Why ADHD instead of ADD? / Why predominantly hyperactive-impulsive instead of predominantly-impulsive?

Question

The types of Attention deficit hyperactivity disorder are: 1. predominantly inattentive 2. predominantly hyperactive-impulsive 3. combined Not sure I understand. People with ADHD are hyperactive because of the H in ADHD. So what's the point of the word "hyperactive" being in both "predominantly hyperactive-impulsive" and "Attention deficit hyperactivity disorder" ? Why not just say predominantly impulsive or attention deficit disorder?

Answer 1

I do not use the terms ADHD and ADD interchangeably with parents or the students themselves unless the child has not been formally diagnosed, and then I use the term "attentional issues." The criteria for part of the diagnoses of both are similar; however, I keep the terms separate for more practical reasons, especially when talking with parents.

A diagnosis of ADHD requires that the learner has impulsive behaviors and is hyperactive or seems to be "on the go." This type of attention deficit manifests in greater difficulty with following rules even if the child knows the rules. Learners with ADHD also have difficulty with focus, concentration, completing tasks, and staying on a task.

A diagnosis of ADD does not include the hyperactive criteria. This type of learner frequently looks more like a daydreamer. I have found over the years that learners with auditory processing disorders or dyslexia or are extremely creative can exhibit behaviors similar to those with a diagnosis of ADD without Hyperactivity. They may still have great difficulty in concentrating and tasks completion, but it is not due to the rapid urgency seen with ADHD. Often children with ADD without Hyperactivity may be seen as just an "average" learner who doesn't try hard enough.

I have found that both of these types of students can become better learners with technology-based cognitive training. Selecting the specific program that works on the child's specific learning needs is important. Not just any brain games will target the right skills for improving concentration or attention. I also write different IEP goals based on the attention issues that need to be monitored in special education or on a 504 Plan.

Answer 2

Well said, Linda. I use ADD and ADHD interchangeably, not because I am uneducated about the subject but because the titles are so entangled. The difference in ADD & ADHD that I have observed would be that both include problems focusing, organizational issues, difficulty with detailed instruction, appearing disinterested just to name a few. Then with ADHD add in hyperactivity, talking fast, interrupting frequently, trouble staying still, and completing a single task to the end is extremely difficult. Or are these just byproducts of ADD? I say call it ADD with each case having its own characteristics. Just like Autism, no two are alike and now we classify all cases as somewhere "On the Spectrum".

Answer 3

Hi Rashawn,

I agree with you! The reason is that initially, “hyperactivity” was one of the most notable symptoms, so the disorder was originally termed “Attention Deficit Hyperactivity Disorder.” Many people focused on the “behavior” aspect of the disorder. Then, over time, diagnosticians noticed a subset of those having inattention without the “hyperactive” component. They added this definitive component to the new DSM...but kept the original name. My name for it all along has been “Attention Deficit Disorder” or “ADD” for all types because I’ve always noticed the inattentive type along with the hyperactivity as an extra, but only with certain clients. My focus has always been more on the cognitive component rather than the “behavior” aspect. I try to use “ADHD” terminology with my clients who have the hyperactive component, but occasionally, a client will correct me when I say, “ADD” to add back in the “H...” To me, it’s all “ADD” with different symptoms and manifestations.

Linda T., M.Ed.

Special Education and AD(H)D Specialist