While it still appears from time to time in some clinical administrative paperwork and other such documents, the term “ADD” (Attention Deficit Disorder) is actually no longer used. In the wake of this, professional psychologists have broken ADHD (Attention Deficit Hyperactivity Disorder) into three classifications, or types of ADHD: “Inattentive ADHD,” “Hyperactive ADHD” and “Combined ADHD,” with each of them exhibiting their own host of manifesting symptoms.
Here’s some truth: Many children become hyperactive in their attempts to “wake up” their brains with new stimuli as well as shifts from routine activities, but hyperactivity itself isn’t an intrinsic component of what was referred to as ADD – nor is it evident from brain scans or neurological tests, according to many experts. This may actually be akin to a reaction to anxiety with regard to the primary disorder rather than an inherent problem; to attach a related behavior would be like diagnosing “depression with or without tears” or “mental retardation with or without behavior issues.”
Some clinical practitioners feel that referencing “ADHD” and “ADD” together does a disservice to the underlying problem, but it has been universally agreed upon that children with “just” ADD are not naturally disruptive. This is one of the reasons why, technically, the term “ADD” is no longer used – instead, children who exhibit the inattentive symptoms of ADHD but who do not display hyperactive/impulsive symptoms are now diagnosed with the predominantly inattentive type (which we will discuss in detail below) of ADHD instead of ADD.
The bottom line is that these terms mean basically the same thing, but Attention Deficit Disorder is no longer technically correct.
Before we get into the three types of ADHD, let’s review the diagnostic criteria for ADHD. Keep in mind that making this diagnosis accurately requires a comprehensive evaluation, however, and should only be handled by a qualified health care provider.
In the United States, ADHD is diagnosed according to criteria specified in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), with symptoms divided into two primary groups: Symptoms of inattention and symptoms of hyperactivity/impulsivity. From there, these groups of symptoms are then further divided into three types of ADHD, the last being a combination of elements exhibited by the groups.
Also important to note is that no one diagnosis or treatment fits all with regard to ADHD. Because everyone is different, groups such as the American Psychiatric Association have identified specific treatments based on particular sets of symptoms.
The Three Types of ADHD
Children are natural-born daydreamers, so it’s not unusual to find them staring out a window, lost in thought. But if a child constantly has trouble focusing, there’s a chance he or she might be suffering from the inattentive type of ADHD. Interestingly and as a connection to what we discussed earlier, inattentive ADHD used to be lumped in with ADD, and therefore was referred to as Attention Deficit Disorder – however, it’s really all referring to children who have a great deal of difficulty paying attention…and that’s the best way to tell it apart from the two other types of the disorder.
Let’s take a closer look at inattentive ADHD:
1. Inattentive ADHD
An individual with this type must exhibit at least six of the following nine symptoms, and very few of the hyperactive-impulsive type:
• Not paying attention to detail
• Making careless mistakes
• Failing to pay attention in a general sense and keep on task
• Not listening
• Being unable to follow or understand instructions
• Avoiding tasks that involve effort
• Being distracted
• Being forgetful
• Losing essential pieces/items required to complete tasks
Now let’s take a gander at the hyperactive-impulsive type of ADHD:
2. Hyperactive-Impulsive ADHD
To be diagnosed with this type, an individual must exhibit, again, at least six of the following nine symptoms and very few of the inattentive type:
• Routinely getting up while seated
• Running or climbing at inappropriate times
• Having trouble playing quietly
• Excessive talking
• Talking out of turn or blurting out
• Often “on the move” as if “propelled by a motor”
3. Combined ADHD
Individuals diagnosed with the combined type of ADHD, which is the most common, exhibit symptoms of both inattentive and hyperactive-impulsive kinds of ADHD – again, at least six from each group.
What Can Be Done
If your own child is diagnosed with any of these symptoms, his or her doctor may prescribe medication to improve the ability to concentrate, but usually a combination of medicine and therapy yields the most optimum results. Behavior therapy also teaches parenting tactics including:
• Reward system for good behavior
• Privilege-withholding policy for unwanted behavior
Further, parents, teachers and counselors can use the following methods to help children with inattentive ADHD stay on track:
• Making To-Do Lists
Create lists of household and homework tasks, and post them in places your child can easily see them.
• Creating “Bite-Sized” Projects
Break down projects and requests into small tasks; rather than saying “Do your homework,” you could say “Finish your math sheet…then read one chapter of your English book. Finally, write one paragraph describing what you have read.”
• Giving Clear Instructions
Make them easy to understand and simple…this is one of the best suggestions on this list when helping a child with ADHD
Ensure your child’s clothes and schoolwork are always in the same place and easy to locate.
• Getting Into a Routine
Following the same schedule every day brings a clear sense of order that helps inattentive kids stay focused. Have the child get dressed, brush their teeth, eat breakfast and put on his or her coat, and post this schedule in a centralized location such as the kitchen or main hallway of the house.
• Cutting Down on Distractions
Turn off the TV, computer, stereo/streaming devices and video games as much as possible at home, and request that your child’s teacher seat him or her away from the windows and doors in class.
• Providing Rewards
We are all human, and we ALL love to receive praise when we do a job well…regardless of age or gender. When homework is finished on time or the bedroom gets cleaned up, let your child know you noticed; you might offer to take him or her on a trip to the zoo or go out for a frozen yogurt.
Wrapping it Up
Hopefully we’ve made clear that the diagnosis of ADHD is not really a simple matter. It requires careful attention that must be given to a number of specific symptoms, and demands that information about a child’s functioning be collected from different sources – i.e. parent, teacher – while also taking into consideration a clear indication of impaired functioning in important life areas. When all other possible explanations for a child’s symptoms are ruled out and when these detailed criteria are applied, you can be confident that the diagnostic judgement is more likely to be accurate.