When a child experiences ongoing difficulties with focus, impulsivity, or restlessness, parents may begin seeking answers. Diagnosing ADHD in children requires a careful, thorough process to understand what’s truly going on.
There is no single test to diagnose ADHD, according to the AAP [*]. Other conditions, such as sleep disorders, anxiety, depression, or learning disabilities, can mimic or overlap with ADHD symptoms, so it’s important to assess the full picture.
This guide presents the DSM-5 criteria, so families can understand how doctors approach diagnosing ADHD in children.
Diagnosing ADHD in Children
If a child between 4 and 18 is showing persistent learning or behavior problems along with symptoms of inattention, hyperactivity, or impulsivity, healthcare providers may begin evaluating for ADHD.
An important consideration during this process is that other conditions can sometimes look like ADHD or occur alongside it.
Recognizing comorbid conditions allows providers and families to create a plan that meets all of a child’s needs, not just those related to ADHD.
To make a diagnosis of ADHD, healthcare providers follow the DSM-5 criteria. This includes confirming that symptoms are present in 2 or more settings — such as at home, school, work, or during social activities — and that they cause significant impairment in functioning [*].
Healthcare providers gather insights from the adults who know the child best. This includes their parents or caregivers, teachers, school staff, and any mental health professionals.
Their observations will help build a clear, accurate picture of the child’s challenges.
DSM-5 Criteria for ADHD Diagnosis
The DSM-5 provides a standard set of guidelines to help identify ADHD in young people. They focus on two main types of symptoms: inattention and hyperactivity-impulsivity.
A diagnosis requires that symptoms appear in at least 2 settings, start before age 12, and cause noticeable challenges in daily life.
It’s important to remember that only trained healthcare providers — such as pediatricians, child psychologists, or child psychiatrists — can make a formal ADHD diagnosis.
Inattention
When evaluating inattention, professionals check whether a child has had 6 or more symptoms for at least 6 months. These symptoms should be more intense than what’s typical for their age and cause them to struggle in their everyday tasks. (Note that 5 symptoms are required for those age 17 and older.)
Here is a list of the inattention symptoms included in the DSM-5:
Misses details or makes careless mistakes
- Home: Skips steps in chores, rushes through tasks, or leaves things half-done.
- School: Errors in worksheets, skipped questions, or work that lowers grades.
- Other: Trouble following instructions during group activities or lessons (e.g., sports, clubs).
Has difficulty staying focused
- Home: Loses focus during homework, long conversations, or while doing routines.
- School: Drifts off during lessons, silent reading, or independent work time.
- Other: Struggles to stay engaged in games or structured activities.
Seems not to hear when spoken to directly
- Home: Appears “zoned out” when parents give directions.
- School: Doesn’t respond to teacher cues or reminders.
- Other: Needs repeated prompts during activities with peers or adults.
Starts tasks but may leave them unfinished
- Home: Moves from one household task to another without completing the first.
- School: Begins an assignment but stops halfway when attention shifts elsewhere.
- Other: Difficulty carrying out longer activities during practices or group programs.
Has trouble organizing tasks or materials
- Home: Bedroom, backpack, or personal items are frequently disorganized.
- School: Misplaces books, papers, or supplies and loses track of deadlines.
- Other: Struggles to plan ahead for activities (e.g., bringing required supplies).
Avoids tasks requiring sustained mental effort
- Home: Puts off homework, reading, or anything that requires long concentration.
- School: Resists lengthy assignments, projects, or note-taking tasks.
- Other: Avoids complex games or structured activities that take effort to follow.
Loses things needed for tasks
- Home: Misplaces toys, school supplies, glasses, or clothing items.
- School: Frequently loses books, pencils, papers, or materials.
- Other: Forgets materials or equipment for clubs, sports, tutoring, or lessons.
Easily distracted by what’s happening around them
- Home: Quickly pulled away by noise, screens, or people moving nearby.
- School: Reacts to classroom noises, peers, or activity outside the window.
- Other: May be distracted by unrelated thoughts in quieter situations.
Forgetful in daily routines
- Home: Needs reminders for chores, hygiene routines, or schedules.
- School: Forgets to turn in assignments or bring needed items.
- Other: Misses appointments or doesn’t remember plans without frequent prompts.
Hyperactivity-Impulsivity
Hyperactive and impulsive behaviors are assessed based on whether a child shows 6 or more persistent symptoms for at least 6 months. These behaviors must clearly interfere with everyday activities, learning, or interactions with others. (Teens aged 17 or above must show 5 symptoms to meet criteria.)
Here is a list of the hyperactivity-impulsivity symptoms included in the DSM-5:
Fidgets with hands or feet, appears restless
- Home: Constantly taps fingers or bounces legs, can’t sit still during meals or homework.
- School: Moves around in their seat, changes position often during lessons.
- Other: Struggles to remain seated during quiet group activities or gatherings.
Leaves their seat inappropriately
- Home: Gets up during meals or chores when expected to stay seated.
- School: Leaves their desk or seat in class without permission.
- Other: Walks away during structured activities or group lessons.
Runs or climbs excessively where inappropriate
- Home: Climbs on furniture or jumps around when it’s not safe or expected.
- School: Moves around the classroom in ways that disrupt learning.
- Other: Runs or climbs in playgrounds, gyms, or public spaces where it’s not suitable.
Has difficulty playing quietly
- Home: Struggles to engage in calm activities, like reading or drawing quietly.
- School: Disrupts group games or quiet time.
- Other: Makes it hard to participate in calm social or community activities.
“On the go,” acting as if driven by a motor
- Home: Constantly moving, can’t sit still for even short periods.
- School: Appears restless and always in motion during class.
- Other: Has trouble staying calm during trips, lessons, or family outings.
Talks excessively
- Home: Talks constantly during meals, chores, or conversations.
- School: Speaks out in class or interrupts lessons with excessive talking.
- Other: Dominates conversations or social interactions, even when inappropriate.
Blurts out answers
- Home: Interrupts parents or siblings before they finish speaking.
- School: Answers questions before the teacher finishes asking them.
- Other: Speaks out in games or group activities without waiting for their turn.
Difficulty awaiting turn
- Home: Cannot wait in line for a game, TV, or activity with siblings.
- School: Struggles in classroom activities that require taking turns.
- Other: Finds it hard to wait during social activities, clubs, or team sports.
Interrupts or intrudes on others
- Home: Cuts into conversations or interrupts siblings and parents.
- School: Intrudes in group work or disrupts peers’ activities.
- Others: Uses other people’s belongings without asking or takes things without permission during play or group activities.
Note for parents and caregivers: To qualify as ADHD, a child’s symptoms need to begin before age 12 and appear in two or more areas of their life — home, school, or social activities. Professionals will also need to make sure the symptoms aren’t caused by another condition, such as anxiety or depression.
What Happens After a Diagnosis?
After your child receives an ADHD diagnosis, the healthcare professional will take time to explain what the diagnosis means and answer any questions you may have. This conversation helps you understand your child’s strengths, challenges, and what to expect moving forward.
The next step is creating a personalized treatment and support plan. This plan may include options such as behavior therapy, parent training, school supports, and (in some cases) medication. The exact approach depends on your child’s age, symptoms, and the recommendations of the provider.
Parents also play an important role after a diagnosis. You can:
- Learn as much as you can about ADHD.
- Talk with your child about the ADHD diagnosis in a supportive way.
- Work with your child’s school to put formal supports in place, such as a 504 Plan or an Individualized Education Program (IEP).
When you understand the diagnosis and stay connected with your child’s care team, you can help make sure they get the support they need at home, at school, and in their daily routines.
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