The classic definition of ADHD is that it is a neurodevelopmental disorder characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning or development. The DSM V diagnostic criteria are listed below, and are an important piece of identifying differences between folks. However, at the Gordon Therapy Group we like to recognize that ADHD isn’t just a deficit – it can also be a plus. While folks with ADHD may have a harder time inhibiting their urge to do interesting things when something more boring has to get done, they also often have the ability to hyperfocus on things they enjoy for hours at a time, have more creativity and more energy than others, and can be charismatic and engaging leaders. Our goal as psychologists with children is to help parents bring out the best in their children and support you as you scaffold them in areas where they need more support, using all of the evidence based techniques that are available. For adults with ADHD, we will teach you skills to manage your life and emotions better so that you can bring your best self to every situation.
DSM-5 Criteria for ADHD
To meet DSM-5 diagnostic criteria, symptoms must:
- Be present before age 12
- Be present in two or more settings (e.g., home, school, work)
- Interfere with or reduce the quality of social, academic, or occupational functioning
- Not be better explained by another mental disorder
Inattention (≥6 symptoms for children, ≥5 for those 17+):
- Often fails to give close attention to details or makes careless mistakes
- Difficulty sustaining attention in tasks or play
- Seems not to listen when spoken to directly
- Often does not follow through on instructions; fails to finish tasks
- Difficulty organizing tasks and activities
- Avoids or dislikes tasks requiring sustained mental effort
- Often loses things necessary for tasks
- Easily distracted by extraneous stimuli
- Often forgetful in daily activities
Hyperactivity and Impulsivity (≥6 symptoms for children, ≥5 for those 17+):
- Often fidgets or taps hands/feet; squirms in seat
- Leaves seat when expected to remain seated
- Runs or climbs excessively (in adolescents/adults, may be restlessness)
- Unable to play or engage in leisure quietly
- Often “on the go” or acts as if “driven by a motor”
- Talks excessively
- Blurts out answers before questions are completed
- Difficulty waiting turn
- Interrupts or intrudes on others
Typical Age of Diagnosis
- Most commonly diagnosed in childhood, usually between ages 6 and 12
- Can also be diagnosed in adolescents and adults, though adult diagnosis often requires evidence of childhood onset
- Earlier diagnosis may occur if symptoms are severe
Statistics (U.S. Focused, but Similar Globally)
- Prevalence:
- Children (ages 3–17): ~9.8% (CDC, 2022)
- Adults: ~4.4% (likely underdiagnosed)
- Gender Differences:
- More common in males than females (approx. 2:1 in children)
- Females more likely to present with inattentive symptoms and may be underdiagnosed
- Co-occurring Conditions:
- Anxiety disorders
- Depression
- Oppositional defiant disorder (ODD)
- Learning disabilities
Comprehensive Treatment for ADHD
Effective treatment often involves a multimodal approach, including behavioral, educational, psychological, and pharmacological components.
1. Behavioral Interventions
- Parent training in behavior management techniques
- Behavioral classroom interventions
- Organizational skills training
- Cognitive-behavioral therapy (CBT), especially helpful in adolescents/adults
2. Medications
- Stimulants (most effective and first-line)
- Methylphenidate (e.g., Ritalin, Concerta)
- Amphetamines (e.g., Adderall, Vyvanse)
- Non-stimulants (for those who don’t tolerate stimulants)
- Atomoxetine (Strattera)
- Guanfacine (Intuniv), Clonidine (Kapvay)
3. Educational Support
- 504 Plans or IEPs (Individualized Education Programs)
- Classroom accommodations: extra time, movement breaks, seating changes
4. Psychosocial Support
- Social skills training
- Counseling for self-esteem, relationships, and coping skills
- Family therapy
5. Lifestyle and Alternative Strategies
- Regular physical activity
- Adequate sleep
- Nutritional support (omega-3s may help, though not a primary treatment)
- Mindfulness and meditation techniques