Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and validity, but vary in how they incorporate "DSM-IV-TR" criteria for pediatric BD. Method: We examined "DSM-IV-TR" criteria and the descriptive text for a manic episode and the mania sections of six commonly used pediatric diagnostic research interviews focusing on the following: interpretation of "DSM-IV-TR," recommendations for administration, and scoring methods. Results: There are differences between the "DSM-IV-TR" manic episode criteria and descriptive text. Instruments vary in several ways including in their conceptualization of the mood criterion, whether symptoms must represent a change from the child's usual state, and whether B-criteria are required to co-occur with the A-criterion. Instruments also differ on recommendations for administration and scoring methods. Conclusions: Given the differences between "DSM-IV-TR" manic episode criteria and explanatory text, it is not surprising that there is considerable variation between diagnostic instruments based on "DSM-IV-TR." These differences likely lead to dissimilarities in subjects included in BD research studies and inconsistent findings across studies. The field of child psychiatry would benefit from more uniform methods of assessing symptoms and determining pediatric BD diagnoses. We discuss recommendations for changes to future instruments, interviews, assessment, and the "DSM-5." (Contains 3 tables and 1 figure.)