DCR-10 Criteria

G1 Inattention

At least six of the following symptoms of attention have persisted for at least six months, to a degree that is maladaptive and inconsistent with the developmental level of the child:

(1) often fails to give close attention to details, or makes careless errors in school work, work or other activities;
(2) often fails to sustain attention in tasks or play activities;
(3) often appears not to listen to what is being said to him or her;
(4) often fails to follow through on instructions or to finish school work, chores, or duties in the workplace (not because of oppositional behaviour or failure to understand instructions);
(5) is often impaired in organising tasks and activities;
(6) often avoids or strongly dislikes tasks, such as homework, that require sustained mental effort;
(7) often loses things necessary for certain tasks and activities, such as school assignments, pencils, books, toys or tools;
(8) is often easily distracted by external stimuli;
(9) is often forgetful in the course of daily activities.

G2 Hyperactivity

At least three of the following symptoms of hyperactivity have persisted for at least six months, to a degree that is maladaptive and inconsistent with the developmental level of the child:

(1) often fidgets with hands or feet or squirms on seat;
(2) leaves seat in classroom or in other situations in which remaining seated is expected;
(3) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, only feelings of restlessness may be present);
(4) is often unduly noisy in playing or has difficulty in engaging quietly in leisure activities;
(5) exhibits a persistent pattern of excessive motor activity that is not substantially modified by social context or demands.

G3 Impulsivity

At least one of the following symptoms of impulsivity has persisted for at least six months, to a degree that is maladaptive and inconsistent with the developmental level of the child:

(1) often blurts out answers before questions have been completed;
(2) often fails to wait in lines or await turns in games or group situations;
(3) often interrupts or intrudes on others (eg butts into others’ conversations or games);
(4) often talks excessively without appropriate response to social constraints.

G4

Onset of the disorder is no later than the age of seven years.

G5 Pervasiveness

The criteria should be met for more than a single situation, eg the combination of inattention and hyperactivity should be present both at home and at school, or at both school and another setting where children are observed, such as a clinic. (Evidence for cross-situationality will ordinarily require information from more than one source; parental reports about classroom behaviour, for instance, are unlikely to be sufficient.)

G6

The symptoms in G1 and G3 cause clinically significant distress or impairment in social, academic, or occupational functioning.

G7

The disorder does not meet the criteria for pervasive developmental disorders (F84.-), manic episode (F30.-), depressive episode (F32.-), or anxiety disorders (F41.-).

Comment

Many authorities also recognise conditions that are sub-threshold for hyperkinetic disorder. Children who meet criteria in other ways but do not show abnormalities of hyperactivity/impulsiveness, may be recognised as showing attention deficit; conversely, children who fall short of criteria for attention problems but meet criteria in other respects may be recognised as showing activity disorder. In the same way, children who meet criteria for only one situation (eg only the home or only the classroom) may be regarded as showing a home-specific or classroom-specific disorder. These conditions are not yet included in the main classification because of insufficient empirical predictive validation, and because many children with sub-threshold disorders show other syndromes (such as Oppositional Defiant Disorder, F91.3) and should be classified in the appropriate category.