Signs of Inattentive ADHD and How to Treat It

Inattentive attention deficit hyperactivity disorder (ADHD) is one of three types of ADHD.

People with inattentive ADHD (previously called attention deficit disorder, or ADD) tend not to show as many "hyperactive" symptoms, but rather have difficulties with paying attention to details, organization, and finishing tasks.

This article will review the characteristics of inattentive ADHD, as well as how the condition is diagnosed and treated.

What Is Inattentive ADHD?

ADHD is a disorder that is neurodevelopmental, which refers to the nervous system as it develops across the lifespan. It can cause inattention, hyperactivity, and/or impulsivity.

ADHD typically appears between the ages of 3 and 6 years old, with an average age of diagnosis at 7 years old.

Approximately 11% of children between the ages of 4 and 17 have ADHD. While often thought of as a childhood disorder, ADHD persists into adulthood. About 4% of Americans over the age of 18 have ADHD.

While not separate disorders, ADHD is divided into three presentations, including:

• Predominantly inattentive presentation
• Predominantly hyperactive-impulsive presentation
• Combined presentation (both inattentive and hyperactive-impulsive symptoms are present)

People with inattentive ADHD have a high occurrence of inattentive symptoms, such as disorganization and distractibility, but do not often show hyperactive-impulsive behaviors.

Symptoms of Inattentive ADHD

All people, particularly children, are inattentive at times. Occasional forgetfulness or other inattentive behaviors are not an indication of ADHD.

People with inattentive ADHD frequently display these characteristics to the point that they impact their daily functioning in areas such as school, work, and interaction with others.

To meet the criteria for inattentive ADHD laid out by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a child must have at least six (or an adult must have five) of the following symptoms over the course of at least six months, to a degree that they impact their level of functioning:

• Trouble paying close attention to details, such as making "careless mistakes" in schoolwork, including missing or inaccurate details in work
• Has difficulty sustaining attention in tasks or play activities, such as staying focused during lectures, in conversations, or reading lengthy items
• Seems not to be listening when spoken to directly and may seem to be daydreaming or not be "in the moment"
• Does not follow through on instructions; has trouble finishing tasks such as schoolwork, chores, or other duties; and may start tasks but lose focus and get sidetracked
• Often has difficulty with organization, such as managing tasks and keeping work or home spaces neat, as well as problems with time management and missing deadlines
• Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort, such as schoolwork or homework, preparing reports, and filling out forms
• Loses items they need for tasks or activities, such as pencils, books, tools, glasses, and keys
• Easily distracted by things around them or by unrelated thoughts
• Forgetful in daily activities and may forget to do chores and errands, return phone calls, pay bills, or keep appointments

Diagnosing Inattentive ADHD

To make a diagnosis of ADHD, a healthcare provider or mental health professional will use a number of tools, including interviewing the person, reviewing their medical and family history, and doing a physical exam.

Interview

To get an overall picture of symptoms, the healthcare provider will ask the person affected, and/or their parent or guardian about:

• Symptoms of ADHD in the home setting
• Symptoms outside of the home, such as at school, at work, or in the community
• Degree of impact these symptoms have on current functioning
  

Review History

In addition to current symptoms, a healthcare provider will ask about:

• Medical history: Such as past development, other health conditions, medications, and any other relevant overall health information
  
• Social circumstances: For instance, stressors at home or elsewhere and social or financial support
  
• Family history: Including a history of ADHD or related conditions in relatives

Physical Examination

This may include:

• A general assessment of overall health
• A cardiac exam (particularly if prescribing medication)
• Neurologic examinations
• Vision and hearing screenings
• Looking for or ruling out other possible causes for the symptoms

Behavioral Ratings

A validated ADHD screening test or assessment may be filled out by one or more of the following:

• The person (a self-report)
• A parent or guardian
• A teacher or other relevant adult in the child's life
  

Causes of Inattentive ADHD

The cause of ADHD isn't known, but research highly suggests a genetic link. About three out of four children with ADHD have a relative who also has ADHD.

ADHD may also have neurobiological causes. Many studies have found differences in brain structure between people who have ADHD and people who do not. 

Other researchers believe that ADHD may have environmental causes. For example, research suggests that the use of nicotine during pregnancy may contribute to the development of ADHD. Other studies suggest there may be a nutritional component. Low birth weight, toxins, and brain injuries may also contribute to the development of ADHD.

Treating Inattentive ADHD

Medication and therapy are both very effective ways to treat ADHD. Many people successfully use a combination of medication and therapy.

Medications

Oftentimes, the types of medications prescribed for ADHD are similar for adults and children, but dosage, exact medication, and frequency will be different.

Psychostimulants

• The medication typically prescribed for ADHD
• Effective in 70%–90% of patients with ADHD
• Most commonly used types are Adderall(dextroamphetamine-amphetamine) Ritalin and Concerta (methylphenidate), and Metadate CD (methylphenidate hydrochloride)

Antidepressants

• May be prescribed if psychostimulants are not effective or cannot be taken
• May include: Tricyclic antidepressants such as Pamelor (nortriptyline), monoamine oxidase inhibitors such as Nardil (phenelzine), Wellbutrin (bupropion), or Effexor (venlafaxine)
• Although antidepressants are not approved by the Food and Drug Administration (FDA) for the treatment of ADHD, they are sometimes used off-label.

Nonstimulants

• May be used if stimulants are ineffective or cannot be taken
• May include: Strattera (atomoxetine), Qelbree (viloxazine), or Intuniv and Tenex (guanfacine)

Medications for ADHD often require adjustments, especially in the beginning. Work with your healthcare provider to find the right fit for you.

Therapy

Several types of therapies can help with ADHD symptoms. Therapy is often used in combination with medication, and can be used on its own.

Psychoeducation

• Discussions about ADHD and its effects
• Helps people make sense of being diagnosed with ADHD and teaches how to cope with it
  

Behavior Therapy

• Uses a system of rewards to help with behavior management
• Involves learning how to plan and structure activities, and giving praise and encouragement to children for even very small amounts of progress
  

Parent/Guardian Training and Education Programs

• Helps parents or guardians learn specific ways of talking to, playing with, and working with their child to improve their attention
  
• Usually arranged in groups of around 10–12 parents/guardians
• Usually consists of 10–16 meetings of up to two hours each
  

Social Skills Training

• Involves role-playing situations
  

Cognitive Behavioral Therapy (CBT)

• A form of psychotherapy (talk therapy)
• Available for children and adults
• Involves identifying faulty or unhelpful thinking and changing it into thinking that is more productive and functional
• Can be done individually or in a group

Coaching

A coach for people with ADHD:

• Provides feedback
• Makes recommendations
• Gives encouragement
• Helps people find and apply their own solutions to problems
• Offers practical solutions to address certain issues, such as time management and organization
• Helps people achieve their goals
  

Coping

The most effective treatments for inattentive ADHD are therapy and medication, but there are other ways to help in addition to these measures.

You can try—or encourage your child to try—the following:

• Exercise regularly.
• Adopt healthy eating practices.
• Get a proper amount of sleep.
• Create and adhere to routines.
• Use notebooks, apps, and other organizers to write down and keep track of assignments and reminders.
• Be clear and consistent with rules and instructions for your child.
• Praise and reward your child often, as children with ADHD are often disciplined and criticized more than other children.
• Minimize distractions, such as working in a quiet room or sending calls to voicemail.
• Work on one task at a time, and break large tasks into smaller ones.
• Set up reminders, such as using visual lists or sticky notes.
• Set up automatic bill payments.
• Make designated spots for items that frequently get lost.
• Take handwritten notes during meetings, school, or similar venues, using a recording device as a backup and filling in details later.
  

Thriving With Inattentive ADHD

Although people with inattentive ADHD have symptoms that can interfere with their ability to focus, attention to detail, and organization skills, people with inattentive ADHD may also have skills and abilities that set them apart from many neurotypical people.

For example, people with ADHD tend to have natural creativity and good verbal communication skills. They are also good at problem-solving and thinking "outside of the box." When used appropriately, spontaneity and abundant energy reserves can also be seen as positive qualities.

Summary

Inattentive ADHD is one of three types of ADHD. This type tends to present with more inattentive symptoms, such as disorganization and distractibility, but do not often show hyperactive-impulsive behaviors. If you suspect you or your child has this type of ADHD, see your healthcare provider for a consultation and diagnosis. ADHD is treatable with a combination of medication and behavioral therapy.