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Diagnosing ADHD

For healthcare professionals
There are two definitive manuals for physicians that contain chapters describing the criteria for diagnosing ADHD. They are known as the DSM-V and the ICD-10. They have slightly different ways of defining the sub-types and levels of severity ADHD, but in general terms they describe the same disorder as follows:


To receive a diagnosis of ADHD, an individual must display some or all of the following characteristics:

  • Inattention: forgetful, loses interest quickly, doesn’t listen when spoken to
  • Hyperactivity: fidgets, talks excessively, runs about and climbs in inappropriate places, difficulty in engaging in activities quietly
  • Impulsivity: high risk behavior, doesn’t think about consequences, difficulty in suppressing what they want to say

Challenges and Conditions

Diagnosis can be quite challenging because:

  • There is no physical test for ADHD (such as a blood test)
  • All children may have some problems with self-control
  • Other problems can result in similar behavior to ADHD
  • Other problems can overlap and hide those of ADHD

In order to compensate for these difficulties, even if all the above symptoms are present, the following conditions must also be met:

  1. Even if diagnosed later, looking back symptoms must have begun before 12 years of age (as of DSM-V).
  2. Symptoms must be noted at school (or work) as well as at home
  3. There must be a definite negative effect on social, school, or work performance
  4. The symptoms are not the result of another disorder

Who can get ADHD?

Attention Deficit Hyperactivity Disorder is a neurobehavioral disorder that is thought to have primarily genetic causes, although a number of environmental factors are also postulated as affecting development of ADHD, specifically prenatally and during birth. Some believe that when present these factors may simply exacerbate an underlying genetic predisposition. These are issues that are still being researched and studied. What is know for certain is that you cannot develop ADHD later in life, nor can you contract ADHD from another individual.

Both boys and girls are affected by ADHD. Boys with ADHD are 2 to 3 times more likely than girls to be hyperactive, while inattention seems to occur in girls as often as it does in boys. It’s possible that this leads to girls with ADHD being overlooked as they do not attract obvious attention with the disruptive behavior seen most often in boys.

ADHD is estimated to affect 2.7% – 13.5% of school-aged children in Saudi Arabia, making it the most common behavioral disorder in children. Adolescents and adults can also have ADHD, even if they were not diagnosed with the disorder when they were younger. It is estimated that one third to one half of children with ADHD will continue to display some or all of their childhood ADHD symptoms as adults. Many – but not all – adults with ADHD lose the hyperactivity they had as children, and instead primarily exhibit the inattentive side of ADHD.

Who can diagnose ADHD?

Only healthcare professionals can officially diagnose ADHD. The diagnosis and management of ADHD is a multi-disciplinary effort and depending on individual requirements the other healthcare professionals may have specific primary or supporting roles to play at different stages of the process.

What tests may be performed?

In addition to evaluation of the abovementioned criteria through clinical interview, members of the diagnostic team may ask parents to complete one or more standardized questionnaires that help to form a clear picture of a child or adolescent’s behavior. As there is no direct school involvement in Saudi Arabia, they may also request parents to provide similar questionnaires for their child’s teachers to complete.

Again, depending on the individual, a member of the diagnostic team may recommend additional tests which measure the length and type of mental process or tests of attention and persistence.

In order to exclude the presence of other lookalike disorders or the possibility of other co-existing conditions contributing to the ADHD-like symptoms, various other tests may also be performed.

A number of self-tests are available that can help you form an educated opinion about whether you or your child may have ADHD, but these are simply screening tests, not diagnostic tests, and should be taken only as a first step in deciding whether to consult a professional. Healthcare professionals are trained to recognize the smallest signs and symptoms that cannot be discovered from a generic self-test. They will examine the detailed history of someone suspected to have ADHD in order to eliminate any other possibility. It is important that they are consulted to ensure an accurate diagnosis.

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