For hyperactivity and impulsivity to be considered in an ADHD diagnosis, six or more of the following symptoms of must have been present for at least six months to an extent that is disruptive and inappropriate for the child’s developmental level:

Often fidgets with hands or feet or squirms in seat

Often gets up from seat when remaining in seat is expected

Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless)

Often has trouble playing or enjoying leisure activities quietly

Is often “on the go” or acts as if “driven by a motor”

Dr. Edward Hallowell and Dr. John Ratey (1994) use the phrase “driven to distraction” in their book of the same title to describe the signs of  hyperactivity and inattention in ADHD kids.

Often talks excessively


Often blurts out answers before questions have been finished

Often has trouble waiting his or her turn (jumps in front of others)

Often interrupts or intrudes on others (e.g., butts into conversations, games, or social situations)

According to the DSM-IV, additional essentials of ADHD diagnosis include the following considerations:

By definition, an ADHD child’s behavior must clearly impair his or her ability to function effectively in two or more environments (school, home, work, social events) where a non-ADHD child could function normally.

The behavior or impairment must cause at least some problem in a minimum of two different environments such as school and home or school and social events.

All of us have a few ADHD traits, but we are not considered ADHD because these traits aren’t present a majority of the time, and they do not impair our daily lives.

Some of the symptoms or behaviors causing impairment should have been present before age seven.

The symptoms attributed to ADHD do not happen only while the child is experiencing another psychiatric disorder such as schizophrenia or psychosis.

Any observed symptoms must not be caused by another mental disorder such as anxiety, mood disorder (such as bipolar disease), dissociative disorder, or a personality disorder.

To help you organize your thoughts and answers to the right questions, you can download a targeted short version of the questions I ask during a suspected ADHD child’s first office visit at www.ADHDbehavior.com/ADHDquestions. Your answers to those questions will help you provide the basic information your child’s doctor will need to evaluate him or her properly and just possibly prevent an ADHD misdiagnosis.

Next, we’ll discuss the forty-six plus disorders that can mimic ADHD.

Frank Barnhill M.D. Frank Barnhill, M.D. is the author of Mistaken for ADHD and founder of the blog of the same name.  He welcomes your questions as the HowToLearn.com Official Expert on ADHD and you may submit them via the contact from below or in the comments.  We will answer them on our blog.

Dr. Barnhill specializes in diagnosing ADHD the right way.

Related Articles: Part 2 Diagnosing ADHD The Right Way

Part 1 Diagnosing ADHD The Right Way