Attention deficit disorders (ADDs) have been classified as part of the Diagnostic and Statistical Manual for Mental Disorders (DSM) which specifically contains changes in the way attention deficit hyperactivity disorder (ADHD) is diagnosed and subtyped. These changes were developed through a long and laborious process by expert consultations and empirical field trials to produce a diagnostic category that is more reliable as a diagnosis (McBurnett, Lahey, and Pfiffner, 1993, 108).
The terminology and classification of ADD has been confusing given that each year a new version of the DSM has included a major revision of the ADD criteria, and children with the same clinical features have been given one of half a dozen different labels. Criteria for diagnosis have appeared and disappeared. The first diagnosis of ADD in DSM was called "Hyperkinetic Reaction of Childhood" in 1968. Criteria were revolutionized in 1980 with a broadening of the assessment into a multiaxial system and by specifying criteria giving a case the diagnosis of a particular syndrome. The new system had clear advantages over the old. One of the DSM-III criteria for the diagnosis of ADD was that a minimum set of behavioral described symptoms would be present. Fourteen symptoms were arranged into three groups to match the hallmark features of the disorder--inattention, impulsivity, and hyperactivity. DSM-III was the first revision to recognize specific criteria for diagnosing subtypes of ADD with and without hyperactivity. Various criticisms led in DSM-III-R in 1987 to new diagnostic criteria and to the determination that 8 of 14 symptoms were necessary for a diagnosis of attention deficit hyperactivity disorder (McBurnett, Lahey, and Pfiffner, 1993, 109-110).
Riccio, Hynd, Cohen, and Gonzalez (1993) consider the neurological basis for ADHD. Neuroanatomical studies focus on the location of brain areas that subserve those systems believed to mediate the ...