ADHD is characterized by two main categories of symptoms:
- Inattention, which refers to difficulty paying attention to and carefully completing a given task, particularly in situations that require continued concentration or mental effort.
- Hyperactivity-impulsivity, which means having an unusually high level of activity and difficulty inhibiting impulses. Motor symptoms of hyperactivity become less obvious in adolescence compared to childhood, but difficulties persist with restlessness and impulsivity.
The Combined Presentation of ADHD is diagnosed if the required number of symptoms of inattention and the required number of symptoms of hyperactivity-impulsivity have been present for the past six months. The symptoms of inattention are as follows:
- Often fails to give close attention to details or makes careless mistakes on schoolwork or other activities
- Often has difficulty holding attention on tasks or play activities
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish schoolwork or chores
- Often has difficulty with organization
- Often avoids or dislikes tasks that require continued mental effort
- Often loses necessary materials
- Is often easily distracted
- Is often forgetful in daily activities
The symptoms of hyperactivity-impulsivity include the following:
- Often fidgets with or taps hands or feet, or squirms in seat
- Often leaves seat in situations when remaining seated is expected
- Often runs about or climbs in situations where it is not appropriate (adolescents may be limited to feeling restless)
- Often unable to play or take part in leisure activities quietly
- Is often "on the go" acting as if "driven by a motor"
- Often talks excessively
- Often blurts out an answer before a question has been completed
- Often has trouble waiting his/her turn
- Often interrupts or intrudes on others (e.g., butts into conversations or games)
In order to meet criteria for ADHD, Combined Presentation, six or more of the inattention symptoms and six or more of the hyperactive-impulsive symptoms must be present for children and adolescents up to age 16. Adolescents 17 and older must show five or more symptoms of inattention and five or more symptoms of hyperactivity-impulsivity. These symptoms must be present for at least six months and be inappropriate for the child or adolescent’s developmental level. Additionally, the following conditions must be met:
- Several symptoms were present before age 12
- Several symptoms are present in two or more settings, such as at school, home, and in peer interactions
- Symptoms clearly interfere with or reduce the quality of the child’s school or social functioning
- Symptoms are not better explained by another psychiatric condition (for example, an anxiety or mood disorder) or occur only during the course of schizophrenia or another psychotic disorder