on the above symptoms listed in its Diagnostic and Statistical Manual, the American Psychiatric Association has identified three subtypes of ADHD:

1. ADHD, Combined Type: Both inattention and hyperactivity-impulsivity symptoms

2.ADHD, Predominantly Inattentive Type: At least 6 out of 9 inattention symptoms, but not enough hyperactivity-impulsivity symptoms

3. ADHD, Predominantly Hyperactive-Impulsive Type: Hyperactivity-impulsivity, but not enough (at least 6 out of 9) inattention symptoms

ADHD Diagnosis Based on Brain Scans -- An Alternative Approach

Amen, a child, adolescent, and adult psychiatrist who serves as medical director of the Amen Clinics in California, Washington, and Virginia, has used a combination of symptoms and brain scans to come up with his own types of ADHD.

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