October is ADHD Awareness Month. In honor of that fact, I feel that it is important for people to have access to accurate information.
One question I frequently get asked is, “Do I, or my child, have ADD or ADHD?
ADD and ADHD are commonly used interchangeably by many people when talking about Attention Deficit Hyperactivity Disorder. So, what is the difference between ADD and ADHD and which one should you use?
Many people use ADD to describe themselves or a loved one who does not have hyperactivity as a symptom. Conversely, people often use ADHD when there is a component of hyperactivity showing up for an individual.
So, where did this name come from? ADHD has been described and labeled in many ways over the decades. Terms such as “hyperkinesis of childhood,” “minimal brain damage,” and “minimal brain dysfunction” were used to label the symptoms that were observed.
It wasn’t until the 1980 that the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) changed the name to “Attention Deficit Disorder (ADD): with and without hyperactivity.” The 1990s and year 2000 (revision), brought the DSM-IV which established, “Attention Deficit-Hyperactivity Disorder.” They also distinguished three subtypes under the ADHD diagnosis, 1) Predominantly Inattentive Type, 2) Predominantly Hyperactive-Impulsive Type and 3) Combined Type (Inattentive, hyperactive and impulsive).
In 2013, a new edition of the DSM, DSM-V, was released and along with it came changes to the definition of ADHD and the criteria necessary for diagnosing ADHD.
Here is an excerpt, from an ADHD Awareness Month resource, describing the most recent changes affecting the diagnosis of ADHD:
What about ADHD has changed with the DSM-5?
- Adult ADHD: For many years, the diagnostic criteria for ADHD stated that it was children who were diagnosed with the disorder. That meant that teens and adults with symptoms of the disorder, and who may have been struggling for many years but didn’t know why, couldn’t officially be diagnosed with ADHD. The DSM-5 has changed this; adults and teens can now be officially diagnosed with the disorder. The diagnostic criteria mentions and gives examples of how the disorder appears in adults and teens.
- In diagnosing ADHD in adults, clinicians now look back to middle childhood (age 12) and the teen years when making a diagnosis for the beginning of symptoms, not all the way back to childhood (age 7).
- In the previous edition, DSM-IV TR, the three types of ADHD were referring to as “subtypes.” This has changed; subtypes are now referred to as “presentations.” Furthermore, a person can change “presentations” during their lifetime. This change better describes how the disorder affects an individual at different points of life.
- A person with ADHD can have now have mild, moderate or severe ADHD. This is based on how many symptoms a person has and how difficult those symptoms make daily life.
What is a significant change between DSM-IV TR and DSM-5?
- A person can now be diagnosed with ADHD and Autism Spectrum Disorder.
What symptoms must a person have for a diagnosis of ADHD?
In making the diagnosis, children still should have six or more symptoms of the disorder. In older teens and adults the DSM-5 states they should have at least five symptoms.
The criteria of symptoms for a diagnosis of ADHD:
- Fails to give close attention to details or makes careless mistakes.
- Has difficulty sustaining attention.
- Does not appear to listen.
- Struggles to follow through on instructions.
- Has difficulty with organization.
- Avoids or dislikes tasks requiring a lot of thinking.
- Loses things.
- Is easily distracted.
- Is forgetful in daily activities.
- Fidgets with hands or feet or squirms in chair.
- Has difficulty remaining seated.
- Runs about or climbs excessively in children; extreme restlessness in adults.
- Difficulty engaging in activities quietly.
- Acts as if driven by a motor; adults will often feel inside like they were driven by a motor.
- Talks excessively.
- Blurts out answers before questions have been completed.
- Difficulty waiting or taking turns.
- Interrupts or intrudes upon others.
Combined inattentive & hyperactive-impulsive presentation:
- Has symptoms from both of the above presentations. *
So, is it ADHD or ADD? According to the DSM-V, the correct label is ADHD. In reality it doesn’t matter what you call it, as long as you find the appropriate resources, supports and structures to allow you, or your child, to live life up to your highest potential. Don’t let a label, ADD or ADHD, limit your resources.
*Reference: American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5), Washington, D.C.: American Psychiatric Association: http://www.adda-sr.org/upload/ADHD-and-the-DSM-5-Fact-Sheet1.pdf. The above information was prepared by the National Resource Center on ADHD: A Program of CHADD (NRC). The NRC is supported through Cooperative Agreement Number CDC-RFA-DD13-1302 from the Centers for Disease Control and Prevention (CDC). The contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.