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What is the difference between ADD and ADHD?

Answered by Dave Anderson, PhD

Q What is the difference between ADD and ADHD?

ADD, or attention-deficit disorder, is an old term, now out of date, for the disorder we call ADHD, or attention-deficit hyperactivity disorder.

It was called ADD up until 1987, when the word “hyperactivity” was added to the name.

Before that, say in 1980, a child would be diagnosed with ADD, either with or without hyperactivity. But starting in the early 1990s, that child would be diagnosed with ADHD.

From the early ’90s until recently diagnosis included one of three types. Children who only had the inattentive symptoms were called inattentive type. Kids who were only hyperactive and impulsive were hyperactive/impulsive type. Kids who had all three symptoms were called combined type.

A lot of people still use the old term ADD, either out of habit or because it’s a more familiar term than ADHD. Some people use it to refer to inattentive type ADHD — without the hyperactivity. But it was never meant to be used that way, and continuing to use an almost 30-year-old term is getting more confusing.

The newest way of thinking about ADHD is actually to get rid of types altogether and just think about which symptoms present prominently. We still use the same clusters of symptoms (inattentive and hyperactive-impulsive), we just don’t consider them separate types. There are also adjustments to reflect new research on how ADHD symptoms present in adolescence or adulthood.

The bottom line is that the diagnosis of ADHD can still apply even if a child doesn’t have hyperactive or impulsive behaviors. That can be confusing for parents. We get this question all the time: “I don’t think my kid has hyperactive/impulsive symptoms—could he still have ADHD?” Yes, he can! And it’s especially crucial that kids with prominent inattentive symptoms of ADHD are still evaluated by a trained clinician, as these children could be more likely to be overlooked at school.

We want to make sure that people understand that kids who aren’t fidgeting or running out of class can still have really significant brain-based difficulties and related ADHD symptoms. The important thing is that a child who has a real problem paying attention, even without the other symptoms that tend to result in more disruptive or problematic behavior, still needs to be understood and to get help.