A diagnosis of attention deficit hyperactivity disorder will include one of three specifiers. These are terms that provide more detail about a person's experience. The specifier "inattentive" describes challenges concentrating and paying attention to detail.
A person with inattentive ADHD likely has difficulties concentrating and paying attention to detail, in the classroom, for example.
Another specifier of ADHD is "hyperactive/impulsive." This describes a person who likely fidgets, has difficulties sitting still, and has very high levels of energy.
If a person experiences some characteristics of both inattentive and hyperactive/impulsive ADHD, a doctor may diagnose them with combined ADHD.
A specifier does not represent a different diagnosis, it is an extension added to a diagnosis. Specifiers help psychological practitioners to better describe a person's symptoms and make treatment decisions.
Inattentive ADHD is not a type of ADHD. It is just a more specific way of describing an individual's symptoms.
It is important to remember that a child may not have ADHD just because they show some symptoms. Many life events, medical conditions, and psychological disorders can result in challenges and behavior similar to those associated with ADHD.
Many children display symptoms of inattentive ADHD, such as having a limited attention span and difficulties following instructions.
However, children with inattentive ADHD have more significant challenges focusing and paying attention than the medical community would expect for most children in the age range.
A psychologist or psychiatrist will diagnose ADHD with "inattentive" as a specifier if a child has at least six of the nine symptoms below:
- seeming unable to pay close attention or regularly making careless mistakes in tasks
- having difficulties staying focused on tasks or activities
- appearing not to listen when spoken to
- seeming unable to complete tasks or duties as instructed
- having trouble organizing tasks and managing time
- avoiding or disliking tasks that require extended periods of thinking
- regularly losing items needed for daily life
- being easily distracted
- forgetting to perform daily tasks and go to appointments
A doctor can diagnose a person over 17 years of age if they demonstrate five of the symptoms above.
However, a person has to demonstrate these symptoms frequently over a 6-month period to meet the doctor's criteria.
There is no blood test or physical examination for inattentive ADHD. The doctor will reach a diagnosis by gathering information from parents and teachers, determining if the child shows the behavior that meets the criteria, and ruling out other issues.
Differences between specifiers
A doctor will diagnose ADHD with "inattentive" as a specifier if distraction is a key characteristic.
In a child, this may involve spending a lot of time looking through a window, rather than focusing on the teacher's words.
If a person has ADHD with"hyperactive/impulsive" as a specifier, the symptoms are different. They involve high levels of energy.
For a diagnosis of hyperactive/impulsive ADHD, a child or adolescent will display at least of six of the following nine symptoms. Anyone older than 17 years will display at least five:
- fidgeting with or tapping the hands or feet, or squirming while sitting
- seeming unable to stay seated
- running and climbing at inappropriate times and places
- seeming unable to play or participate in activities quietly
- being constantly "on the go" or seeming motorized
- talking an unusual amount
- blurting out answers
- finding it difficult to wait in turn
- interrupting or intruding on others, such as by cutting into or taking over games, activities or conversations
While many children have high levels of energy and may display some of the symptoms above, for a doctor to diagnose hyperactive/impulsive ADHD, the symptoms would have to be on the extreme side and cause problems in everyday life. The symptoms would also have to occur frequently for more than 6 months.
A person may have six or more of the above symptoms, some of which characterize inattentive ADHD and others which characterize hyperactive/impulsive ADHD.
If these symptoms are all present for more than 6 months, a doctor will likely diagnose combined ADHD.
According to research published in 1997, definitive symptoms of hyperactive/impulsive ADHD are likely to show by the time a child is 7 years old.
The findings suggest that a doctor can usually diagnose combined ADHD by the same age.
The researchers also found that fewer than half of the children later diagnosed with inattentive ADHD showed definitive symptoms in the first 7 years of life.
Overall, more males have ADHD than females, but females are more likely than males to have the inattentive specifier.
Before doctor diagnoses ADHD, they need to rule out other possible causes of symptoms. These can include:
- learning difficulties
- responses to life events
- other psychological or behavioral disorders
- medical conditions
The specific causes of inattentive ADHD are unclear.
However, some research suggests that the following factors may play a role in developing ADHD:
Genetics: Around 3 out of 4 children with ADHD have a relative with the condition.
Premature birth: Infants born even 1 month prematurely may face an increased risk of developing ADHD.
Low birth weight: Results of one meta-analysis suggest a small but significant link between low birth weight and the development of ADHD.
Stress and other lifestyle factors during pregnancy: Findings of a study from 2012 support a previously established connection between maternal stress during pregnancy and the development of ADHD. The authors of this study conclude that smoking tobacco and drinking alcohol during pregnancy may also increase the child's risk of developing the disorder.
No research supports claims that the following can cause ADHD:
- certain parenting styles
- too much TV
- environmental or social factors, such as poverty or a stressful home life
However, these and similar factors may worsen symptoms of ADHD.
While there is no cure for inattentive ADHD, medications and therapies can help to reduce symptoms and manage behavior.
Treatment for ADHD is similar, regardless of the specifier. A healthcare professional will often recommend a combination of medication and educational, behavioral, and psychological therapies.
Therapies and interventions
- Behavioral therapy: This aims to identify and change behaviors that are not healthful and may harm the individual or people around them.
- Psychotherapy: There are many approaches to psychotherapy, but the main goals are for the individual to talk about the emotional impact of their condition and for the therapist to help them find healthful ways of handling it.
- Parent training: When a child shows regular signs of ADHD, family members usually have to adapt. Trained professionals can provide guidance and support for parents.
- Family therapy: This involves a therapist speaking with each member of the family and encouraging discussion. The goal is to provide collective support for a child with ADHD.
- Social skills training: This can help an individual with inattentive ADHD to adapt to social situations. The goal is to reduce some of the social and emotional effects of the condition.
Having a specifier attached to the diagnosis of ADHD can help therapists and other professionals to personalize treatment plans.
Medicinal treatments for inattentive ADHD include:
- stimulants, which are medicines that increase levels of chemicals in some areas of the brain
- antidepressants, which are medications developed to treat depression and anxiety
- atomoxetine, a medication that helps to control the processing of noradrenaline, a hormone similar to adrenaline
- guanfacine, a prescribed non-stimulant drug
- clonidine, which doctors also prescribe to treat high blood pressure and anxiety
Stimulants are the most widely used medications for ADHD. Between 70 and 80 percent of children with ADHD experience fewer symptoms when they take stimulants.
However, every individual responds to medication differently, especially children.
It is important that parents and caregivers work with healthcare professionals to find the medication and dosage that is best for the child.
Any combination of ADHD symptoms can sometimes be distressing, [MOU18] for both the person with the disorder and those close to them.
However, a wide range of strategies can make life easier for young people and adults with ADHD.
Tips for parents and caregivers
Parents and caregivers may find that making the following types of changes helps children with inattentive ADHD to adjust:
- Routine: Aim to follow the same schedule each day.
- Organization: Always keeping clothing, toys, and school bags in the same place can help the child to remember what they need and avoid losing things.
- Planning: Break down complicated tasks into smaller, more straightforward steps, and make sure to take breaks during longer activities to limit stress.
- Limit choices: Avoid overstimulation by presenting a few concrete options. For example, let a child with inattentive ADHD choose between only two meal plans or weekend activities.
- Identify and manage distractions: For some children with ADHD, listening to music or moving helps them to learn, but for others, these activities have the opposite effect.
- Supervision: Children with ADHD may need more supervision than other children.
- Clear conversation: Give clear, brief instructions, and repeat the child's statements back to them, to show that they have been understood.
- Goals and rewards: List goals, track positive behaviors and reward the child when they have acted in line with their goals.
- Effective discipline: Use time-outs and remove privileges, such as video game time, as a consequence of inappropriate behavior.
- Positive opportunities: Encourage the child to participate in activities in which they show skill and are more likely to have positive experiences.
- School: Maintain regular communication with the child's teachers.
- Healthful lifestyle: Provide a nutritious diet, encourage physical activity, and help to ensure that the child is getting enough sleep.
Parents and caregivers should experiment and learn what works for each child. As a general rule, however, it is best to limit noise, clutter, and time spent watching TV.
Tips for managing inattentive ADHD in adulthood
An adult with inattentive ADHD may find it challenging to perform some everyday tasks, such as staying organized, keeping appointments, paying bills on time, and maintaining relationships with friends and family.
However, several strategies and can help a person with ADHD to maintain focus and regain control over their daily tasks.
Some helpful techniques include:
Getting organized: This can compensate for any symptomatic forgetfulness. Make to-do lists, use calendars and planners, and try to avoid procrastination.
Also, it can help to designate specific areas for important items, to reduce the risk of losing them.
It may help to avoid clutter by paying bills online and opting for paperless transactions.
When a collection of paperwork is unavoidable, it can help to set up and maintain a clearly labeled or color-coded filing system.
Managing time: Time perception can be difficult for people with ADHD.
Set specific times to do certain tasks. It can help to keep clocks handy, and to set alarms and reminders. Alarms can also help a person to plan for breaks during longer activities.
Ahead of appointments, plan to arrive early instead of on time.
Staying focused: It can help to start each workday by setting aside 5–10 minutes in which to organize tasks and the workspace. Try to work in a space with as few distractions and as little commotion as possible.
People with ADHD tend to have multiple ideas at once and lose track of them, so it can help to write down ideas as they occur. Some people also find it helpful to ask for notes ahead of a meeting.
Also, when making plans, it may help to repeat the arrangements back to the person proposing them.
Managing stress and moods: Exercise, a consistent and sufficient sleep schedule, and a varied, nutritious diet can help to boost mood and reduce stress.
If a person makes these changes and finds them inadequate, it is a good idea to seek further treatment.
Difficulties concentrating and paying attention to detail [MOU21] are hallmarks of inattentive ADHD.
Children with the condition and the "inattentive" specifier often find it challenging to handle daily social interactions, such as joining in play, initiating friendships, and resolving disputes. They sometimes experience social rejection, as a result.
Children with inattentive ADHD account for 25 percent of all kids with ADHD who receive treatment in mental health centers.
This relatively small representation may be because children with inattentive ADHD are often less disruptive than kids with combined ADHD, and their behavior may be easier to overlook.
The goals of treating inattentive ADHD are to reduce symptoms, to address challenges that affect behavior, and to improve functional performance.
Around one-third of children with ADHD will continue to have the defining symptoms into adulthood.
However, receiving appropriate treatment can reduce and manage symptoms so that people with ADHD lead productive, fulfilling lives.