ADD vs. ADHD
If your child daydreams a lot at school, is easily distracted while doing homework or chores, or fidgets constantly, you might wonder if they have attention deficit hyperactivity disorder (ADHD). Or is it attention deficit disorder (ADD)? Or perhaps you're wondering if you could have ADD or ADHD yourself, ever since you were a younger person, and never got diagnosed.
Is there a difference between ADD and ADHD?
Not exactly. These are really two names for the same condition, but ADD isn't used by doctors anymore. You might still hear people use the name ADD, but it isn't an official diagnosis. A person with ADD today would be diagnosed with one of the three subtypes of ADHD instead.
History of ADD vs. ADHD
In the 1800s, doctors began noticing signs of what we now know as ADHD. Back then, they described it as "nervous child," "simple hyperexcitability," or other similar terms. In the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 1980, the American Psychiatric Association (APA) gave this mental health condition the name attention deficit disorder (ADD). ADD had two types — it could be either with or without hyperactivity.
ADD focused on difficulties with attention and impulse control. The diagnosis included three different groups of symptoms: inattention, impulsivity, and hyperactivity. They also were more specific than before. The ADD classification also:
- Had a cutoff score for symptoms
- Included guidelines for age of onset
- Specified how long symptoms lasted
- Required that other psychiatric conditions had been ruled out
In 1987, doctors changed the name ADD to ADHD. They also got rid of the idea that there were two subtypes and merged the three lists of symptoms into one.
In 1994, there was another change when the next edition of the DSM came out. The APA described three types of ADHD:
- Inattentive
- Hyperactive/impulsive
- Combined
Researchers identified these three types based on interviews in a field trial. At this time, they also realized that ADHD isn't only something kids can have. They noted instead that it could be chronic and lasting into adulthood.
According to the CDC, 7 million kids in the U.S. have ADHD. That's according to a survey of parents. It's more often diagnosed in boys than girls, but girls have ADHD, too. ADHD symptoms can be mild or more severe. It sometimes happens together with other conditions including:
- Behavioral or conduct problems
- Learning disorders
- Anxiety
- Depression
The right diagnosis for you, your family member, or your child will depend on the specific symptoms and how they affect you. It's important to talk with an experienced mental health provider to make sure you get the right diagnosis.
Signs of ADHD
ADHD is a brain-based disorder. It can interfere with your child's everyday activities at home and school. Kids who have it have trouble paying attention and controlling their behavior and are sometimes hyperactive.
Before they are diagnosed, you will want to note your child's symptoms. The CDC offers an ADHD checklist for children that may help you keep track of them.
Here are the signs to look for:
Inattention. Includes disorganization, problems staying on task, constant daydreaming, and not paying attention when spoken to directly.
Impulsivity. Includes spur-of-the-moment decisions without thinking about the chance of harm or long-term effects. They act quickly to get an immediate reward. They may regularly interrupt teachers, friends, and family.
Hyperactivity. Involves squirming, fidgeting, tapping, talking, and constant movement, especially in situations where it's not appropriate.
Types of ADHD
Mental health professionals in the U.S. use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose all psychiatric conditions, including ADHD. The latest version divides it into three types:
- ADHD, predominantly inattentive presentation
- ADHD, predominantly hyperactive-impulsive presentation
- ADHD, combined presentation (both inattentive and hyperactive-impulsive symptoms)
Your diagnosis will depend on their specific symptoms.
ADHD Inattentive
Kids with this condition aren't hyperactive. They don't have the high energy level seen in others with ADHD. In fact, children with this form may seem shy or "in their own world." They may seem "spacey," not interested, or easily distracted. Trouble paying attention is the main sign.
ADD is diagnosed if a child under age 16 has six or more symptoms of inattention (five or more for older teens) for at least six consecutive months but no signs of hyperactivity/impulsivity.
The symptoms include:
- Trouble paying attention (easily sidetracked)
- Avoiding long mental tasks (such as homework)
- Trouble staying on task during school, at home, or even at play
- Being disorganized and forgetful
- Not appearing to listen when directly spoken to
- Not paying close attention to details
- Losing things often
- Making careless mistakes
- Struggling to follow through with instructions
Children with this subtype of ADHD may go undiagnosed because the symptoms may be chalked up to daydreaming.
ADHD Hyperactive-Impulsive
Children with this form of ADHD have tons of energy and are constantly moving in a way that causes problems. It's diagnosed if a child under age 16 has six or more (five or more for older teens) hyperactive/impulsive symptoms for at least six months. This form is more noticeable than the inattentive type.
Symptoms include:
- Blurting out answers before a question is finished
- Constantly interrupting others
- Trouble waiting for their turn
- Talking too much
- Fidgeting, tapping, and squirming
- Getting up when it's not appropriate (such as when the teacher is talking or in the middle of dinner)
- Running or climbing in inappropriate situations
- Inability to play quietly
- Always being "on the go"
ADHD Combined Type
A child with this type has symptoms of both inattention and hyperactivity/impulsivity. They'll be on the move a lot while also struggling to pay attention.
ADHD Diagnosis
There's no one test you can take to find out if you or your child has ADHD. Many other things can look like ADHD, such as:
- Sleep disorders
- Anxiety
- Depression
- Learning disabilities
Health care professionals such as pediatricians, psychiatrists, and child psychologists can diagnose ADHD with the help of standard guidelines from the American Academy of Pediatrics or the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
You can also find a professional who specializes in ADHD diagnosis through your health plan, your child’s teacher or school counselor, other parents of children with ADHD, or nonprofit organizations such as Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
The diagnosis involves gathering information from several sources, including schools, caregivers, and parents. The health care professional will consider how a child's behavior compares with that of other children the same age, and they may use standardized rating scales to document these behaviors.
To diagnose ADHD, your child should have a full physical exam, including vision and hearing tests. Also, the FDA has approved the use of the Neuropsychiatric EEG-Based Assessment Aid (NEBA) System, a noninvasive scan that measures theta and beta brain waves. The theta/beta ratio has been shown to be higher in children and adolescents with ADHD than in children without it. The scan, approved for use in those aged 6-17 years, is meant to be part of a complete medical and psychological exam.
The evaluation may also include interviewing you, your child's teachers, and any other adults who are a big part of your child's life. The evaluator may ask each of you to fill out standardized forms, known as “behavior rating scales,” to rate different aspects of your child’s behavior. These scales may also be used later to track progress with treatment.
The health care professional should take a complete medical history to check for other conditions that may affect a child's behavior. Certain conditions that could mimic ADHD or cause ADHD-like behaviors are:
- Recent major life changes (such as a divorce, a death in the family, or a recent move)
- Undetected seizures
- Thyroid problems
- Sleep problems
- Anxiety
- Depression
- Lead toxicity
Though many children show some of the behaviors of ADHD, they do not necessarily have the disorder. An ADHD diagnosis requires that:
- These behaviors have been around for at least six months.
- Some symptoms began before age 12.
- Symptoms are present in two or more settings (such as school and home).
- Symptoms significantly affect the child in at least two places (social life, school, etc.).
Keep in mind that many people with ADHD as kids continue to have it as adults. If you're an adult and think you may have ADHD, see a mental health professional to find out. Sometimes, parents may realize they have ADHD when they recognize it in their kids.
Takeaways
ADD is an older name for the condition that's now called ADHD. You can have ADHD in three different types depending on whether the symptoms are more about trouble with attention, impulsivity and hyperactivity, or both. ADHD starts in childhood, but for many people, it doesn't go away. You could find out you have ADHD at any age.
ADD vs ADHD FAQs
Are ADD and ADHD the same?
ADD stands for attention deficit disorder. It's the old name for the condition now diagnosed as ADHD.
Why is ADD no longer a diagnosis?
The manual mental health professionals use to diagnose mental health conditions doesn't recognize ADD as a diagnosis anymore. In 1987, the official name for the condition changed from ADD to ADHD.
Was ADD changed to ADHD?
Yes, ADD was officially changed to ADHD in 1987 when a new edition of the DSM came out. Sometimes people may still use the name ADD in common language, but it isn't officially recognized as a diagnosable condition. It's called ADHD instead.
What are the three main symptoms of ADHD?
The three main symptoms of ADHD are inattention, hyperactivity, and impulsivity. You don't have to have both inattention and hyperactivity to get a diagnosis of ADHD.
