SCIE Research briefing 7: ADHD - background, assessment and diagnosis

Published August 2004

Updated August 2005

Introduction

A SCIE Research briefing provides up-to-date information on a particular topic. It is a concise document summarising the knowledge base in a particular area and is intended to act as a 'launch pad’ or signpost to more in-depth material. The briefing is divided into the different types of knowledge relevant to health and social care research and practice, as defined by the Social Care Institute for Excellence (SCIE).

The topic of this particular briefing is Attention Deficit/Hyperactivity Disorder (ADHD), and the related disorder or sub-type, Hyperkinetic Disorder (HKD), although the literature generally does not distinguish between the two in its recommendations or evaluations of assessment or management strategies. The client group being considered by this briefing is children and adolescents only. The behavioural disorder ADHD is characterised by early onset and three particular elements: hyperactivity, inattention and impulsiveness. There are three principal sub-types: predominantly inattentive type; predominantly hyperactive or impulsive type; and a combination of the two types. The basic definition of ADHD is "a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparative level of development". The essential diagnostic criteria for ADHD demands that a child must be under seven years of age and demonstrate clear social and functioning impairment across more than one setting, for example, home and school, for more than six months. Diagnosis is often difficult because other problems, such as epilepsy, autism, oppositional defiant disorder (ODD), conduct disorder, anxiety, depression, and a range of learning difficulties, can result in similar behaviour to ADHD and/or mask symptoms.