Inattentive Attention Deficit Disorder
Symptoms, Causes & Options for Inattentive ADD, ADHD-PI
Inattentive ADD or ADHD-PI, more often that not, is a symptom of a learning delay. Your child’s lack of focus is not because he “has ADD.” It’s because a deeper-seated difficulty is making learning and reading challenging, making it hard for your child to engage.
This is an important distinction. It means that instead of medicating the symptoms, a better way to help inattentive ADD is to target the underlying cognitive or learning delay — aim for a permanent improvement, rather than a medical bandaid.
Causes and Types of Inattentive ADD
ADHD is a behavior disorder that can be inattentive and hyperactive according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) written by the American Psychiatric Association (APA), DSM-5. With inattentive ADD or ADHD-PI (Predominately Inattentive), the main symptoms involve a lack of focus or sustained attention, but even with ADHD-PI, hyperactivity is often present but less prevalent.
There are various types of attention to consider. Sustained attention is the ability to stay on task for a sustained period. Selective attention is the ability to focus on a particular task or activity when there are other stimuli present. Both are important. A successful student is able to focus selectively and for long periods.
Hyperactivity and Inattentiveness Have Different Causes
ADHD-PH (Predominantly Hyperactive) and Hyperkinetic disorder (where impulse control is lacking) are most often occur when there are sensory integration and brain chemistry issues.
On the other hand, ADHD-PI (Inattentive ADD) is almost always due to language processing delays that create learning inefficiencies and inattentiveness:
- Slow processing makes listening in class exhausting — many children just tune out
- Language processing disorder impacts phonological awareness, causing labored reading and a lack of engagement
- Missing instructions in class and reading difficulties lead to lack of interest in homework and/or arguments at study time
These processing inefficiencies can plague your child all day long — in class, in social situations and at home. When the world is coming at you too quickly, sometimes the best form of self-defense is to just tune out. The same applies to reading time and homework, where the required tasks amount to mission impossible for your child.
This avoidance or inattentive behavior will often lead to the inattentive ADD diagnosis. In a few cases, rather than disengage children may act out, distracting attention from the learning issues he is experiencing. As a result, in these cases, because of this hyperactivity, ADHD-PH may end up as the diagnosis.
Recognizing the Signs and Symptoms of ADD
In early life, many if not most children have periods of hyperactivity or inattentiveness. Because we expect young children to be vulnerable to distractions and hyperactive at times, it’s the impulsive behaviors — the dangerous jump, the blurted insult — that provide the clues for preschoolers with ADD.
However, by age four to six, most children have learned how to sit quietly, to listen while others speak and to resist blurting things out. While you should not confuse a lack of focus with five-year-old-otis, there are telltale signs of ADHD-PI that can give you a head start in dealing with it.
Here is a checklist of ADD symptoms around the three main traits of ADHD-PI: inattentiveness, hyperactivity, and impulsivity.
Inattentive Symptoms of ADD or ADHD-PI
Children with inattentive symptoms of ADD often go under the radar early on since they do not cause issues in class or on the playground. However, the symptoms of their inattention does have consequences: upsetting teachers and parents for not following directions; apparently under-achieving in school; or having run-ins with classmates over not playing by the rules.
Here is a checklist of symptoms of inattentiveness in children:
- Doesn’t pay attention to details
- Makes careless errors
- Appears not to be listening when spoken to
- Has difficulty following directions or remembering instructions
- Is not organized, and struggles with planning ahead and finishing projects
- Frequently loses things, such as homework, belongings, etc
These symptoms of inattentive ADD center-around distractedness caused most often by processing delays. Slower processing means a child has to concentrate hard just to listen accurately or to read. This distracts from thinking and understanding, leading to the symptoms above.
Hyperactive Symptoms of ADD
Hyperactivity in a child is much harder to ignore — children with ADHD-PH (Predominantly Hyperactive) are pretty much always diagnosed.
While many children are naturally active, even hyperactive at times, children with hyperactive symptoms of attention deficit disorder are always on the move. Checklist of symptoms of hyperactivity in children:
- Constantly fidgeting or squirming in his seat
- Often gets out of his seat where sitting quietly is expected
- Constantly moving, often runs or climbs inappropriately
- Talks too much
- Has difficulty sitting quietly and playing
- Had difficulty learning to ride a bike
- Struggles with hand to eye skills like catching a ball
Hyperactive symptoms of ADD can be ambiguous in younger children in particular. There is a lot more 5-year-old-itis in America than ADHD-PH. While processing delays can sometimes produce hyperactivity, most of the time ADHD-PH is caused by sensory integration difficulties.
The last two ADD symptoms are looking for balance and hand-to-eye difficulties — signs of sensory integration issues. Many children with these hyperactivity symptoms respond very well to Occupational Therapy (OT) and physical exercise treatments that improve coordination, like Interactive Metronome.
Impulsivity Symptoms of ADD
Impulsivity is a source of social problems for children with ADD symptoms. It is all about self-control. Because they do not censor themselves as well as they should, they interrupt conversations, ask offbeat or irrelevant questions in class and in social situations, are prone to making tactless comments or asking overly personal questions. These children are often viewed as needs, disrespectful or weird.
Symptoms of impulsivity in children:
- Acts or speaks without thinking
- Blurts out answers in class without waiting to be called
- Keeps wanting to go first
- Capable of angry outbursts or temper tantrums
- Tends to guess rather than attempt to solve a problem
Impulsive ADD symptoms stem mainly from sensory or processing over-loading that can be caused by sensory integration or language processing delays. If you are not keeping up, you will tend to guess, lose interest, have no capacity for empathy or reading the signs, change the subject or act in a way that does not connect to the conversation or lesson.
Is it ADD or Something Else?
Certain medical conditions, psychological disorders, and stressful life events can cause symptoms that look like ADD or ADHD-PI.
Before resorting to medication, talk to teachers, neighbors and carefully observe your child in different situations. Try to rule out the following possibilities:
- Learning difficulties — signs here might be language delays, difficulty with background noise, reading difficulties
- Life difficulties — such as bullying or family trauma or disruptions
- Psychological or behavioral disorders — such as anxiety, depression or bipolar disorder
- Medical conditions — including thyroid problems, neurological conditions, epilepsy, nutritional issues and sleep disorders
A common error is to medicate a learning disability when natural and more permanent solutions might be available. Not all learning difficulties respond to treatment or therapy, but those that access the underlying source of the learning difficulty can be effective.
Signs That Your Child’s ADD Is Learning Related
It’s a chicken and egg story. Is the inattentiveness slowing down learning or are the learning issues leading to avoidance and a lack of engagement? More often it’s the latter. If there are learning issues, they are a great starting place when looking at your treatment versus coping options.
Here are a few common signs of language processing delays and working memory dysfunction, the two primary sources of learning and reading delays often associated with ADD.
- Difficulty sounding out words when learning to read
- Reading comprehension problems in 4th or 5th grade
- Listening difficulty with background noise
- Cannot reliably follow multi-step directions
- Takes too long over homework
- Does not perform well on tests
Does your child exhibits 2 or more of these common signs of learning difficulty associated with inattentive ADD? If so, a learning intervention may be able to make all the difference.
Coping and Treatment Options for Inattentive ADD
Most parents treat ADHD-PI as a psychiatric disorder and manage the symptoms of ADHD using counseling, stimulant medications or both. A number of behavioral therapies, aerobic exercises and dietary modifications (such as free fatty acid supplements) may also help. Psychological therapies such as behavior modification therapy and family therapy can dampen symptoms. In some cases biofeedback or neurofeedback as it now called can help, albeit temporarily.
All of these approaches have one element in common. They are all band-aids, coping options. Their goal is to help ADHD by modifying behavior and changing habits. They do not address the source of the problem, the cognitive delays that cause the inattentive behavior.
Treat The Cause of Difficulty
If your child has learning difficulties in addition to ADHD-PI symptoms, there is an opportunity to target the cause of the learning difficulty and thereby help both issues in one treatment – the learning difficulty and the ADD.
Learning difficulties are caused by cognitive skill gaps that will respond to exercise. By improving language processing and other cognitive skills, it is possible to significantly boost reading and learning efficiency. This is where Gemm Learning can help with its programs for ADD.
If you have a question or would like to know if we can help your child, call a specialist for a free consult.