ADHD DSM-5 Criteria

(only cross boxes if the given criteria (for example, "Displays poor listening skills" or "Diminished attention span" has occurred for at least six months/half a year, if the criteria has occurred for less than six months (e.g. "I've been misplacing my notebooks and pens more often, for the last month") leave blank) DSM-5 ADHD Diagnosis Criteria Form Inattentive Type Diagnosis Criteria: - [ ] Displays poor listening skills (if displays poor listening skills for over six months cross box, else leave blank) Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to poor listening skills else input "not mentioned in transcript") - [ ] Loses and/or misplaces items needed to complete activities or tasks Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to losing/misplacing items else input "not mentioned in transcript") - [ ] Sidetracked by external or unimportant stimuli Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to being sidetracked else input "not mentioned in transcript") - [ ] Forgets daily activities Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to forgetting daily activities else input "not mentioned in transcript") - [ ] Diminished attention span Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to diminished attention span else input "not mentioned in transcript") - [ ] Lacks ability to complete schoolwork and other assignments or to follow instructions Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to lacking ability to complete schoolwork/follow instructions else input "not mentioned in transcript") - [ ] Avoids or is disinclined to begin homework or activities requiring concentration Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to avoiding homework/activities else input "not mentioned in transcript") - [ ] Fails to focus on details and/or makes thoughtless mistakes in schoolwork or assignments Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to failing to focus on details/making mistakes else input "not mentioned in transcript") Inattentive Type Diagnosis Criteria met: [yes/no] (Tick the box if 6 or more of the above criteria have been met for the past 6 months in ≥ 2 settings) Hyperactive/Impulsive Type Diagnosis Criteria: Hyperactivity Symptoms: - [ ] Squirms when seated or fidgets with feet/hands Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to squirming/fidgeting else input "not mentioned in transcript") - [ ] Marked restlessness that is difficult to control Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to restlessness else input "not mentioned in transcript") - [ ] Appears to be driven by “a motor” or is often “on the go” Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to being driven by a motor/always on the go else input "not mentioned in transcript") - [ ] Lacks ability to play and engage in leisure activities in a quiet manner Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to lacking ability to play quietly else input "not mentioned in transcript") - [ ] Incapable of staying seated in class Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to being incapable of staying seated else input "not mentioned in transcript") - [ ] Overly talkative Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to being overly talkative else input "not mentioned in transcript") Impulsive Symptoms: - [ ] Difficulty waiting turn Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to difficulty waiting turn else input "not mentioned in transcript") - [ ] Interrupts or intrudes into conversations and activities of others Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to interrupting/intruding else input "not mentioned in transcript") - [ ] Impulsively blurts out answers before questions completed Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to blurting out answers else input "not mentioned in transcript") Hyperactive/Impulsive Type Diagnosis Criteria met: [yes/no] (Tick the box if 6 or more of the above criteria have been met for the past 6 months in ≥ 2 settings) Additional Requirements for Diagnosis (all must be met): - [ ] Symptoms present prior to age 12 years Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to symptoms present before age 12 else input "not mentioned in transcript") - [ ] Symptoms not better accounted for by a different psychiatric disorder (e.g., mood disorder, anxiety disorder) and do not occur exclusively during a psychotic disorder (e.g., schizophrenia) Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to other psychiatric disorders else input "not mentioned in transcript") - [ ] Symptoms not exclusively a manifestation of oppositional behavior Quotations: [list of quotations] (if present, include a list of quotations from the transcript related to oppositional behavior else input "not mentioned in transcript") Classification: - [ ] Combined Type: Patient meets both inattentive and hyperactive/impulsive criteria for the past 6 months: [yes/no] - [ ] Predominantly Inattentive Type: Patient meets inattentive criterion, but not hyperactive/impulsive criterion, for the past 6 months: [yes/no] - [ ] Predominantly Hyperactive/Impulsive Type: Patient meets hyperactive/impulsive criterion, but not inattentive criterion, for the past 6 months: [yes/no] (Symptoms may be classified as mild, moderate, or severe based on symptom severity) (Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes or clinical note as a reference for the information included in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or section blank.)(Use as many bullet points as needed to capture all the relevant information from the transcript.)(do not include placeholders [example] or instructions (example) in actual text, unless for boxes to be ticked)(Diagnosis Instructions for Heidi - If 6 or more symptoms are ticked in either the Inattentive Type or Hyperactive/Impulsive Type criteria, an ADHD diagnosis can be made; All additional requirements need to be ticked for the diagnosis to be confirmed; Use the classification section to determine the specific type of ADHD; Symptoms must be present in at least two different settings and have a significant impact on academic, social, or occupational functioning.)(only tick symptom box if: Symptoms and/or behaviours that have persisted ≥ 6 months in ≥ 2 settings (e.g., school, home, church) OR Symptoms have negatively impacted academic, social, and/or occupational functioning OR In patients aged < 17 years, ≥ 6 symptoms are necessary; in those aged ≥ 17 years, ≥ 5 symptoms are necessary.)