Recognizing Inattentive ADD
January 6, 2016 by Jay Chalnick
How To Recognize True Inattentiveness And What To Do About It
The popular image of ADHD is the hyperactive boy who can’t sit still, who is disruptive and full of misdirected energy. However, many children with ADHD don’t meet this stereotype, and more subtle ADHD symptoms often go undetected by parents, teachers and sometimes even medical professionals who aren’t aware that hyperactivity isn’t always a part of ADHD.
Specifically, children with inattentive ADD, also known as ADHD-PI (Predominantly Inattentive), have the attention issues associated with ADHD but display fewer hyperactive symptoms. Because recognizing inattentive ADD is more challenging from the outside than hyperactivity, children with inattentive ADD are more likely to go undiagnosed and untreated. This difference in presentation between hyperactive ADHD and inattentive ADD is one reason for under diagnosis of ADHD among girls, who tend to have fewer hyperactive symptoms – although many boys do also have inattentive ADD.
Spotting Symptoms of Inattentive ADD
As the name suggests, inattentive ADD is characterized by difficulty sustaining attention. Children with inattentive ADD have a much harder time than their peers focusing, staying on task and paying attention. In school, they miss much of the information presented in classes and often have trouble following instructions.
Since children with inattentive ADD have difficulty sustaining attention, they may start homework assignments or other projects but soon become distracted. Alternatively, because they find it hard to focus, these children may avoid cognitively demanding tasks entirely.
In general, an ADD child’s inattentive symptoms will be worse during tedious activities than during activities that the child enjoys, so teachers might mistake inattentive ADD simply for unwillingness to work or even laziness. Children want to please, and so laziness is almost never the issue — this case was made most persuasively by Rick Lavoie in his FAT City videos.
These kinds of apparent anomalies in focus — not an issue playing with Legos but can’t focus while reading — can be a great way to identify an underlying learning difficulty that is causing inattentiveness. Is there a common thread to the inattentiveness — it is mainly apparent while reading or while listening for instance?
If there is a common thread, that is the best path to follow for your child –resolve the reading, listening, working memory or whatever issue it is, and the inattentive ADD symptoms will almost certainly fade. However, sometimes there is no thread, you are able to identify inattentive ADD in many situations. In this case, it’s important to recognize inattentive ADD for what it is and not assume it’s simply the result of a poor work ethic because children with inattentive ADD have a condition that can only be improved through treatment, not by trying harder.
Making careless mistakes is another classic inattentive ADD symptom. Children with inattentive ADD tend to skip over details and often make mistakes even when they “know better.” In math classes, for example, children with inattentive ADD may make more careless arithmetic mistakes than other children. Similarly, their lack of attention to details may cause them to frequently lose items or simply forget to do things.
Besides inattentive symptoms, children with inattentive ADD are also prone to more general difficulties with organizational skills and planning ahead. They are often disorganized and messy in the way they operate.
As a result of their organizational problems, children with inattentive ADD often procrastinate more than their peers. Because these children also have such a hard time sustaining attention, they have a general tendency towards avoiding cognitively taxing tasks like schoolwork, which also feeds into a pattern of putting work off as long as possible.
Moreover, this tendency towards procrastination is part of more general issues with time management for children with inattentive ADD. These students may find it hard to organize their lives in a way that lets them complete things in a timely manner.
Also along the lines of problems with time, children with inattentive ADD often have trouble keeping track of time, causing them to take far longer on some tasks than their peers (or, alternatively, to rush through things). Similarly, they may be chronically late and have problems sticking to a schedule.
Therefore, inattentive ADD appears in the form of a variety of symptoms. Underlying the disorder is an impairment in the ability to sustain attention and remain on task which leads to additional issues with organizational skills, time management and so on.
Inattentive ADD and Coexisting Conditions
One thing that can make inattentive ADD especially hard to spot is that it can be easily mistaken for other learning disabilities – or alternatively, it can appear along with other learning disabilities in the same person. In fact, often times it is better to think of inattentive ADD as a symptom, not a condition. Recognizing inattentive ADD in different learning situations may offer clues to the underlying cause.
Finding the underlying cause is important, as many underlying difficulties can be resolved with therapy or software exercises, avoiding the need for medication. All too often, recognizing inattentive ADD leads directing to ADD medication.
For example, inattentive ADD and reading difficulty often co-exist. But which causes which? Children struggle to read for many different reasons. Many children with language processing delays that cause reading difficulties have trouble learning to translate written symbols into words they’re familiar with. Nobody finds it easy to engage in activities they find painful, and so many of these struggling readers are inattentive, and so end up being diagnosed with ADD. However, in these cases the inattentive ADD is a symptom.
Alternatively, it is possible for inattentive ADD to hold back reading progress. Their inattention and distractibility prevents them from putting in the intensity of effort required to get over the reading hump.
A common difficulty with struggling readers is that they appear to be going through the motions of reading, but they are not taking in the meaning of the words they’re reading. They may have to reread passages several times before grasping what they’ve read.
One way to look at this is to say a child has ADD and so has a problem paying attention to what they’re reading rather than with reading itself. In our ADD medication-addicted world this is a common interpretation, and so the child ends up on drugs. A different, and perhaps more better analysis of the need-to-read-and-re-read problem is to say inefficiencies in language processing mean that both decoding (reading) AND comprehension require concentration, and working on both at once is exhausting leading to lack of focus. Until decoding is automatic and subconscious, reading with comprehension will be a struggle.
Similarly, many children are diagnosed with inattentive ADD and dyslexia. In fact, having dyslexia makes it more likely that one has inattentive ADD, and having inattentive ADD makes it more likely that one has dyslexia. That is because the more severe the reading difficulty, the less likely it is for your child to find it engaging.
A similar situation occurs with Auditory Processing Disorder (APD). Both APD and inattentive ADD interfere with the ability to listen, but in different ways – children with APD actually perceive sounds differently and sometimes have trouble making sense of words, whereas children with inattentive ADD do not necessarily process sounds differently but do have trouble paying attention to what they’re hearing. As in the case of dyslexia, recognizing inattentive ADD in students with APD is very common.
Because of the overlap between inattentive ADD, dyslexia and APD, children with dyslexia and APD should be considered for signs of inattentive ADD, and children with inattentive ADD should be considered for signs of dyslexia and APD.
Seeking Non Medication Treatment for Inattentive Symptoms
Although the symptoms of inattentive ADD interfere with affected children’s ability to thrive in school and in most other aspects of life, inattentive ADD can nonetheless be difficult to recognize from the outside. Parents or teachers may chalk up inattentive ADD symptoms to absentmindedness, daydreaming or simple laziness. And since children with inattentive ADD are less disruptive in classroom settings than children with hyperactive ADHD, their struggles are more likely to go unnoticed.
The key to recognizing inattentive ADD is understanding that while all children get distracted at times, children who get distracted so often that it affects their lives may benefit from treatment for inattentive ADD. Lack of focus, procrastination, losing items – all children experience these things at times, but in children who experience them chronically, they are often symptoms of an underlying condition like inattentive ADD. If inattentive behaviors are showing up consistently and in different settings, and if they’re interfering with a child’s life (by affecting schoolwork, for example), it’s probably time to seek a professional evaluation.
Recognizing Inattentive ADD The Symptom
Inattentive ADD often goes undiagnosed, but it doesn’t have to. Parents can play detective and observe when the inattentiveness is most prevalent. If a child can sit for hours and play Lego or some other hobby, but is inattentive while reading or doing homework, the chances are you have a reading difficulty, not an ADD issue. Similarly, if a child struggles to stat focused in class but does OK on the sports field, you may have an auditory processing issue, not an attention issue.
Really, inattentive ADD is better named “Un-diagnosed Inattentive ADD” — i.e., ADD without any apparent root cause. Most of the time though, there is a source learning issue at play — it’s just a matter of identifying it through careful observation.
However, even if the ADD cause is not specified, treatment options are available. Attention is a cognitive skill that can be trained. This is important. While many children do grow out of their inattentiveness, many do not, meaning they fall behind. Only by treating the AD can children become more engaged and successful in school and in all aspects of their lives.