Inattentive ADHD, Too Rare a Diagnosis

I recently received a comment from a reader who had difficulty in school her entire academic career. She had, while scouring the internet, realized that she had all the symptoms of Inattentive ADHD (ADHD-I). She had been to several therapist and doctors but no one had ever suggested to her that she might have ADHD-I, and no doctor had ever given her a behavioral checklist to test her for ADHD-I. She is frustrated that she had to find the behavioral checklist on her own and that she had not, earlier in her life, received the support that may have helped her in school and in life.

Unfortunately, Inattentive ADHD is a diagnosis that is hard to come by. Many teachers are aware of the problem but do not know what to call it or are calling it 'garden variety' ADHD. Parents of children who are not hyperactive go home, after the parent teacher conference, scratching their heads at a diagnosis of ADHD. They know that their child is not hyperactive and, in their limited understanding of ADHD, kids with this diagnosis are hyperactive. The parent is angry that the teacher has such a limited knowledge of the personality of their child and therein begins the parent/teacher battle.

Unless the teacher explains to the parent, in great detail, that ADHD can exist without hyperactivity, that the spaciness, disorganization, and distraction are part of a bigger academic picture called Inattentive ADHD, then the parent will dismiss the suggestions of the teacher and the child will remain without support and without classroom accommodation for their disability.

In the April "Journal of Attention Disorder" there is a telling study on the state of the diagnosis rate of Inattentive ADHD (ADHD-I). The researchers looked at about 1000, 10 years olds. Eight percent of them had symptoms of ADHD and of these; five percent had the hyperactive/impulsive subtype. Of these kids, most were receiving classroom help. The other three percent had either Inattentive ADHD or combined type ADHD (ADHD-C) and were not receiving any additional classroom support. The researchers concluded that it was imperative to test children early and afford them necessary classroom help so that these children did not worsen and continue to fall behind.

If the DSM V, the psychiatric diagnostic manual, used by the American Psychiatric Association and by psychiatrist around the world, gives ADHD-I its own category, it is possible that the awareness of the inattentive type of ADHD will increase.

Regardless of what you believe about how ADHD-I should be treated, regardless of what you think about how similar or different ADHD-I is from the other subtypes, the fact remains that children with ADHD-I are the least diagnosed children of all the subtypes and the least treated.

Many inattentive kids are not receiving the help that they need because no one understands what it is that they have. The child with symptoms of ADHD-I looks significantly different, in a classroom, from the child with hyperactive impulsive ADHD (ADHD-HI). We have to increase awareness regarding the ‘look’ of the child with ADHD-I. We have to let our teachers and parents know about the symptoms of Inattentive ADHD so that children and adults with this condition are promptly diagnosed and treated.

"Journal of Attention Disorders"; The Prevalence of AD(H)D-Like Symptoms in a Community Sample;
Alloway T, Elliott J, Holmes J; April 2010


  1. I have been reading your blog pretty much since my diagnosis of PI this past February. I am 26, and as you can imagine, the simplicity of a professional listening and saying 'Have you ever thought about this?' was as helpful (if not more) as the charts, check lists, adderall, coping skills, and coffee. She just followed my words and where my eyes focused until I got distracted mid-sentence and the ellipses actually hung the air while I watched the goings-on at the apartment out the office window.
    My few semesters of college became increasingly miserable as the real world descended with all of its needs, all which could not appear to be organizable or thrown into anything but a to-do pile. Going from any sort of aid at my college's mental health center led to the buzz word 'depression' and treatment for it went as helpful as could be imagined, which was not helpful at all. I barely graduated, failed classes while knowing all the material, as time to do papers disappeared, and personal projects simply wouldn't finish.
    The signs of PI have been with me always- that is the one thing that is clear. What is equally as present is how much more, if not quantity than quality, I could have done if help would have been there (I deleted the words 'earlier' and 'too late', as four months with the most basic aid, I'm more the person I'd want to be than the person in the fog).

    Anyway, thank you for all the links, advice, and tips. For someone just coming into this, you are such an amazing source for insight.

  2. Dan,

    Thanks so much for your comment. As I watch my own son succeed with targeted interventions that address his problems, I realize that inattentive ADHD is very successfully treated but it FIRST needs to be diagnosed. I really appreciate hearing from you and I am so glad that you have a diagnosis and a treatment plan. Life gets better from here. I promise.



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