ADD and ADHD: Differences, Diagnosis, & Treatments

Attention deficit disorder (ADD) is a term that is sometimes used for one of the presentations of attention-deficit/hyperactivity disorder (ADHD). ADHD is a neurological disorder that causes a range of behavior problems such as difficulties with attending to instruction, focusing on schoolwork, keeping up with assignments, following instructions, completing tasks, and social interaction.

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), this condition is officially known as "attentional deficit/hyperactivity disorder, predominantly inattentive presentation."

Symptoms of ADD (Inattentive Type ADHD)

People with the inattentive type of ADHD struggle to pay attention or stay focused for long periods of time. Some of the symptoms of this type of ADHD include:

• Being easily distracted
• Difficulty following directions
• Difficulty staying on task
• Forgetfulness
• Losing personal items such as keys or books
• Not paying attention to details
• Problems staying organized
• Short attention span

Children with ADHD without the hyperactivity component may appear to be bored or disinterested in classroom activities. They may be prone to daydreaming or forgetfulness, work at a slow pace, and turn in incomplete work.

Their assignments, desks, and lockers may look disorganized. They may lose materials at school and at home or misplace schoolwork and fail to turn in assignments. This can frustrate teachers and parents and result in the child earning poor marks in class.

Symptoms in Kids vs. Teens vs. Adults

While symptoms of the condition are similar in kids, teens, and adults, they may also change over time. Children may be more likely to be affected by symptoms of hyperactivity. These symptoms may become more noticeable and disruptive when children are in classroom settings.

While symptoms change as people grow older, teens and adults are likely to continue to experience symptoms such as poor attention, difficultly remembering information, and troubles with organization.

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ADD vs. ADHD: What's the Difference?

While many people continue to use the terms ADD and ADHD interchangeably, it's important to recognize that they are not the same. Here are some key points to be aware of:

• ADD is an older term for what is now known as the inattentive type of ADHD. 
• The term ADHD has been used to describe both inattentive and hyperactive types since the mid-1990s.
• However, some people continue to use the term ADD as a way to indicate that the condition does not include hyperactivity as a symptom.
• The DSM-5 currently recognizes three subtypes of ADHD: inattentive type (sometimes casually called ADD), hyperactive-impulsive type, and combined type.

ADD (inattentive type ADHD) doesn't manifest itself in the same way that predominantly hyperactive-impulsive or combined types do. Children with these presentations have different symptoms.

Children with the other two presentations of ADHD, for example, tend to act out or exhibit behavior problems in class. Children with inattentive type ADHD are generally not disruptive in school. They may even sit in class quietly, but that doesn't mean their disorder isn't a problem and that they're not struggling to focus. In addition, not all children with inattentive type ADHD are alike.

Children with combined type ADHD display several symptoms of both hyperactive-impulsive type and inattentive type.

Diagnosis

If you suspect your child has ADHD, talk to your child's school counselor, teacher, or physician about appropriate treatment. If you have any concerns, begin these discussions today. Earlier intervention can ensure that your child experiences fewer disruptions due to their condition.

Your child's pediatrician may recommend seeing a child psychologist who can do formal testing to see if your child fits the criteria for ADHD and, if so, where they fall on the spectrum. Not only can this testing help differentiate ADHD from other issues that may be causing difficulty with schoolwork, but it can be used to follow a child's response to interventions over time.

Primarily Inattentive ADHD (Previously ADD)

When people use the term ADD, they are likely referring to this type of ADHD. Some of the behaviors that someone with this type might experience include forgetfulness, problems with organization, difficulty listening, and lack of focus. 

To be diagnosed with this type, a person must display six of the following nine symptoms:

• Difficulty sustaining attention 
• Often seeming to not be listening
• Failing to pay attention to details
• Difficulty organizing tasks and activities 
• Frequently losing things
• Getting easily distracted
• Forgetfulness
• Avoiding tasks that required sustained mental effort
• Trouble following instructions

Hyperactive-Impulsive ADHD

This presentation of ADHD is characterized by hyperactive and impulsive behavior. To be diagnosed, a person must display six of the following symptoms:

• Fidgeting hands and feet or squirming while seated
• Running or climbing inappropriately or feelings of restlessness
• Difficulty engaging in activities quietly
• Seeming to always be on the go
• Excessive talking
• Blurting out responses
• Problems taking turns
• An inability to stay seated
• Frequently interrupting others

Combined Type ADHD

This presentation of ADHD involves exhibiting symptoms of both the inattentive and hyperactive-impulsive types. To be diagnosed with this type of ADHD, a person must display six or more inattention symptoms and six or more hyperactive-impulsive ADHD symptoms.

Treatment

There is no cure for ADHD, but treatment can help children manage their symptoms and improve daily functioning. Treatment for ADHD often involves medications, behavioral interventions, or a combination of the two. The type of treatment chosen depends on the child's symptoms and needs.

Medications

ADHD is often treated with one of three types of medication: psychostimulants, antidepressants, or non-stimulant drugs. These medications can help children with inattentive type ADHD (ADD) stay on task and focused.

• Psychostimulants: Psychostimulants affect neurotransmitters in the brain, and may help to boost energy and increase alertness. The extended-release form is often recommended (instead of the immediate-release form). Psychostimulants include amphetamines such as Adderall and methylphenidates such as Ritalin and Concerta.
• Antidepressants: Antidepressants also affect neurotransmitters in the brain, and may help to improve mood and attention. Common antidepressants prescribed for the inattentive presentation of ADHD include Wellbutrin (bupropion) and Effexor (venlafaxine).
• Non-stimulant drugs: Non-stimulant medications can be helpful for those who experience unwanted side effects from stimulants and include Strattera (atomoxetine), Qelbree (viloxazine), and Intuniv (guanfacine). Non-stimulants affect a specific neurotransmitter, norepinephrine, and may help to regulate emotions and improve focus on specific tasks.

As with any medication, there are common side effects. Psychostimulants, antidepressants, and non-stimulants can cause dizziness, loss of appetite, upset stomach, and more. Be sure to talk to your doctor if you notice that your child is experiencing any unusual symptoms.

Behavior Management

Whether or not parents choose medication as a treatment option, most physicians and child psychologists suggest that a behavior intervention plan should be developed to help teach kids adaptive behavior skills and reduce off-task and inattentive behaviors.

Often, a combination of various methods is used, including:

• Behavior therapy: With young children, a therapist will usually meet with you and your child. A session often includes the therapist facilitating a conversation with your child or even providing them with an activity to help them express their feelings. Your doctor or therapist might recommend family therapy so that all members of the family can learn healthy ways of managing your child's condition.
• Parent training in behavior management: Recommended for parents of children under 12 years old, a therapist will train the parent to facilitate their child's behavior changes. You will learn strategies such as play therapy and talk therapy to allow your child to freely express their feelings and help them adopt healthy coping mechanisms to deal with tough emotions.
• Behavioral interventions at school: Your child may meet the criteria for extra assistance under the Individuals With Disabilities Education Act (IDEA), or Section 504 of the Rehabilitation Act of 1973. Accommodations may include extra time on tests, additional break time, changes to their environment, positive reinforcement, and assignments made specifically for your child.
• Behavioral peer interventions: With this approach, a therapist or trained professional will lead a group of children in activities that teach them how to interact constructively with their peers. Skills are taught such as having conversations, coping with teasing, and making friends. Parents and teachers may be trained to reinforce the lessons at home and at school.
  

Many people find that holistic methods are effective at managing the behavioral symptoms of ADHD in children. Engaging in regular physical exercise has been shown to boost mood, improve attention and executive functioning in adults and children with ADHD.

Studies have shown improved focus and emotional regulation in people with ADHD after they practiced yoga.

Diet may also play a role in managing behaviors of ADHD. There is some research that indicates fried food, added sugars, salt, and artificial ingredients may worsen behavioral problems and attention.

However, more studies are needed to understand how diet affects ADHD. Talk to your child's doctor to make sure they are getting adequate nutrition, regular meals, and a high intake of vegetables—all of which are linked with improved mood in children with ADHD.

A Word From Verywell

If you think that your child may have "ADD," it is important to talk to your child's doctor about inattentive type ADHD. Effective treatments are available that can help kids who struggle with inattention, and early intervention can prevent the disorder from taking a detrimental toll on their life.

Some parents fear the stigma associated with getting their child evaluated for ADHD. It's important to talk to your child so that they know that everyone has different skills and abilities. By getting treatment, you can help your child develop new skills and ways of coping with their symptoms.