Could This be Inattentive ADD?

Could This be Inattentive ADD?

Recently I have received several questions from parents with young children with symptoms of:

  • Inattention
  • Disorganization
  • Procrastination
  • Plodding Work Pace
  • Lethargy

The parents of these kids want to know if these symptoms are Inattentive ADD symptoms and they want to know what to do.  They often are concerned about the “labeling” of their kids and this is a legitimate concern and they are concerned about not acting on these issues as they fear that the symptoms will only become more of an issue as their children age.

As an aside, I am always heartened by the fact that 95% of the parents who write me, describe their children as poor students but “delightful people”.  I always ask parents if their children are “good company” and they almost always say “yes”.  I mention this because, at the end of the day, a person who is “good company” has a lot more potential than a person who is not.  Excellent, A+ students, can be obnoxious, arrogant and “bad company” and I like to point this out to parents who are despairing about their children’s academic performance.

Anyway... back to the topic.  The above symptoms may or may not be Inattentive ADD symptoms. It does not really matter as these children need help.  In children who are ten and younger, the plan should be to help them establish life and academic skills that will support them in years to come.  These skills include:

  • Regular Exercise
  • Healthy Diet Habits
  • Healthy Sleep Habits
  • Good Parent/Teacher Communication
  • Organizational Aids such as wall charts, Big visible task calendars,
  • Appropriate Incentives

For older kids, the support plan should include all the above plus:

  • Having a spare set of school books (a whole extra set) at home to help eliminate the issues of not having the right books to do whatever assignment is due. 
  • Engaging the help of a high school student, paid minimum wage, to be your child’s "homework helper". Communicating teachers and asking that assignments be put online or available in such a way that you, the Homework Helper and the student know what it due, when it is due and what is required to complete the assignment.
  • In addition all the recommendations in this post talks about classroom changes that help all students and especially helps students with memory and organization problems.

To find more of my suggestions, you can use the search bar in the top right hand corner of my blog and search under the terms "teacher" and "classroom".  This will bring up posts with more recommendations. 

The Difference Between Sluggish Cognitive Tempo and Inattentive ADD

The Difference Between Sluggish Cognitive Tempo and Inattentive ADD
I have been posting to 'Primarily Inattentive ADD' very infrequently.  The main reason for this is that I found about a year ago, after I finished my second book, Commanding Attention, that I had written about most of what I had to say.  At that time I decided I would only post if some new Inattentive ADD news story warranted coverage.

I do not have any amazing new discoveries to post about but I wanted to address a question that I get emailed a lot.  The question of the difference between Inattentive ADD and Sluggish Cognitive Tempo (SCT).  These conditions are different but they are equally difficult to treat as they both often fail to respond to stimulants.  New studies suggest that Strattera, a non-stimulant ADHD medication, may help SCT as well as helping Inattentive ADD but the amount of benefit that any individual ADD or SCT patient may get from Strattera is still highly variable.

My short answer to, What is the difference between SCT and Inattentive ADD? has always been this, Children and adults with Inattentive ADD are normally active.  Not hyperactive, not hypo-active.  The difficulty in diagnosing children with either condition (and with hyperactive ADHD for that matter) is that many children under the age of 12 have a normal development lag in their ability to regulate their activity levels.  To make matters more complicated, teenagers can be perpetually tired because of all sorts of normal developmental issues (sleep deprivation, anxiety, depression, etc) and these same issues can cause some teenagers to be hyperactive.

There is no doubt in my mind that there are adults and children who are legitimately and concernedly sluggish but I believe that we are only now in the infancy or our medical understanding of the cause and possible solutions to this sluggishness.  Until we understand better the causes of mental sluggishness, we cannot begin to treat it.

I am in classrooms a lot.  In every third Kindergarten through 12th grade classroom there is at least one student who appears unable to stay awake.  Teaching a child like this is obviously impossible but does every child who is half asleep have a diagnosis of SCT.  I do not think so.  Inattentive ADD is, in my opinion, more prevalent.  You can find a Inattentive ADD kid in every K-12 classroom if you know what to look for.  That kids is not falling asleep.  That kid looks like he/she even may be paying attention.  The problem is, that Inattentive ADD kid is paying attention to something going on in their head, NOT to what is going on in the classroom.

In an April article on SCT in the New York Times, Alan Schwarz reported that Psychiatrists and drug companies are "claiming to have identified a new disorder that could vastly expand the ranks of young people treated for attention problems".  In his article, Schwarz reports that Steve S. Lee, an associate professor of psychology on the editorial board of The Journal of Abnormal Child Psychology, is concerned that SCT may be diagnosed in children with common behaviors that are the result of common youthful problems such as lack of sleep."  Of course, the same concerns can be said of the diagnosis of both hyperactive ADHD and ADD.  

So there is a difference but the take home message here is this.  There are hyperactive kids and adults, there are inattentive kids and adults and there are sluggish (and usually inattentive) kids and adults and we know a lot more about the former two than we know about the latter.