The
way Attention Deficit Hyperactivity Disorder, or ADHD, is diagnosed has changed
a number of times and the next change is expected in 2013. This article
explains the changes over the years and why the new change is necessary.
How Attention Deficit
Hyperactivity Disorder is diagnosed continues to change
The
understanding and diagnosis of ADHD has changed over the years in accordance
with the development and changes within the Diagnostic and Statistical Manual
of Mental Disorders. ADHD was first
referred to in the DSM-II in 1968 where the condition was described as
“hyperkinectic reaction of childhood,” emphasising on inattention, impulsivity
and motor activity (APA, 1968). In the
second edition, the disorder was referred to as Attention Deficit Disorder
(ADD), consisting of two subtypes; with hyperactivity and without hyperactivity
(APA, 1980). In 1987, the DSM-III was
revised and the condition was renamed from ADD to Attention Deficit
Hyperactivity Disorder (ADHD) with a single diagnostic checklist (APA,
1987). In 1994, the current DSM-IV was
released, consisting of the three subtypes of ADHD; predominately inattentive,
predominantly hyperactive-impulsive, and combined subtype (APA, 1994).
The disadvantages of the
current method of diagnosing ADHD
However,
there are several disadvantages with the current DSM criteria. One disadvantage includes unreliable recall
of age of onset, before the age of seven, which is particularly difficult to
account for in adults. Age of onset, is
not justifiable and not based on any empirical evidence and the duration of
only 6 months of experiencing difficulties is too short, and does not reflect
that ADHD is a developmental disability rather than a difficulty based solely
on the context (Barkley, 2003). The
current criteria is primarily constructed for a child population and does not
reflect the growing understanding and acceptance of adult ADHD (Bresnahan &
Barry, 2002). Another disadvantage is
that the symptoms are not adjusted for genders.
For example, males typically exhibit more symptoms and to a more severe
degree than females, but this is not considered in the DSM-IV.
When and how will
diagnosing Attention Deficit Hyperactivity Disorder change?
The
next edition of the DSM, DSM-V is planned to be published in May 2013. A draft version of the DSM-V has already been
released and is currently being revised.
Diagnosis of ADHD will be altered in the following ways; the age of
onset will be raised from seven years of age to twelve years of age, whereby
symptoms of inattention or
hyperactivity-impulsiveness must be noticeable by this time. Furthermore, the current DSM states that at
least six symptoms must be met where as it is being proposed that this will be
lowered to four symptoms for individuals aged seventeen or over. This therefore means that adults will need to
meet fewer symptoms for a diagnosis of ADHD and consequently reflects that ADHD
is understood to be a child but also an adult condition.
About The Learning Assessment and Neurocare Centre
The Learning Assessment and Neurocare Centre was
established in 1993. Over the past 17 years the centre has seen more than
6000 people with these conditions, sees up to 240 new patients annually from
all over the country and overseas, and has about 1600 patients on its active
long-term clinical management list. The centre has developed a local and
also a national reputation for being able to assess children,
adolescents, and adults with suspected neurodevelopmental
difficulties in an experienced and comprehensive way. Whilst it
sees people with the more straightforward problems, it also has a great deal of
expertise in the assessment and management of people with complex difficulties.
