Understanding the Differences: ADD vs. ADHD Explained

What was once most often diagnosed as Attention Deficit Disorder (ADD) is now reflected in the diagnostic label of Attention Deficit Hyperactivity Disorder (ADHD). That is, those who would’ve met diagnostic criteria for ADD without hyperactivity are now instead diagnosed with ADHD, primarily inattentive presentation. Changes to the diagnostic process and increased awareness regarding ADHD have helped providers detect and treat ADHD effectively in people who need support for the disorder but were once unable to get it. 

While the term ADD no longer exists, primarily inattentive ADHD still differs from combined type ADHD or primarily hyperactive/impulsive ADHD in a number of ways. Gaining an understanding of how primarily inattentive ADHD differs from other presentations can be crucial for parents looking into a potential diagnosis for their child’s symptoms. It can also be important for those hoping to better understand how inattentive symptoms affect a person’s life.

What should parents know about the term ADD? First, let’s discuss what ADD is, as well as symptoms and common misconceptions. Then, we'll talk about diagnosis, treatment, and how to improve quality of life while living with what is now known as primarily inattentive ADHD.

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First, parents download the Joon Parent App and make a task list for their child. You can choose from 500+ pre-loaded tasks, like homework, household chores, and self-care activities, or add your own. Joon uses ADHD-friendly practices, like reminders, and makes it easy to break your child’s tasks down into smaller pieces; a common strategy among those with ADD or inattentive ADHD. When kids finish tasks, they get rewards that let them continue playing the game, take care of a virtual pet, and unlock new, exciting features.

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What is ADD?

In 1987, the American Psychiatric Association (APA) released a revised version of the third Diagnostic and Statistical Manual of Mental Disorders (DSM). In that revised edition, ADD was removed and replaced with the term ADHD. As of the year 2000, when the fourth DSM came out, providers have diagnosed ADHD only, distinguishing different presentations into one of the following three types of ADHD: primarily inattentive, primarily hyperactive/impulsive, and combined type ADHD.

What was once called ADD is now known as primarily inattentive ADHD. Someone with primarily inattentive ADHD won’t show hyperactivity/impulsivity symptoms like someone with primarily hyperactive/impulsive or combined type ADHD would. In other words, your child doesn’t need to be hyper to have ADHD.

Definition of ADD

ADD, now most accurately known as inattentive ADHD, is a neurodevelopmental disorder that primarily affects things like focus, concentration, and attention span. Unlike those with a combined or primarily hyperactive type of presentation, people with inattentive ADHD don't experience enough (if any) hyperactivity or impulsivity symptoms to fit another presentation of ADHD.

Symptoms of ADD

ADD symptoms, more commonly known as inattention symptoms, include:

• Trouble with attention to detail or making seemingly careless mistakes
• Trouble listening when spoken to directly (may get distracted or zone out - this is unintentional)
• Difficulty following through with instructions or finishing tasks at work, home, or school (may start tasks but lose focus)
• Trouble organizing tasks and activities (can present through lateness, difficulty with multi-step tasks, organizing belongings or materials, or general problems with time management)
• Avoidance of tasks, like homework or paperwork, that require sustained mental focus
• Difficulty paying attention during tasks, play, or conversations
• Being easily distracted by thoughts or external stimuli
• Losing or misplacing items necessary for daily tasks (e.g., school supplies, phone, or keys) frequently 
• Forgetfulness in daily activities

The diagnostic criteria for ADHD includes a primarily inattentive presentation of ADHD. If a child shows six of the above symptoms before age 12 and fewer than six symptoms associated with hyperactivity and/or impulsivity, they can be diagnosed with primarily inattentive ADHD at any point in their life.

Common misconceptions about ADD

One of the most common misconceptions about people with inattentive ADHD symptoms is that they can sustain focus on a task or avoid other symptoms if they try hard enough. In reality, treatment and ADHD-friendly tools or strategies, such as those that aid time management, can be both empowering and necessary for those with the diagnosis. 

What is ADHD?

Attention Deficit Hyperactivity Disorder, or ADHD, is the most common neurodevelopmental disorder diagnosed in childhood. A person with any presentation of ADHD, including inattentive type ADHD, can simply say that they have ADHD. Presentations are considered specifiers that aid providers in identifying the most problematic symptoms for targeting in treatment rather than separate diagnoses. While symptoms may present very differently based on the type of ADHD your child has, the diagnosis covers all presentations of the disorder and the presentation of ADHD may even change over the course of development in individuals.

Definition of ADHD

ADHD is defined as a neurodevelopmental disorder marked by at least six symptoms of inattention, hyperactivity, or both, in kids under the age of 17. If aged 17+ at the time of diagnosis, an individual may only need to show five signs in one or both categories. If your child shows 6+ signs in both categories along with meeting other symptom criteria, they may get diagnosed with combined type ADHD.

Symptoms of ADHD

ADHD symptoms can relate to inattention (difficulty sustaining focus or a short attention span), hyperactivity (excessive energy or movement that isn't suitable for the activity or one's surroundings), or impulsivity (acting hastily or without thought, sometimes in ways that results in one getting in trouble).

Common misconceptions about ADHD

In addition to the misconception that ADHD symptoms can be avoided with enough effort or willpower, a very common misconception about ADHD is that childhood ADHD will go away. Most people who meet the criteria for ADHD as a child still do as an adult. What usually happens is that adults with the disorder start to show symptoms differently. For example, people with hyperactive/impulsive type ADHD might get out of their seat and run around in class as a child, but as a pre-teen, teen, or adult, this could be limited to restlessness.

Key Differences Between ADD vs. ADHD

There are key differences in how those with primarily inattentive ADHD present in comparison to those with primarily hyperactive/impulsive or combined type ADHD. In looking at the symptom categories below, you can differentiate inattentive ADHD vs. presentations of ADHD with hyperactive/impulsive symptoms.

Hyperactivity

• Not being able to say seated, or restlessness, depending on age
• Trouble engaging in leisure, play, and other activities quietly
• Acting as though one is "always on the go" or "powered by a motor"
• Fidgeting, tapping hands or feet, or squirming in one's seat
• Excessive talking

Impulsivity

• Interrupting others
• Intruding ("butting into") other people's activities or conversations
• Trouble waiting for one's turn
• Blurting things out 

Inattention

• Making mistakes that appear careless to others or having trouble following instructions (e.g., missing important parts of a multi-step task)
• Avoiding tasks that require ongoing focus (e.g., homework or paperwork)
• Getting sidetracked more easily than others during tasks
• Losing or misplacing objects frequently
• Forgetfulness 

Diagnosis and Treatment

ADHD symptoms must start before age 12 for a diagnosis to occur. Even if someone is diagnosed as an adult, a medical or mental health professional qualified to diagnose ADHD will ask when symptoms began. It isn't uncommon for adults with neurodevelopmental disorders like ADHD to have been misdiagnosed with a mental health condition, like bipolar disorder, earlier in life (although these can be comorbid, meaning that someone can have both). Early detection is the goal. 

How ADD and ADHD are diagnosed

ADHD is diagnosed using the criteria in the most recently updated version of the DSM. As of 2024, qualified providers use the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, revised in 2022, to diagnose ADHD. If you notice ADHD symptoms in your child, their pediatrician can refer you to someone equipped to provide an ADHD diagnosis. Some pediatricians feel comfortable diagnosing ADHD themselves, but this isn't always the case.

Treatment options for ADD

Treatment options for those who would've been diagnosed with ADD are the same as those used for ADHD. Proper education regarding ADHD treatment can make a huge difference in a person's life. For example, while many parents worry about the possible consequences of including medication in a child's treatment plan, they're actually shown to reduce the risk of substance use disorders and other possible adverse consequences of untreated ADHD.

Treatment options for ADHD

Combined medication and parent training in behavior management is the gold standard in ADHD treatment for kids under age 12. If a child is under age six, parent training in behavior management is used alone before medication is considered. Stimulant medications are the first line of medication treatment for ADHD aged 6+, as they have been proven highly effective for most people with the disorder. Classroom accommodations are also recommended. 

Living with ADD and ADHD

Some recommendations for ADHD treatment will depend on a person's age and other factors, like how they’ve responded to previous interventions, if applicable. Medications used to treat ADHD are shown to reduce symptoms in all three areas (inattention, hyperactivity, and impulsivity), so the same medications may be prescribed regardless of type. However, the specific ADHD symptoms one endures can impact which strategies are most advantageous alongside medication and other treatments.

Strategies for managing symptoms

In parent training, you'll work with a mental health professional who will help you make a game plan for your child's unique symptoms. The strategies one uses for hyperactive type ADHD symptoms or disruptive behavior can differ from strategies used for kids who generally display good behavior but struggle with inattention, which is part of why individualized support is so critical.

Strategies for kids with inattentive ADHD can include but aren't limited to:

• Compassionate, patience-oriented parenting strategies
• Reminders, calendars, timers, and other tools that support executive functioning
• Structured daily routines
• Chore charts
• Sleep hygiene
• Exercise

Joon is an excellent fit for kids struggling with inattention and similar symptoms, as it encourages independence and helps kids stay on track naturally.

Support for individuals with ADD and ADHD

Some people with ADHD have co-occurring mental health conditions. For example, anxiety or depression. Learning disabilities can also co-occur. Therapy can be helpful for anyone going through a difficult time, but for kids facing a co-occurring mental health disorder, difficulty in friendships, or other challenges related to ADHD, it can be particularly beneficial. Kids may get a referral for social skills training if their symptoms interfere with social function.

Parents of ADHD kids might also need support, especially if their child was recently diagnosed or is going through a rough patch in any way. Support groups like the Parenting ADHD support group by Joon can be incredibly valuable for parents and family members.

Importance of education and awareness

Research shows that untreated ADHD is associated with poorer school performance, social function, and lower self-esteem. Inattentive ADHD is the type most likely to go undiagnosed. Increased awareness and education regarding ADHD can help children get diagnosed and avoid the consequences of untreated ADHD.

Conclusion

The term ADHD now encompasses what was once called ADD. Even though the term ADD is no longer used, there are different types of ADHD. One type of ADHD is primarily inattentive type ADHD, which is generally used for those who would’ve been diagnosed with ADD in the past. Although inattentive type ADHD sometimes goes overlooked, it isn't any less serious. Early detection and treatment sets kids up for success.

Parenting strategies, medication, and behavioral therapy can help kids with ADHD. Lifestyle factors like sleep also make a difference. Continued awareness surrounding the reality of ADHD, including a greater understanding of inattentive ADHD, will lead to increased understanding and a higher likelihood of appropriate diagnosis earlier in life.