Inattentive ADHD

Sometimes parents say they don't think their child could have ADHD because they don't see any signs of hyperactivity. You may remember when you were a child when Jamie T in your class was on Ritalin because of behavior problems. Now that we have a better understanding of the full complexities of the diagnosis, we know that probably Jamie wasn't the only one who had ADHD, he was just the only one receiving support for it. He was the squeaky wheel in the class, and he was likely identified and/or medicated for the benefit of the adults in his life. Does this sound familiar? 

Luckily ADHD doesn't have the stigma it did in the 80s and 90s, though public understanding of the diagnosis is . In 2013 when the newest edition of the Diagnostic and Statistical Manual of Mental Health (DSM-5) was published, ADD was removed as a standalone diagnosis and was absorbed by the larger ADHD diagnosis. ADHD was expanded to include three subtypes: 

• Predominantly Inattentive Presentation

• Predominantly Hyperactive Presentation

• Combined Presentation

What was previously Attention Deficit Disorder (ADD) is now ADHD Inattentive Type. ADHD has two parts: the inattentive symptoms and the hyperactive symptoms. The diagnostic criteria for the inattentive type are as follows: 

1. Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:

   • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.

   • Often has trouble holding attention on tasks or play activities.

   • Often does not seem to listen when spoken to directly.

   • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).

   • Often has trouble organizing tasks and activities.

   • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).

   • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

   • Is often easily distracted

   • Is often forgetful in daily activities.

Additionally these conditions must be met: 

• Several inattentive symptoms were present before age 12 years.

• Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).

• There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

• The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

If you think your child could have ADHD Inattentive Presentation, see my previous post about the pros and cons of ADHD testing.