The Three Types of ADHD in Children
ADHD Support & Awareness
ADHD is one of the most commonly diagnosed developmental disorders in children, but many people don’t realize there are actually three types of ADHD. Despite the fact that symptoms of inattention and distraction are present in most ADHD diagnoses, media portrayals and caricatures of kids with ADHD tend to focus on the more sensational hyperactive characteristics.
Estimates of ADHD prevalence range from 1% to 13% and boys are three times more likely to be diagnosed than girls. (This fact is considered evidence of greater prevalence amongst boys as well as a trend of misdiagnosis of girls with ADHD.) ADHD is typically diagnosed in early childhood, though the diversity of symptoms can create confusion among parents about what is, and isn’t, an indication of ADHD. This is particularly true in the diagnosis of girls with ADHD.
A diagnosis of ADHD necessitates that symptoms have been not just present but present to the extent of interrupting a child’s ability to function at home and school. These symptoms fall into two main categories: inattentiveness and distraction, and hyperactivity and impulsivity.
The 3 Types, or Presentations, of ADHD
Three major types of ADHD include the following:
- ADHD, combined type. This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.
- ADHD, impulsive/hyperactive type. This, the least common type of ADHD, is characterized by impulsive and hyperactive behaviors without inattention and distractibility.
- ADHD, inattentive and distractible type. This type of ADHD is characterized predominately by inattention and distractibility without hyperactivity
How Is ADHD Diagnosed?
ADHD is categorized as a Neurodevelopmental Disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), considered the gold standard reference in North America for the assessment and treatment of mental health disorders.
The 2013 DSM-5 defines ADHD as “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development…” Symptoms must persist at least six months to be considered indicative of ADHD.
A child must demonstrate at least six symptoms categorized as inattention and/or hyperactivity, persisting 6 months or longer, to be diagnosed with ADHD. Children 17 and over must only demonstrate five (or more) symptoms over six months or longer. The symptoms must also be present in at least two settings (e.g., home and school) and some symptoms must have become present before the age of 7 years old for an ADHD diagnosis to be considered.
Symptoms of Inattentive ADHD in Children
- Often fails to give close attention to details or makes careless mistakes
- Often has difficulty sustaining attention in tasks or play activities
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish schoolwork or chores
- Often has difficulty organizing tasks and activities
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
- Often loses things necessary for tasks or activities
- Is often easily distracted by extraneous stimuli or, in older teens, by thoughts
- Is often forgetful in daily activities
Symptoms of Impulsive/Hyperactive ADHD in Children
Impulsive/Hyperactive ADHD may be the more stereotypically portrayed presentation of the disorder. To be diagnosed with ADHD–predominantly hyperactive-impulsive type, a child must exhibit six of the following symptoms for 6 months or longer:
- Often fidgets with or taps hands or feet or squirms in seat
- Often leaves seat in situations when remaining seated is expected
- Often runs about or climbs in situations where it is inappropriate
- Often unable to play or take part in leisure activities quietly
- Is often “on the go” acting as if “driven by a motor”
- Often talks excessively
- Often blurts out an answer before a question has been completed
- Often has trouble waiting his/her turn
- Often interrupts or intrudes on others
These symptoms of impulsiveness and hyperactivity must also be shown not to be solely due to “oppositional behavior, defiance, hostility, or failure to understand tasks or instructions.”
What Is the Most Common Type of ADHD?
The third subtype of ADHD is ADHD–combined type, in which the individual has at least six of the inattentive symptoms and at least 6 of the hyperactive-impulsive symptoms. ADHD-combined type is the most often diagnosed presentation of ADHD.
Symptoms of ADHD in Girls
Girls and women are more likely to present with symptoms of inattentiveness than of hyperactivity. Coupled with the “low index of clinical suspicion” of ADHD among females, this may contribute to their under-diagnosis. It’s estimated that as many as 75% of girls and women with ADHD are never diagnosed.
A 2014 review of the most recent decade’s research suggested another potential explanation for the under-diagnosis of ADHD amongst girls and women: “Females with ADHD may develop better coping strategies than males to mask their symptoms.” Study authors stated the importance of not mistaking academic success for a counter-indication of ADHD, among girls and women.
What to Do If You Think Your Child Has ADHD
If your child has been displaying symptoms of inattentiveness and/or hyperactivity and impulsiveness over a sustained period of time and to the detriment of their performance with school and home tasks, it may be time to speak to your family doctor.
Find local resources for ADHD support in Canada here.
If your child has been diagnosed with ADHD and is struggling in school, reach out for a friendly chat with The Reading School Director, Diane Duff, to learn more about online academic assessments, support, tutoring and advocacy for your child with ADHD.
Were you surprised by the symptoms of ADHD in your child? Did you find it easy to access medical care and receive an ADHD diagnosis? Share below!