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How Is ADHD Diagnosed? Methods and Criteria Unveiled

Our experts have compiled this 5-step guide about the process of obtaining an ADHD diagnosis so you can know what to expect.
Written by
Jenna Neilsen
Clinical Social Work/Therapist, MSW, LCSW

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For many adults, a formal ADHD diagnosis can be a life-changing moment: a new world of treatment options, a fresh perspective about yourself and your behaviors, and a solid first step toward building a happier and more productive life.

Because of this importance, however, the experience can often seem daunting. To help alleviate some of the stress of an ADHD diagnosis, we've broken the ADHD diagnostic process down step-by-step. That way, you can be sure you're getting the right help and the most accurate diagnosis possible.

Understanding ADHD

According to the American Psychiatric Association, ADHD, or attention deficit hyperactivity disorder, affects almost 9% of children and at least 2.5% of all adults worldwide, making it one of the most common mental disorders worldwide. In reality, many experts believe that adult ADHD is even more common than those statistics suggest, with up to 80% of adults living with the disorder going undiagnosed.

In day-to-day life, ADHD can have profound effects on a person's ability to perform simple tasks, remain focused, or operate in a healthy and comfortable way in various social, academic, or professional situations. Fortunately, modern research continues to explore ADHD, how it affects different types of individuals, and how to diagnose and treat the disorder.

What Are the Steps in the ADHD Diagnostic Process?

Typically, the process of diagnosing ADHD involves five distinct steps. Although previous generations required many of these steps to be carried out in person, modern mental health professionals are usually comfortable performing an ADHD diagnosis via video call.

By doing so, patients can undergo the process in a more familiar, comfortable location and collaborate with some of the most experienced therapists from around the world.

  1. Observing Potential ADHD Symptoms

A key first step in diagnosing ADHD is establishing potential symptoms. Often, this is done using various ADHD symptom checklists. Some people prefer to perform a self-assessment prior to meeting with a mental health professional, but your therapist will inevitably ask questions of their own to help identify symptoms or behaviors you might have overlooked.

ADHD symptoms are traditionally broken down by "presentations," or the type of ADHD. These presentations are:


Hyperactive-impulsive symptoms are some of the most readily recognized by the general public due to their often physical nature. In children, these symptoms can manifest as a difficulty staying seated, fidgeting or squirming, or talking too loudly or quickly.

For adults with ADHD, hyperactive-impulsive symptoms may involve unnecessary risk-taking behavior, difficulties with impulse control, substance abuse, or interrupting others during conversations.


For many people, symptoms related to inattentive ADHD can be more difficult to identify in both children and adults. These symptoms usually involve difficulty focusing on prolonged tasks, stopping a project or activity halfway through, struggles with organization, or frequently missing deadlines.

While inattentive ADHD symptoms can significantly impact a child's life, that potential impact is just as severe for adults. Whether it's trouble maintaining finances, poor performance at work, or interpersonal conflict in relationships, it's vital to address these symptoms.


The combined presentation of ADHD is, by far, the most commonly diagnosed in the world. Simply put, this diagnosis means that an individual displays a mixture of both inattentive and hyperactive-impulsive symptoms, though that balance can look very different from person to person.

No matter what type of ADHD you are ultimately diagnosed with, remember that these symptoms affect everyone differently, and personalized treatment is key to ensuring the best results.

Display of Symptoms

Usually, adults seeking an ADHD diagnosis will have recognized certain behaviors or habits in their lives that lead them to believe they may have the condition. As you prepare for the formal diagnostic process, take the time to record any symptoms you've observed over the past two weeks. Remember, these can be symptoms related to hyperactivity, impulsivity, inattentiveness, or any combination of the three.

Finally, some people prefer to ask friends, coworkers, or family members for help recognizing and recording potential symptoms. If you're comfortable with this, getting multiple perspectives can allow you to identify behaviors you may have overlooked on your own.

  1. Initial Assessment

Initial assessments, or "quizzes," are an optional but suggested step toward an official ADHD diagnosis. These tests, like the one offered by ADHDAdvisor.org free of charge, help you to identify and better understand potential signs and symptoms of ADHD in your daily behaviors.

By taking the time to perform an initial assessment this way, you can go into your clinical assessment equipped with the perspective and information needed to receive the most accurate diagnosis possible.

  1. Clinical Assessment

To properly diagnose ADHD, individuals must undergo a clinical assessment with a licensed mental health professional. In years past, these assessments typically took place in person in order to allow a therapist to observe behavior first-hand. Today, however, clinical assessments can easily be performed by video call for those who prefer the privacy or convenience of a remote meeting.

During this clinical exam, your mental health professional will guide you through a series of questions designed to explore any ADHD symptoms or behaviors with which you frequently struggle. This process is designed around the DSM-5, a diagnostic and statistical manual that outlines various mental health conditions, how they should be diagnosed, and other vital information.

  1. Physical or Neurological Testing

Sometimes, a mental health professional will ask for additional physical or neurological testing based on what they observe during an ADHD assessment. Usually, this is done to rule out other psychiatric disorders that may resemble ADHD or even underlying physical conditions that may complicate different treatment options and medication choices.

In these cases, your assigned therapist can work with your primary care doctor to arrange whatever testing is necessary.

  1. Exploring Treatment Options

In the case of a positive ADHD diagnosis, your therapist will begin the process of explaining and exploring different ways to treat ADHD. Depending on your symptoms, the results of any additional testing, your medical history, and your personal preferences, your treatment options may be anything from medication to therapy or success coaching. Often, patients will opt for some combination of the three for the best possible results.

It's important to remember, however, that finding the ideal treatment plan for each case of ADHD can take time, so working with a qualified, dedicated therapist is crucial to your success. Following your clinical diagnosis with ADHDAdvisor.org, for instance, you'll be given the option to schedule more sessions with your diagnosing physician.

Criteria for an ADHD Diagnosis

Although symptoms may differ from person to person, the American Psychiatric Association outlines very clear criteria for therapists to follow during the ADHD diagnostic process.

Symptom Scale

In order to perform as accurate a diagnosis as possible, mental health professionals will use one of several standardized behavior rating scales based on criteria outlined in the DSM-5. Typically, symptom scales will sort behaviors into two separate categories, which are:

ADHD: Predominantly Inattentive Presentation

In order to receive a formal diagnosis of inattentive ADHD, individuals aged 16 or younger must demonstrate six or more symptoms from the list below for a span of at least six months. For those 17 years or older, only five symptoms must be identified. Symptoms include things such as:

  • Difficulty paying attention
  • Difficulty following direction
  • Losing focus during conversations
  • Struggling with organization
  • Frequently forgetful
  • Fails to finish tasks or projects

ADHD: Predominantly Hyperactive-Impulsive Presentation

In order to receive a formal diagnosis of hyperactive-impulsive ADHD, individuals aged 16 or younger must demonstrate six or more symptoms from the list below for a span of at least six months. For those 17 years or older, only five symptoms must be identified.

Additionally, any symptoms must be severe enough to significantly impact day-to-day life or be at odds with the person's developmental level.

Symptoms include things such as:

  • Fidgets, squirms, or has other involuntary physical movement
  • Struggles to pause or take a break
  • Talks too loudly, quickly, or too much
  • Interrupts others during conversations
  • Difficulty relaxing (either physically or mentally)

Other Considerations

In addition, individuals must demonstrate the above symptoms in two or more settings, the symptoms must cause significant impairment in social, academic, or professional life, and the symptoms must not be able to be better attributed to a different mental health condition.

Age of Onset and Duration

Unlike some other psychiatric disorders, which only start showing symptoms later in life, ADHD is typically characterized by symptoms that appear during early childhood. For most, these symptoms begin sometime before the age of 12, though experts acknowledge that symptoms may appear in children as young as three years old. Additionally, symptoms must persist for at least six months to qualify for a clinical diagnosis.

For adults who have gone undiagnosed, speaking about the age of onset can be more difficult. In these cases, speaking with family members or long-term friends may help you remember and recognize behaviors from when you were younger.

Differential Diagnosis

One of the primary complications of ADHD is its tendency to resemble other mental health conditions, such as a mood disorder, various learning disabilities, or anxiety disorders. Because of this, therapists will sometimes perform a more thorough evaluation to firmly establish ADHD as the cause of your symptoms.

Remember, however, that up to 80% of all individuals diagnosed with ADHD will also be diagnosed with at least one other psychiatric disorder in their lifetime, so be prepared for a situation in which your ADHD diagnosis also reveals other truths about your mental health.

ADHD Diagnosis in Adults vs. Children

Like with many other mental disorders, attention deficit hyperactivity disorder (ADHD) can manifest much differently in children than it does in adults. Because of this, the process of diagnosing ADHD in adults is also a much different process.

In general, adults may show fewer or less obvious signs of hyperactivity compared to children with the disorder. This means that while it is possible to self-administer a basic symptom checklist as an adult, it's best to consult a licensed professional to help guide you through a proper diagnosis.

Additionally, obtaining a clinical diagnosis as an adult often involves remembering things about your childhood, specifically before the age of 12. By doing so, you can demonstrate a pattern of symptoms that began early in your development and have continued into adulthood.

How to Find an ADHD Specialist

When looking for an ADHD diagnosis, it's possible to begin your journey in a number of ways. Regardless of which path you choose, it's crucial to find a mental health professional with whom you are comfortable and who has the necessary experience and credentials to perform a formal diagnosis.

  • ADHDAdvisor.org: By trusting us with your diagnosis and eventual care, you give yourself the freedom to focus on the things that matter, like finding answers and improving your quality of life. With ADHDAdvisor.org, you gain access to a broad network of licensed professionals, each of whom is passionate about helping their patients. Even better, you can schedule an ADHD diagnosis and therapy sessions from the comfort of your own home.
  • Primary Care Physician: Often, individuals will speak with their general practitioner for a reference to a mental health professional. For those with other conditions that might complicate medication choices, this can be an excellent choice. Remember, however, that ADHDAdvisor.org's therapists can also collaborate with your doctor to coordinate care.
  • Contact Your Insurance Provider: Sometimes, an ADHD diagnosis may be partially or fully covered by your insurance policy. In these cases, reaching out to a customer service representative from your provider may help identify therapists in your area.
  • Ask Friends and Family: Every year, the conversation surrounding mental health is becoming more open and inclusive. Today, there's no reason not to speak with friends or family about therapy and what their recommendations might be.
  • Speak with a Local Health Clinic: Many areas maintain local clinics to support their communities. Often, these organizations will have the necessary information and resources to point you in the right direction for a diagnosis.

Why Choose ADHDAdvisor.org

At ADHDAdvisor.org, we believe that the path toward better mental health should be as painless and convenient as possible. And, as long-time believers in the power of therapy and coaching, we understand the enormous impact that the right diagnosis and treatment can have on a person's life.

In order to bring those two values together, we created an online platform dedicated to connecting people in need to the passionate professionals best suited to serve them. When you trust us with your ADHD diagnosis and care, you give yourself access to some of the most powerful tools possible, including personalized treatment plans, advice and guidance about medication choices, reliable therapy sessions from the comfort of your own home, and success coaching designed to build new habits and healthy behaviors.

We're so confident in the value of our services that not only do we offer a complimentary assessment to get you started, but we also provide a 100% money-back guarantee if you are at all dissatisfied with your diagnosis experience. All you need to do to get started is take our short assessment to find out if scheduling a diagnostic appointment with our professionals is right for you. And once you've obtained your diagnosis, we'll be there every step of the way to plan your treatment and help find solutions.

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