There is no single diagnostic test for ADHD; instead, diagnosis has been a mostly subjective stepwise process that also has to take into consideration several other conditions, such as anxiety, learning disabilities, and sleep disorders, which may cause similar symptoms.
This diagnostic dilemma is illustrated quite effectively by Dr. Eric Berg in this video, along with some insights regarding treatment. Although his solutions may be a bit oversimplified.
ADHD is defined primarily by persistent symptoms of impulsivity, hyperactivity, and/or inattention that can severely affect a person’s quality of life. Some people present mostly with symptoms related to inattention, others present mostly symptoms related to hyperactivity and impulsivity, while others have all three types of symptoms in combination.
Symptoms of inattention (ADD) include
Symptoms of hyperactivity (generally in children) include
Symptoms of impulsivity include
Many children with ADHD struggle academically and in social situations. Also, symptoms are frequently accompanied by other problems, including depression, anxiety, sleep disturbances, and substance abuse.
Most diagnostic criteria describe the three types of ADHD: predominantly inattentive, predominantly hyperactive/impulsive, or a combination of both. Symptoms must be present for at least six months, occur frequently, and impair aspects of function in academic, social, or occupational activities.(*)
The DSM-5 criteria for ADHD diagnosis can be seen on Table 1
| Type of ADHD | |||
|---|---|---|---|
| Age | Inattentive Dominant | Hyperactive/impulsive Dominant | Combined Presentation |
| ≤ 17 | ≥ 6 symptoms of inattention | ≥ 6 symptoms of hyperactivity and impulsivity | ≥ 6 symptoms from both dimensions |
| ≥ 18 | ≥ 5 symptoms of inattention | ≥ 5 symptoms of hyperactivity and impulsivity | ≥ 5 symptoms from both dimensions |
Table 1. DSM-5 criteria for ADHD diagnosis (*)
The term ADD (Attention Deficit Disorder) has been replace by ADHD to take into account the hyperactivity that is often associated with attention deficits. However, although it is no longer in vogue, we believe that term is still useful, especially for adults who may have significant attention issues, but who are not “hyperactive nor impulsive.”
To assist in the diagnosis of ADHD, in July 2013 the Food and Drug Administration (FDA) approved the use of Neuropsychiatric EEG-Based Assessment Aid (NEBA), a new brain-wave-monitoring system, to assist physicians in diagnosing ADHD in children and adolescents aged 6–17 years. The non-invasive test takes about 15–20 minutes and involves placement of sensors on the scalp of the individual to monitor their brainwaves. Individuals with ADHD typically have a significantly higher theta/beta brainwave ratio, and the NEBA system can identify this phenomenon,(*)
Dr. Amen’s 6-7 Types
One of the most popular authorities on this topic, is the PBS presenter and author Daniel Amen, M.D.. Dr. Amen, a board certified Psychiatrist, has written and lectured extensively on this topic. And in 2001 he came out with a book titled Healing ADD The Breakthrough Program That Allows You To See And Heal The 6 Types Of ADD. This has become somewhat of a classic in this field, at least among those interested in alternative treatments, although Dr. Amen also advocates for the use of medications for these disorders, where it seems most appropriate.
Some of his colleagues don’t particularly like him however, as he has strayed significantly from the medical norm, employing brain scans and a more holistic, or nutritional approach that are not always appreciated in main stream psychiatry. The American Brain council, however, recognizes this as a well written, insightful, and worthwhile manual for parents, as well as adults with ADD/ADHD. You may want to obtain a copy of his more recent revision: Healing ADD Revised Edition: The Breakthrough Program that Allows You to See and Heal the 7 Types of ADD, available on Amazon.
However, for now, here is a link to a presentation by Dr. Amen and his wife on The 7 Types of ADD and How To Treat Them.
(Obviously an additional “Type” was added after his first book was published.) You will see that due to his SPECT scanner use, his Types have a different focus than the more traditional types noted above – which provide some additional insights for treatment.
Unfortunately, although Dr. Amen’s organization is growing and he has various medical centers around the country, SPECT scanners are generally quite hard to find.
