Have you heard both ADHD and ADD as ways to describe a child who may struggle with paying attention, hyperactive or impulsive behaviors, or trouble in school?
Do you have a child with an ADHD diagnosis, but are confused by some of the terminology?
In this article, I will cover:
The difference between ADD and ADHD
The accurate terminology to describe the diagnosed disorder your child may have
Common misconceptions about the ADHD
Before you keep reading, drop a comment below about what you think the difference is between ADD and ADHD.
Table of Contents
How is ADHD diagnosed?
The DSM-5 is the diagnostic and statistical manual of mental disorders that clinicians use to diagnose ADHD. Every few years the manual is revised and updated.
Before 1987, the DSM referred to ADD and ADHD as two separate disorders.
Attention deficit disorder, ADD, referred to a set behaviors and challenges in which more inattentive symptoms present prominently.
Although ADD is still a term we hear, it is now an outdated term.
Attention deficit hyperactivity disorder, ADHD, was characterized as a similar disorder but with predominantly hyperactive and impulsive symptoms.
Once the manual was revised in 1987, ADHD became the only term used however they included three subtypes which are important to distinguish which flavor of ADHD a person exhibits.
The three subtypes of ADHD you will learn more about in this article are:
What are key characteristics of ADHD?
Some key characteristics of ADHD are:
Hyperactivity
Impulsivity
Trouble focusing
Chronic disorganization
Poor executive function skills
Challenges with self regulation (emotional dysregulation)
Rejection sensitive dysphoria
Low frustration tolerance
Perfectionist paralysis
It should be noted that a diagnosis of ADHD can only come from a mental health professional such as a physician or psychiatrist. It is crucial to obtain the right diagnosis, so if you suspect that your child has ADHD, please speak to a healthcare professional.
A diagnostician will ask you about family history because ADHD does have a genetic component and there is a higher likelihood of having ADHD if someone in your family has ADHD.
If you are wondering how to get an indecent education evaluation for you child, check out the article, How do I obtain an Independent Education Evaluation (IEE) for my child?
Student Stories: Sound familiar?
In my practice as an executive function coach, students come to me struggling in school and often believe they are "stupid" because they can't seem to get good grades.
Typically, these students have a deep feeling of failure because of the educational system and how it tends to respond to students who are neuro-diverse.
I have a student who does his homework yet forgets to turn it in so his grades tend to be lower. Is he "stupid?"
Absolutely not!
Does he need support with his working memory and developing a turn in system?
Yes.
Another one of my students forgets to check in Google Classroom every day and then gets overwhelmed with the amount of work that piles up. Is he "stupid?"
No!
Does he need a better system with external support?
Yes.
Most parents would agree that their child simply needs better skills and habits.
That is precisely what executive function skills are and until those skills are explicitly taught and developed over time, students need extra support from parents, teachers, and other professionals.
To learn more about what executive functioning coaching is, check out the article, Executive function coaching: The definitive guide (2022).
What is inattentive ADHD?
ADHD predominantly inattentive is what we previously called ADD. Sometimes called inattentive ADHD, this subtype is characterized by:
Difficulty sustaining attention
Makes careless mistakes
Being easily distracted by irrelevant and extraneous stimuli.
Poor organizational skills
Daydreaming when they should be focusing
Poor time management
This type of ADHD is under diagnosed, especially in girls and women and is one reason for the misconception that only boys can have ADHD.
Many people with inattentive ADHD, lose focus easily and have trouble attending to one thing at a time. Filtering out irrelevant stimuli is often challenging.
So, it's not really that people have an attention deficit, rather they are attending to too many things and struggle to regulate themselves.
What is hyperactive ADHD?
ADHD predominantly hyperactive/impulsive is what people typically think of when they hear the term ADHD.
If you had to designate a cartoon character to ADHD predominantly hyperactive/ impulsive, Tigger from Winnie the Pooh would be your guy.
People with this subtype typically have symptoms such as:
Trouble regulating themselves
Constant movement
Interrupting
Making impulsive decisions without any analysis of the potential consequences.
The predominantly combined type of ADHD, sometimes called combined ADHD, is a blend of inattentive ADHD and hyperactive and impulsive behaviors observed in predominantly hyperactive impulsive ADHD.
Students with these behaviors can seem like they are trying to be difficult. I've had teachers mention how challenging it is to make this type of student sit still and attend to class.
This is a prime example of a way in which a student cannot yet self regulate. In almost every case where a student behaves like this, I promise they are not trying to be difficult.
Sometimes, they are unaware of their behavior, other times they truly cannot down regulate, and very occasionally they are doing it for another reason such as attention seeking.
What are characteristics of Attention Deficit Hyperactivity Disorder?
The underlying challenges that are observed in all types of ADHD are caused by the inability to self regulate which can result in hyperactive behaviors, executive dysfunction, and inattentive symptoms along with other behaviors.
Another tenet of ADHD is executive dysfunction which is typically a result of the delayed maturation of the frontal lobe.
Executive dysfunction can look like:
Difficulty organizing tasks
Trouble with sustained mental effort
Challenges prioritizing tasks
Difficulty with task initiation
On average, students with ADHD are two years behind in their frontal lobe and prefrontal cortex development.
The "normal" point of maturation for the prefrontal cortex is between the ages of 25-32. You can now understand why your high schooler might still seem like a middle schooler!
How is ADHD misunderstood?
Misconception #1: Only children have ADHD
There are lots of misconceptions about attention deficit hyperactivity disorder (ADHD) but one of the most prevalent is that only children have ADHD.
In reality, ADHD is a lifelong disorder which can be managed with an individualized treatment plan.
A child's symptoms of ADHD are typically different behaviors than those observed in adults which may be why there is this misunderstanding about the disorder.
ADHD is often diagnosed in elementary school because students who are challenging behaviorally or who exhibit other common symptoms such as hyperactivity and impulsivity, will be referred for diagnosis. The inattentive type of ADHD is typically harder to diagnose in the younger grades.
Hyperactive behaviors are more easily observed by classroom teachers and other educators since they tend to be disruptive to the classroom environment. Again, the underlying problem is the child cannot self regulate.
Adult ADHD symptoms look different often because as we age, our brain matures and we develop coping skills.
Adults also tend to have a better understanding and awareness of societal expectations, many of which frown upon those hyperactive and impulsive symptoms that we typically see in children with ADHD.
Misconception #2: People with ADHD are lazy
Another misconception of people with ADHD is that they are lazy. People with ADHD, both children and adults, can sometimes have a hard time generating the motivation to do tasks that are not inherently interesting to them.
This is due to a chemical imbalance of the neurotransmitter, dopamine. People with ADHD generate less dopamine which is a major contributor to motivation.
The bottom line is people are always motivated to do something, it just may not be what they need to or should be doing. Tasks that require sustained mental effort can be challenging due to the executive skills it takes to regulate your attention on a non desirable task.
To learn more about executive function skills, check out the article, What are executive functioning skills?
Misconception #3: ADHD is curable
ADHD is a lifelong challenge due to the fact that it is a combination of chemical imbalance, developmental differences, and a result of environmental and genetic factors.
The treatment for ADHD is highly individualized and requires a collective effort on the part of the family system, mental health professionals, teachers, and of course, the student or person with ADHD.
According to Dr. Russell Barkley, the appropriate treatment for ADHD includes the intersection of:
Medication
Skills development (coaching)
Therapy
Understanding of the disorder from all involved
There is more research emerging about the impacts of mindfulness on ADHD symptoms. Mindfulness has been proving to help people regulate, improve focus, and develop strategies to deescalate big emotions when they arise.
The key takeaway is that ADHD cannot be cured but it can be treated and managed with the right plan and resources.
What are the potential impacts on mental health?
People with ADHD also tend to have lower self esteem because they are more likely to get in trouble, especially in a school setting, feel incapable, and feel unworthy because their brains function differently.
Luckily, our society is becoming more and more aware of children's mental health and the necessary emphasis and resources that must be allocated towards it.
At worst, if not addressed properly, people with ADHD are more prone to substance abuse and other self numbing behaviors that can be extremely detrimental.
Are there any benefits to having ADHD?
So are there any positives to having ADHD?
YES!
I am sure it is hard to read about all the negative characteristics of ADHD, but there are positives. Many people diagnosed with ADHD are incredibly social and socially motivated.
People with ADHD can also be super creative and think outside the box. People with ADHD also tend to have hobbies and passions that they care deeply about.
Tons of people with ADHD are highly motivated entrepreneurs, brimming with ideas.
Many students I work with refer to their ADHD as a superpower because they can think so differently. Often times, they are the ones who think best on their feet in moments of panic or crisis.
Those impulsive symptoms can be hugely beneficial in the right setting and situation.
How can you help?
If you have a child with ADHD, considering looking into some community programs that support students or that leverage your child's interests. Building community that your child feels comfortable in and safe around is incredibly important to their overall success.
Therapy
Another way to support your child is individual or family therapy.
ADHD can be extremely challenging to deal with and a therapist can help students work through some of the mental toll that it can take as well as help develop coping mechanisms for dealing with the emotional dysregulation that can be accompanied with ADHD.
Summary
ADHD is the accurate term used these days to describe both inattentive type of ADHD and hyperactive/impulsive type ADHD
You must get a diagnosis from a mental health professional or physician
ADHD is lifelong
ADHD is not curable, but it is manageable
ADHD is not being lazy
Treatment must be unique to the individual and multifaceted
So, despite some of the downsides of having ADHD, what positives do you notice in yourself or your child?
Drop them in the comments below!
About the author
Ella Holton-McCoy is an Executive Function Coach and Educational Therapist at EF Specialists. She is a firm believer that executive functioning skills are the key to success in education as well as in life. Her speciality is working with college aged students who are interested in exploring how mindfulness can reduce stress and improve their executive functioning. In her free time, she enjoys playing frisbee golf, swimming, reading, and spending time with her family.