The three subtypes of ADHD are:
- ADHD - predominantly inattentive subtype
- ADHD - predominantly hyperactive-impulsive subtype
- ADHD - combined subtype
It is important to remember that just because a child might display symptoms of ADHD, they may not have the condition. There are many psychological disorders, medical conditions, and stressful life events that can cause ADHD-like symptoms.
Before ADHD is diagnosed, other possibilities such as learning difficulties, life difficulties, psychological or behavioral disorders, and potential medical conditions need to be ruled out.
Causes and risk factors
Scientists are unsure of what specifically causes inattentive ADHD. However, there is evidence to suggest that the following factors may play a role:
At present, there is no reliable evidence to prove that sugar intake leads to ADHD.
- Genetics - 3 out of 4 children with ADHD have a relative with the condition
- Being born prematurely
- Low birth weight
- Brain injury
- Mother smoking, drinking alcohol, or experiencing extreme stress during pregnancy
While sugar has come under fire as a potential suspect in causing hyperactivity, there is no reliable evidence to prove this claim.
Research also does not support claims that watching too much TV, parenting, or social and environmental factors, such as poverty or family problems, cause ADHD, although they may make symptoms worse.
Symptoms and diagnosis
Many symptoms of inattentive ADHD, such as having a limited attention span and not following instructions, are often seen in children. However, the difference in children with inattentive ADHD is that their lack of ability to focus and pay attention is greater than what is expected for their age.
Inattentive ADHD is diagnosed if a child has at least six of the nine symptoms below, or five for people over 17 years of age:
- Seeming unable to pay attention or making careless mistakes in tasks
- Finding staying focused on tasks or activities difficult
- Not appearing to listen when spoken to
- Seeming unable to follow through on instructions or complete tasks
- Having trouble organizing tasks and managing time
- Avoiding tasks that require thinking for long periods
- Often losing items needed for daily life
- Being easily distracted
- Forgetting to do daily tasks and go to appointments
These symptoms would have occurred over the past 6 months and occur frequently.
There is no test to diagnose inattentive ADHD. A diagnosis is reached by gathering information from parents and teachers, completing checklists, and ruling out other medical problems.
Differences between inattentive ADHD and hyperactive/impulsive ADHD
Inattentive ADHD has symptoms that center around distractedness. The child finds it difficult to process information, which distracts them from thinking and understanding. They may also find that other action around them prevents them from focusing on the task at hand.
The symptoms of inattentive ADHD are largely related to distractedness.
For instance, at school, the child may be focused on activities they can see out the window of the classroom, instead of what the teacher is saying.
Hyperactive/impulsive ADHD has symptoms that revolve around extreme high-energy and that make the child seem as if a motor drives them.
Hyperactive/impulsive ADHD has fewer than six of the symptoms of inattentive ADHD, and at least of six of the following nine symptoms, or five for people over 17 years of age:
- Squirming, fidgeting, and tapping hands or feet
- Being unable to stay seated
- Running and climbing at inappropriate times and places
- Being unable to quietly play or take part in activities
- Being constantly "on the go"
- Talking too much
- Blurting out answers
- Finding it difficult to wait their turn
- Intruding on or interrupting other people
While many children like to run and jump around, that alone does not mean that they have hyperactive-impulsive ADHD. The symptoms would have to be on the extreme side and cause problems in everyday life, as well as occurring frequently for more than 6 months.
Inattentive ADHD has fewer than six of the symptoms of hyperactive/impulsive ADHD.
Combined ADHD has a combination of at least six symptoms of inattentive ADHD and at least six symptoms of hyperactive/impulsive ADHD that have been present for at least 6months.
Hyperactive/impulsive ADHD and combined ADHD usually begin by the age of 7 years. However, inattentive ADHD begins later, by age 9, and the symptoms may not become significant until age 11.
Overall, more boys have ADHD, but girls are more likely to have inattentive ADHD than boys.
Inattentive ADHD is often treated with medication and educational, behavioral, and psychological intervention. Although there is no cure for inattentive ADHD, there are medications to help reduce symptoms and therapies to help manage behavior.
Treatments for inattentive ADHD include:
- Behavioral therapy
- Parenting skills training
- Family therapy
- Social skills training
Stimulants are the most widely used medication for ADHD. Between 70-80 percent of children with ADHD have a reduction in symptoms when treated with stimulants.
Every child responds differently to medication. A dose that works well for one child may not have the same effect on another. For this reason, it is important that caregivers work with the child's doctor in order to find a medication and dosage that works best for the child.
Tips for parents and caregivers
Caregivers should encourage children with inattentive ADHD to follow a healthy lifestyle.
There are positive actions that can be taken by parents or caregivers that may help children with inattentive ADHD function on a day-to-day basis. These include:
- Routine: Aiming to follow the same schedule each day
- Organization: Always storing clothing, toys, and schoolbag in the same place to avoid losing them
- Plan: Helping to break down complicated tasks into simpler, smaller steps and taking breaks in longer tasks to limit stress
- Limit choices: Only offering a choice of a few things at a time to avoid overwhelming and overstimulation
- Manage distractions: For some children with ADHD, listening to music or moving helps them learn, whereas for others, it has the opposite effect
- Supervision: Children with ADHD may need supervising more than other children
- Clear conversation: Using clear, brief directions and repeating what the child says to let them know that they are being listened to
- Goals and rewards: Listing goals, tracking positive behavior, and rewarding when the child has done well
- Effective discipline: Using timeouts and removing privileges as a consequence of behaving inappropriately
- Positive opportunities: Encouraging taking part in activities that the child does well to create positive experiences
- School: Keeping up regular communication with the child's teacher
- Healthy lifestyle: Providing a nutritious diet, encouraging physical activity and enough sleep
It is best for caregivers to watch and see what works best for each child. TV, noise, and clutter should be kept to a minimum.
Tips for managing adult inattentive ADHD
Someone with inattentive ADHD may find everyday tasks such as paying bills and keeping up with friends, family, and social demands overwhelming. However, there are self-help techniques that can help the person focus and calm the chaos.
- Getting organized
- Managing time
- Managing money and bills
- Staying focused
- Managing stress
A lack of concentration and reduced effort are hallmarks of inattentive ADHD. Children with this subtype of ADHD may seem to be daydreamers who have "tuned out" or are "not with it."
Children with inattentive ADHD often have difficulties with handling everyday social interactions, such as joining in with other kids at play, initiating a friendship, or resolving a dispute, and may be socially rejected as a result.
While children with inattentive ADHD account for 25 percent of children with ADHD seen at mental health centers, they are less likely to be diagnosed and more likely to be overlooked when compared with the hyperactive-impulsive or combined subtypes. This could be due to their lack of hyperactivity.
The goals of treating inattentive ADHD is to improve symptoms and functional performance and remove obstacles that may affect behavior. Around one third of children with ADHD will continue to have the disorder into adulthood.
Although inattentive ADHD is a lifelong condition, symptoms can be reduced with proper treatment, and people with the disorder can lead a normal, fulfilling life.