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Recognising and Diagnosing ADHD

ADHD Myths

Popular stereotypes and misconceptions can often be an obstacle to both recognising ADHD and receiving an accurate ADHD diagnosis.


These often prevent people receiving much needed support for the wide-ranging practical and emotional challenges which can arise from living with undiagnosed, unrecognised, or wrongly diagnosed ADHD.

Myth 1: ADHD is a childhood condition which we grow out of in adulthood​.

  • Our current understanding is that for many people with ADHD it is a lifelong and lifespan condition.

  • The latest research suggests that for individuals diagnosed with ADHD as children between 50% to 70% will continue to be impaired by ADHD symptoms in adulthood.

  • As our knowledge, awareness, and ability to diagnose ADHD increases many adults are receiving a diagnosis of ADHD having never been formally or accurately diagnosed as children.

  • The strong genetic component of ADHD often means adults are retrospectively diagnosed with ADHD, or recognise and seek help for their own ADHD, when their children or those of close family members receive an ADHD diagnosis.

Myth 2: ADHD only or predominantly affects boys.

  • Historically ADHD has been diagnosed approximately three times more frequently in boys than in girls contributing to the perception of it being a condition which predominantly, or even overwhelmingly, affects males.


  • Research is increasingly challenging this as a misconception and recognising that ADHD is potentially missed altogether in girls and women, or attributed to other conditions, with a greater frequency than it is in boys and men.

  • The prevailing stereotype associating physical hyperactivity and disruptive behaviour as hallmark symptoms of ADHD is even less valid for girls, for whom the inattentive manifestations of ADHD prevail in a greater percentage of cases.

Myth 3: ADHD is always characterised by bad behaviour and "physical hyperactivity"​.​

  • Whilst visible physical hyperactivity, an inability to sit still and associated disruptive behaviour linked to physical restlessness can be an indicator of ADHD it is often wholly absent.

  • For many the restlessness of ADHD is internalised, characterised by racing thoughts and an inability to switch our minds off, or a more subtle combination of internal and external restlessness, rather than overt manifestations of physical hyperactivity.

  • Even where physical hyperactivity is a feature of an individual's ADHD in childhood in many cases this becomes much less pronounced as they move through their teenage years' and into adulthood.

Myth 4: ADHD is a Stand​-alone Condition with a single treatment approach.

  • Comorbidities or co-existing conditions are indicated in over 50% of individuals with ADHD complicating both the diagnosis and management of ADHD.

  • Amongst the most commonly seen co-existing conditions are Depression, Anxiety, Obsessive Compulsive Disorder (OCD), Oppositional Defiant Disorder (ODD) and learning disabilities such as Dyslexia and Dyspraxia.

  • There is no cure for ADHD nor a single treatment approach. A multi-disciplinary approach is recommended which may incorporate medication and/ or non-medication.

  • Non-medication options that can effectively support the ongoing management of ADHD include specialist Coaching, Counselling, Occupational Therapy, Behavioural Therapy and Educational Interventions.

  • Five medications are currently licensed for the treatment of ADHD in the UK: Methylphenidate, Dexamfetamine, Lisdexamfetamine, Atomoxetine and Guanfacine.

Myth 5: You can't possibly have ADHD because...

  • You have managed to get a degree, masters, PhD, or any other form of academic or professional qualification.

  • "You don't look like you have ADHD".

  • "It would have been spotted as a child."

  • You didn't get in trouble at school.

  • You can sit still without fidgeting.

  • You are married, have a long-term partner, are in a stable relationship or have children.

  • You have a "good job".


What is ADHD and How Prevalent Is It?

ADHD is a complex, often misunderstood and misdiagnosed condition which is estimated to impact around

  • 5 to 7% of children worldwide.

  • 2 to 5% of adults worldwide. 


Depending on the diagnostic criteria used.

Defining ADHD from a Clinical Perspective

The Diagnostic and Statistical Manual of Mental Disorders 5th Edn (DSM-5) which is used in the USA and much of the rest of the world to provide a formal clinical framework for diagnosing ADHD classifies ADHD as:

"a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development".

Along with exceeding a threshold number of symptoms in either or both of these core areas of impairment the DSM-5 further specifies that

  • Symptoms have persisted for at least 6 months (for children to a degree which is incompatible with developmental level).

  • Several inattentive and/ or hyperactive-impulsive symptoms were present prior to the age of 12 years old.

  • Several inattentive and/ or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).


  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic or occupational functioning.

  • Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

Formally Diagnosing ADHD

  • Currently there is no physical test or neurological screening process that unequivocally confirms the presence of ADHD.

  • Instead, a formal diagnosis of ADHD requires gathering and aggregating evidence in alignment with the DSM-5 classification of ADHD.


  • This can only be performed by an appropriately qualified medical professional (in the UK usually a Psychiatrist or Paediatrician with specialist knowledge of ADHD).

An ADHD Assessment

  • An ADHD assessment will be made through evaluation of the severity and pervasiveness of symptoms, and associated level of functional impairment, in these core areas of Inattention and Hyperactivity & Impulsivity.

  • For adults evidence is additionally sought to ascertain the presence and prevalence of symptoms in childhood

  • The current National Institute for Health and Care Excellence (NICE) Guidelines for ADHD  stipulate that diagnosis should be made on the basis of:

    • full clinical and psychosocial assessment of the person. 

    • full developmental and psychiatric history.

    • Observer reports and assessment of a person's mental state.


  • Additionally, Structured Diagnostic Interviews and Ratings Scales such as the Conners' Rating Scales and the Strengths and Difficulties Questionnaire are often used to support the diagnostic process.

Sub-Types of ADHD

Depending on the relative predominance and symptom pattern of Inattentive v Impulsive/ Hyperactive symptoms one of three sub-types of ADHD may be diagnosed as follows :

  • ADHD Predominantly Inattentive Sub-Type

  • ADHD Predominantly Hyperactive/ Impulsive Sub-Type

  • ADHD Combined Sub-Type

In the simplest terms this amounts to ADHD with or without visible manifestations of hyperactivity.

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