Understanding ADHD and Its Types

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that commonly begins in childhood and can persist into adulthood. It affects attention, impulsivity, and activity levels, often impacting social, academic, and occupational functioning. According to the American Psychiatric Association (APA), ADHD is one of the most common mental health conditions among children, with an estimated prevalence of 5-10% globally (APA, 2022). ADHD manifests in different forms, categorized into three primary types: predominantly inattentive, predominantly hyperactive-impulsive, and combined presentation.

What is ADHD?

ADHD is characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with daily functioning or development. The exact cause of ADHD is not entirely understood, but research suggests it results from a combination of genetic, neurological, and environmental factors (National Institute of Mental Health [NIMH], 2022). Key symptoms include difficulty sustaining attention, forgetfulness, excessive talking, and acting without considering consequences.

Types of ADHD

ADHD is divided into three types based on the predominant symptoms:

1. Predominantly Inattentive Presentation

Individuals with this type primarily exhibit symptoms of inattention, such as:

• Difficulty focusing on tasks or sustaining attention.

• Being easily distracted by external stimuli.

• Frequently losing items needed for daily activities.

• Forgetfulness in daily routines.

This type is often referred to as “ADD” (Attention Deficit Disorder), though this term is no longer officially used in medical diagnoses. It is more common in girls and may be underdiagnosed due to the subtler nature of the symptoms compared to hyperactivity.

2. Predominantly Hyperactive-Impulsive Presentation

This type is marked by symptoms of hyperactivity and impulsivity, such as:

• Fidgeting or squirming when seated.

• Inability to remain seated in situations where it is expected.

• Interrupting others during conversations.

• Difficulty waiting for one’s turn.

This presentation is more noticeable in children, as they may frequently run, climb, or exhibit other inappropriate behaviors for the context.

3. Combined Presentation

The combined type is diagnosed when an individual exhibits significant symptoms of both inattention and hyperactivity-impulsivity for at least six months. This is the most common type of ADHD and can result in significant challenges in academic, occupational, and social settings.

Diagnosis and Treatment

ADHD is diagnosed based on criteria outlined in the DSM-5-TR, which requires that symptoms be present for at least six months and interfere with functioning in at least two settings (e.g., home and school) (APA, 2022). A comprehensive evaluation often includes clinical interviews, behavior assessments, and input from caregivers or teachers.

Treatment for ADHD typically includes:

1. Behavioral Therapy: Focuses on teaching strategies to manage symptoms and improve functioning.

2. Medication: Stimulants such as methylphenidate (e.g., Ritalin) and amphetamines (e.g., Adderall) are the most common pharmacological treatments. Non-stimulant medications may also be used.

3. Educational Support: Individualized Education Plans (IEPs) or accommodations under Section 504 of the Rehabilitation Act can help students with ADHD succeed academically.

ADHD is a complex and multifaceted condition that affects individuals differently depending on the type and severity of symptoms. Early identification and tailored interventions are essential to support those with ADHD in managing their symptoms and achieving their full potential. Ongoing research continues to uncover insights into ADHD, paving the way for improved understanding and treatment approaches.

This article was written by John S. Collier, MSW, LCSW. John has over 25 years in the social work field. He is currently serving as the executive Director and outpatient behavioral health provider at Southeast Kentucky Behavioral Health based out of London Kentucky. John may be reached by phone at 606-657-0532 extension 101 or by email at [email protected].

References

• American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., Text Revision). American Psychiatric Publishing.

• National Institute of Mental Health. (2022). Attention-Deficit/Hyperactivity Disorder (ADHD): Overview and Diagnosis. Retrieved from https://www.nimh.nih.gov.

• Centers for Disease Control and Prevention (CDC). (2022). ADHD Throughout the Lifespan. Retrieved from https://www.cdc.gov.

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