What Is Inattentive ADHD?
Kids don’t have to be hyperactive to have ADHD
Clinical Expert: Adam Zamora, PsyD
What You'll Learn
- What are the common symptoms of inattentive ADHD?
- How does having inattentive ADHD affect a child's success at school?
- How can you help your child with inattentive ADHD at home?
Inattentive ADHD is a type of ADHD where children have a hard time paying attention but don’t have hyperactive behavior. Kids with this type of ADHD, especially boys, are often overlooked because they don’t fit the stereotype of a kid who acts out and can’t stay in their seat.
Some of the symptoms of inattentive ADHD include difficulty paying attention to details, forgetfulness, and losing important items. They also struggle with executive functioning and working memory, which are processes in the brain that help with attention, planning, and organization.
It can be difficult to diagnose inattentive ADHD in elementary school children because they can often compensate for their limitations until they get to middle school or high school. Then, the workload increases and they are expected to work independently, which is often a struggle. Inattentive ADHD can be also missed by educators because kids who have it are less likely to be disruptive.
As a parent, it is important to advocate for your child and seek help if you suspect they may have ADHD. You can work with your child’s teachers to provide extra support, often with an Individual Education Plan (IEP) or a 504 Plan. It is also helpful to create a structured environment at home. You can help your child establish routines and use checklists or visual aids to stay on task.
It also makes a big difference to recognize your child’s strengths and passions and encourage them to pursue them. Children with ADHD are often creative, outside-the-box thinkers. With the right support and treatment, children with inattentive ADHD can thrive academically and personally.
“My brain is an overstuffed garbage can — the lid doesn’t stay on, and stuff is falling out all over the floor.”
This is how my son describes what it’s like to have ADHD.
When he was initially diagnosed, I thought I understood what ADHD meant. I thought it was found mostly in boys who were hyperactive, impulsive, fidgeting, blurting out in the classroom. My son, who had been diagnosed with the inattentive subtype of ADHD, had none of these behaviors.
Unfortunately, the stereotypical view of a boy with ADHD has changed little over the past several decades. As I’ve helped my son manage his ADHD, discussion of the inattentive subtype has increased. However, the focus is mainly on how it manifests in girls and adults.
What is inattentive-type ADHD?
In children with the inattentive subtype of ADHD, the primary symptoms are being distracted, forgetful, and disorganized, with little to no hyperactivity. These children can fly under the radar at school and at home, often being misunderstood as lazy, spacey, and callous. Symptoms of inattentive ADHD include:
- Failure to pay close attention to details
- Careless mistakes
- Difficulty maintaining sustained attention on disliked tasks (e.g. homework)
- Losing important items (e.g. school materials, keys, cell phone)
- Not seeming to listen when spoken to directly
- Not following through on instructions and failing to finish schoolwork or chores
- Trouble staying organized
- Getting distracted easily
- Being frequently forgetful in daily activities (e.g. brushing teeth)
Inattentive ADHD symptoms are thought to be caused by deficits in executive functioning, the cognitive process that enables us to pay attention to what is most important at a given time. It’s involved in planning and initiating tasks, time management, organization, and emotional control — all those things ADHD kids struggle with!
Adam Zamora, PsyD, the senior director of the ADHD & Behavior Disorders Center at the Child Mind Institute, notes that the hippocampus — the structure of the brain involved in learning and memory — can be thought of as a library, where working memory and executive functioning are the librarian putting the incoming information on shelves. “If you have ADHD and difficulty with attention regulation, your librarian will be carrying a giant load of books, with information spilling out, and will end up throwing those books on random shelves, making it harder to retrieve the information later on.”
Inattentive-type ADHD at school
Inattentive-type ADHD is often difficult to diagnose in younger children. Dr. Zamora notes that children in elementary school may be able to compensate for limitations associated with their ADHD. “Bright kids who have ADHD are better at learning the foundational aspects of school due to their intelligence, and when they miss information, they can piece things together more easily with stronger cognitive abilities and good inferencing skills.”
For instance, my son excelled academically when he was in elementary school. It wasn’t until middle school, when he was required to work more independently as the courseload increased, that he could no longer compensate for the inattention, disorganization, forgetfulness, and time blindness associated with his ADHD.
Dr. Zamora also points out that some kids with ADHD are able to rely on their strengths and advocate for themselves in the classroom, especially if they have support at home. For example, these kids might raise their hand and ask for information they missed when they weren’t paying attention. Or they might succeed in getting a good grade on a homework assignment, but spend all day struggling to focus on it, when the assignment was only supposed to take an hour. A downside to this kind of coping behavior is that their ADHD symptoms may be overlooked, as they’re not displaying any obvious red flags.
Another reason inattentive ADHD is often missed by educators is that knowledge of the disorder varies across teachers. As you may expect, teachers are most familiar with hyperactive and impulsive symptoms in students, like fidgeting, squirming in their seat, and being easily distracted. When teachers don’t recognize the symptoms of inattentive ADHD, they often misunderstand a child’s behaviors. My son was pigeonholed by educators, coaches, and others as lazy, apathetic, and unintelligent because they didn’t understand his symptoms.
I’m grateful to my son’s second grade teacher for recognizing his ADHD-like behaviors in the classroom (not completing work and disappearing from the classroom for extended periods of time) based on her experience managing her own son’s inattentive ADHD. As a result, my son received a diagnosis, treatment, and academic support early on in school. His teacher’s understanding that he didn’t just need to try harder was critical to his academic success.
Inattentive-type ADHD at home
Inattentive-type ADHD may manifest itself differently in a less structured environment, like being at home with family. For example, my son’s emotional dysregulation was never evident at school, but he would routinely have meltdowns at home where he was more comfortable and less likely to receive serious repercussions.
Raising a child with inattentive-type ADHD is no easy task. Most parents have a hard time understanding their child’s strengths and weaknesses and don’t have a plan for managing their symptoms at home. And unlike teachers, parents don’t have the opportunity to observe the behaviors of dozens of different children daily. Therefore, they may not recognize atypical behaviors, especially when those behaviors are not disruptive.
It took me several years after my son was diagnosed with ADHD to understand that he wasn’t choosing to fail classes in school, have meltdowns, or ignore tasks I asked him to do. I cannot count the number of times I said the words, “Why can’t you just . . .” to my son. “Why can’t you just clean your room, do your homework, or put your bike away?” When he’d forget to turn in assignments for school, I would get frustrated with him, he would yell at me, I would yell back at him, and then he would have a full-blown meltdown. After I began to understand my son’s ADHD symptoms, I realized I had to modify my own behavior. It was actually contributing to his emotional meltdowns.
A misunderstanding of ADHD symptoms may not be the only hurdle for parents. The parents may have unrecognized ADHD symptoms themselves. Heredity plays a part in ADHD and according to Dr. Zamora, “If the child has ADHD, one of the parents may also have it, making structure and consistency difficult at home.”
How you can help your inattentive child at school
Dr. Zamora offers these helpful strategies for academic success:
- Get an evaluation for your child as soon as you suspect something may be wrong.
- Reach out to your child’s teachers regularly; most are willing to provide extra help.
- Enlist a neuropsychologist to advocate for getting your child accommodations in school through a 504 Plan or an Individual Education Plan (IEP).
Based on his experience advocating for ADHD children within the school system, Dr. Zamora believes that to help students with inattentive ADHD, it’s important to note when they become frustrated. “If you have a child who is very inattentive and they are struggling to complete their work without a lot of prompting and reminders,” he explains, “that child is going to likely present as more frustrated, and easily exasperated by their academic and inattentive challenges.” Recognizing frustration early on can aid in an earlier ADHD diagnosis, allowing children to receive academic accommodations and treatments so they don’t fall behind their peers.
One of my most important roles as a parent was to advocate for my son with the school system and teach him to advocate for himself. Knowing that my son’s performance did not always reflect his capabilities, I emailed his middle and high school teachers at the beginning of each semester detailing his ADHD, his weaknesses, and, most importantly, his strengths. I was pleasantly surprised that the reaction from many of the teachers over the years was positive; they were grateful for parental communication and support.
How you can help your inattentive child at home
To help manage your child’s ADHD at home, Dr. Zamora recommends:
- Creating a structured environment
- Being consistent and establishing routines
- Using checklists or visual aids to help with task completion
- Providing positive reinforcement and rewards for desired behaviors
One lesson it took a while for me to learn was how important it was to work with my son’s inattentive ADHD brain. I had to involve him when coming up with strategies to help him manage his symptoms. For example, we were only able to set up an organizational system that worked for my son after we worked together. I was trying to get him to use organizational tools that worked for me, not realizing that my son will never, for example, put something away in a bin and then put the bin on a shelf.
As parents, we shouldn’t limit our thinking to just figuring out how to manage our child’s ADHD symptoms. We also need to encourage their strengths and passions. Kids with ADHD are often creative, excellent problem solvers, and outside-the-box thinkers. Encouraging my son’s passion for learning about outer space and rockets led him to become a national finalist in a NASA-sponsored contest about going to Mars. He’s now thriving as a college freshman at a small aviation and aerospace university.
I like to think of my son as a smart, creative, fearless, forgetful, emotional whirlwind of disorganization. There is more to ADHD than hyperactivity. Rethinking our ideas about how ADHD presents in children can aid in earlier diagnosis and treatment of the inattentive subtype.