ADHD Doesn’t Always Have a Hyperactivity Component
When does ADHD not look like ADHD? When the most notable symptoms of hyperactivity and impulsivity are not present, a diagnosis of ADHD (Attention Deficit Hyperactivity Disorder) often gets overlooked. When parents, teachers, and even doctors, think about ADHD, we most often think about the little boy who can’t be still or control his impulses. It is common to overlook ADHD being a problem when we only witness the symptoms of the inattentive type.
There are three types of ADHD. There is the Predominantly Hyperactive/Impulsive ADHD, the Predominantly Inattentive ADHD, and the Combined Type ADHD. Two of the three types include the hyperactivity and impulsiveness that we most often associate with ADHD. However, children with the Predominantly Inattentive subtype of ADHD may not display these symptoms at all. This is why the diagnosis is often missed.
How would you know if your child has the inattentive type of ADHD? This child may appear to daydream frequently. Some may describe this child as “spacey,” “apathetic,” or even “lazy.” Young students with this form of ADHD often have difficulty focusing and following directions. They are easily distracted and regularly have trouble with organization. These children may frequently lose things, and they may experience difficulty completing tasks. They may also appear to not be listening when you speak to them.
It can be difficult to distinguish between typical childlike behavior and ADHD. Any health concerns might begin with a visit to your child’s healthcare professional to rule out physical issues, including hearing and vision. If your child experiences at least six of the following symptoms, you may want to seek the help of a therapist who specializes in working with children with ADHD:
- Makes frequent careless mistakes.
- Has trouble focusing.
- Seems to not be listening when being spoken to.
- Frequently doesn’t finish chores or schoolwork.
- Has trouble with organization.
- Has difficulty with activities which require sustained mental effort.
- Frequently loses items.
- Often forgetful.
- Easily distracted.
One common misconception is that children with ADHD aren’t able to focus their attention on anything. For example, in my practice, I was frequently told that, “My child can focus on video games for hours.” Children with ADHD can often remain focused on an activity they enjoy. They may even appear to become hyper-focused on such activities. This does not mean that the child does not have ADHD.
The student with inattentive ADHD frequently appears to be careless. I have witnessed this in my own third-grade classroom. These students will not only skip questions on a test, but will actually skip entire pages. This child may want to do well on her assignment, but she may find it almost painful to slow down and work carefully. As a third-grade teacher, I would suggest taking steps to treat all subtypes of ADHD by third grade. These students will struggle throughout the year, and especially during the high- stakes testing that begins in third grade.
Unfinished homework, classwork and reading assignments are common among students who have the inattentive symptoms of ADHD. This is another reason to have problems addressed by the time the child enters the third grade. This is notably the big transition year, when much more is expected of our students, letter grades are given, and students must become more responsible. Unfinished work will lead to poor performance in the third-grade classroom.
Children with this form of ADHD commonly miss many of the verbal directions they are given. They also struggle to pay attention as lessons are taught, and they will often begin to daydream or doodle in class. These students also frequently lose things, which may include their homework or various items they need in order to complete assignments, often due to their struggle with organization. One of the things I notice at school is the cluttered desks. At times, their desks are so messy that items seem to just start tumbling out. Due to their forgetfulness, they may not remember to complete homework assignments, prepare for tests, or turn in projects on time. These are additional reasons to have ADHD or other learning issues addressed by the time the serious work of third grade begins.
If you suspect your child may suffer from this subtype of ADHD, your child’s teacher can be a good resource. However, parents should know that teachers are generally precluded from discussing the diagnosis with you. Instead, parents should listen for key phrases such as, “daydreams often,” “has trouble focusing,” “struggles to pay attention,” “trouble with organization,” and “often loses materials.” This is how the teacher will often let parents know that they suspect a problem. It is important to realize that teachers are not generally qualified to make the diagnosis. However, they often have an abundance of experience with numerous students, and their observations can be quite valuable.
The students with the inattentive form of ADHD often don’t get the treatment they need because the issue has not been properly identified. These students may be frustrated by school and begin to feel like failures. They may appear apathetic, but they are more likely feeling shame. For these reasons, a child’s self-esteem can be significantly impacted. It’s important to identify this form of ADHD or any learning disability, early in childhood, and have it treated by a professional. Some parents may be fearful of seeking help because they believe that their child will be put on medication. Treatment does not always involve the use of medication. If you question whether your child may suffer from this subtype of ADHD, consider consulting a child therapist who specializes in ADHD.