Combined type ADHD occurs when an individual has both inattentive and hyperactive-impulsive symptoms. A person with combined type ADHD will meet the criteria for both subtypes.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that has various symptoms. The three hallmark symptoms are inattention, hyperactivity, and impulsivity. Depending on the symptoms a person has, doctors classify ADHD into three subtypes:

This article discusses combined type ADHD, its diagnostic features, related conditions, and treatment options.

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Doctors diagnose combined type ADHD when a person has symptoms of both inattention and hyperactivity-impulsivity. A person’s behavior may indicate this subtype if they meet sufficient criteria for both the inattentive and hyperactive-impulsive subtypes.

Evidence suggests that around 8.4% of children and 2.5% of adults in the United States have ADHD. Combined type ADHD is the most common presentation of ADHD. A small 2019 study estimates that 70% of adults with ADHD have the combined subtype.

Children with combined type ADHD may have difficulty paying attention in school and find it challenging to stay seated during class or social gatherings. Adults with combined type ADHD may have difficulty managing tasks and maintaining relationships.

ADHD has three subtypes. The symptoms and diagnostic criteria for each subtype are as follows:

ADHD predominantly inattentive presentation

  • difficulty paying close attention to details, which can result in careless mistakes
  • difficulty maintaining attention
  • an apparent lack of listening
  • difficulty following through with instructions
  • trouble with organization
  • avoidance or dislike of tasks that require sustained mental effort
  • tendency to lose items
  • easy distraction
  • forgetfulness in daily activities

ADHD predominantly hyperactive-impulsive presentation

  • frequent fidgeting with hands or feet or squirming
  • difficulty staying seated
  • excessive running or climbing in children or extreme restlessness in adults
  • problems engaging in activities quietly
  • excessive talking
  • answering before a person has finished asking a question
  • impatience or difficulty taking turns
  • frequently interrupting or intruding on others

ADHD combined presentation

Combined type ADHD involves symptoms of both the inattentive and hyperactive-impulsive types.

Experts do not know the exact cause of ADHD, but certain risk factors can increase the risk of developing the condition. One of the biggest risk factors is genetics — individuals whose family members have ADHD are more likely to have the condition themselves.

Research also indicates that an individual may have a higher risk of ADHD if their birthing parent experienced health conditions such as:

  • obesity or overweight before pregnancy
  • high blood pressure during pregnancy
  • preeclampsia

People who smoke during pregnancy are also more likely to have children with ADHD.

Additionally, babies with low birth weight or certain neonatal diseases are at a higher risk.

Are boys more likely to get ADHD?

Boys are generally more likely to receive an ADHD diagnosis than girls. In the past, this led researchers to believe that being male was a risk factor for ADHD.

However, recent studies suggest this difference has more to do with subjective social perceptions of gender. The criteria for ADHD symptoms relate to their presentation in boys. Girls are not likely to display the same symptoms as boys.

Additionally, girls typically face more social pressure to conform to certain behavior patterns. They are often better at developing coping strategies to mask their ADHD symptoms in public. The fact that more boys than girls receive a diagnosis may ultimately be a result of social bias.

In ongoing studies of ADHD, researchers hope to develop better strategies for identifying and diagnosing the condition in people of all genders.

There is no single test for ADHD, so diagnosis requires a thorough evaluation. Medical professionals who may be involved include:

Parents or caregivers who suspect their child may have combined type ADHD should visit their family doctor. They may refer them to the appropriate specialist for an assessment.

To meet the criteria for combined type ADHD, individuals must show a certain number of symptoms of both inattention and hyperactivity-impulsivity for at least 6 months. These symptoms include:

  • a tendency to lose or misplace necessary items
  • forgetfulness of daily tasks
  • limited attention span
  • difficulty listening
  • inability to sit still
  • difficulty waiting
  • excessive talking

While many people receive an ADHD diagnosis as children, it is also possible later in life. The evaluation process is similar regardless of age, but the criteria for diagnosis may differ slightly between children and adults.

Treatment options for ADHD may involve medication, therapy and other behavioral treatments, or a combination of methods.

Treatment for children with ADHD may include education for parents or caregivers. By receiving training, caregivers can help children manage ADHD symptoms.

Individuals with ADHD may also receive behavioral therapy to help them understand which behaviors are appropriate in which settings. Behavioral therapy is typically the first line of therapy for managing ADHD in children.

A doctor may also prescribe medication to assist with managing ADHD symptoms. Medications for ADHD can include short/intermediate-acting stimulants such as Ritalin and Adderall, long-acting stimulants such as Ritalin LA and Adderall XR, or nonstimulants such as Strattera.

A person living with ADHD may also experience problems with self-esteem and depression. In that case, a person may benefit from other treatment options, such as psychotherapy.

Learn more about ADHD medication types.

Individuals with ADHD may experience difficulties with life transitions, particularly during adolescence. Symptoms of ADHD can make it harder for people to succeed in academic settings and can affect people’s relationships with friends, family, or romantic partners.

However, with the proper support and treatment plan, a person can manage ADHD symptoms. Tools such as behavioral therapy, caregiver education, and medication can help make school, work, and relationships more manageable.

ADHD resources

Visit our dedicated hub for more research-backed information and in-depth resources on ADHD.

Can you have ADHD and ODD together?

Individuals with ADHD often have other conditions, such as oppositional defiant disorder (ODD), learning disorders, depression, and anxiety.

Most people with ODD show symptoms of this condition before 8 years old. Some of the symptoms of ODD are:

  • getting angry often and more easily than others
  • becoming annoyed easily
  • annoying other people intentionally
  • going against rules adults have given

Some 2016 research suggests that children of parents with ADHD have a higher risk of ODD. Children who experience negative life events are also more likely to develop ODD.

Is combined ADHD a disability?

Any type of ADHD may be considered a disability if it limits a person’s ability to succeed in one or more major life activities. A person with ADHD may be entitled to accommodations and support in the workplace or educational setting.

Combined type ADHD is one of three potential presentations of ADHD. It is the most common type. As the name suggests, it features a combination of inattentive and hyperactive-impulsive symptoms. Individuals with ADHD may also experience comorbid conditions such as ODD.

Although experts do not yet know the cause of ADHD, people with a family history have a higher risk of developing the condition.

After a person receives a diagnosis, behavioral therapy and medications can help them manage ADHD symptoms. With the proper diagnosis and support team, people with combined type ADHD can manage their symptoms and live a fulfilling and healthy life.