Hyperactive, Inattentive, and Combined Presentations
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects millions of children and adults worldwide. ADHD is characterized by patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. The American Psychiatric Association identifies three primary presentations of ADHD: hyperactive-impulsive type, inattentive type, and combined type. Each type has distinct features, though individuals may experience symptoms that overlap.
ADHD Hyperactive-Impulsive Type
The hyperactive-impulsive presentation of ADHD is marked by excessive movement, fidgeting, and impulsive actions. People with this type may:
- Fidget or squirm in their seat
- Have trouble remaining seated in situations where it is expected
- Run or climb in inappropriate situations
- Feel restless or act as if “driven by a motor”
- Talk excessively
- Interrupt conversations or blurt out answers before questions are completed
- Have difficulty waiting their turn
This type is more commonly identified in younger children, particularly in boys, and can be disruptive in school or social settings. The hyperactive-impulsive symptoms may diminish with age, but some may persist into adolescence and adulthood.
ADHD Inattentive Type
The inattentive presentation of ADHD is primarily characterized by difficulties with sustaining attention, organization, and follow-through. People with this type may:
- Fail to pay close attention to details or make careless mistakes
- Struggle to maintain focus on tasks or play activities
- Appear not to listen when spoken to directly
- Not follow through on instructions or fail to finish tasks
- Have trouble organizing tasks and activities
- Avoid or dislike tasks that require sustained mental effort
- Lose things necessary for tasks (e.g., books, keys, paperwork)
- Be easily distracted by extraneous stimuli
- Forget daily activities
This type is sometimes referred to as “ADD” (Attention-Deficit Disorder) and is more commonly seen in girls and adults. Because symptoms are less overtly disruptive, inattentive ADHD is sometimes underdiagnosed.
ADHD Combined Type
The combined presentation of ADHD is diagnosed when an individual exhibits significant symptoms of both hyperactivity-impulsivity and inattention. This is the most common form of ADHD. People with the combined type display a mix of behaviors from both categories, leading to challenges in multiple areas of life, including academics, work, and relationships.
Diagnosis and treatment of ADHD involve a comprehensive evaluation by a healthcare professional. Treatment often includes behavioral therapy, educational support, and, in some cases, medication. Recognizing the type of ADHD is crucial for developing effective management strategies tailored to an individual’s unique needs. If you are concerned that your child has ADHD, please talk to your doctor at Children’s Medical Group.