The 3 types of Attention Deficit Hyperactivity Disorder

The 3 types of ADHD – Inattentive Type, Hyperactive Type, Combined Type

ADHD Types: According to the Centers for Disease Control, there are 3 types of attention deficit hyperactivity, defined in relation to the symptoms which stand out the most:

The inattentive type

This category manifests with apparent listening problems, difficulty following instructions and  staying focused on play activities or school tasks, forgetfulness in daily activities, tendency to lose toys and school supplies or homework, distractibility and trouble paying attention to details.

The hyperactive-impulsive type

This type includes symptoms like excessive talking, constant fidgeting or squirming, difficulty remaining seated or waiting for a turn or in a line, excessive running or climbing, problems with interrupting in conversations and difficulty playing quietly.

The combined type

This is the most common form of the disorder and is a combination of the previous 2 types, in which all the symptoms are equally predominant.

What causes ADHD?

The biological root cause of ADHD is still unknown. However, researchers are making progress in discovering the underlying genetic and environmental links associated with this disorder.

Several risk factors may lead to the development of the disorder, including: heredity (the disorder tends to run in families), brain changes (experts have found that certain areas of the brain responsible for attention and impulse control are about 5% to 10% smaller in size and less active in children with ADHD), exposure to certain toxins (for instance, lead – which can affect brain development) and brain injury (damage to the front of the brain, known as the frontal lobe, can lead to a lack of emotion and impulse control).

The mother’s health habits also play an essential role in lowering or raising the risk factor for ADHD. Smoking, excessive drinking, substance abuse, poor nutrition and infections during pregnancy can all affect the baby’s brain development. Moreover, very low birth weight, premature delivery and injuries to the brain at birth can all contribute to an increased risk of ADHD.

Related disorders which can occur in children with ADHD

ADHD has also been linked to certain coexisting conditions like CD (Conduct Disorder – severe hostility and aggression), ODD (Oppositional Defiant Disorder – outbursts, stubbornness, in compliance with rules and acts of defiance) and learning disabilities (approximately half of the children with ADHD also suffer from a specific learning disability such as dyslexia).

Given the fact that school failures and social problems can oftentimes lead to feelings of isolation, frustration and, consequently, low self-esteem, ADHD is also linked to mood disorders. Up to 20% of children with ADHD also experience depression and between 15% and 20% of them are diagnosed with bipolar disorder, which involves irritability, aggression and rapid alternations between manic and depressive moods. 30% of children who suffer from ADHD are also affected by anxiety disorders, with mental and physical symptoms ranging from sweating and a racing heart to excessive worry and panic.

Why ADHD is hard to diagnose

Since there is no single, exact test that can detect ADHD, the diagnosis depends on a complete evaluation by a primary care doctor. He or she will observe behavior, administer questionnaires and perhaps interview family members or even teachers.

In order to be considered for a diagnosis of ADHD, a child must display the previously enumerated behaviors of one of the three subtypes before the age of 12. The behaviors must be more severe than in other children of the same age and must last for at least 6 months.

The doctor or specialist will then collect information from you, your family and school teachers, as well as examine your child using several questionnaires and rating scales in order to detect and track ADHD symptoms. It is difficult to pinpoint this disorder due to the fact that symptoms can often appear to be related to other issues and can lead to a misdiagnosis.

After your doctor will perform a physical examination and take a medical history, you will have to discuss with him or her the next steps necessary for efficiently managing your child’s condition.

Your pediatrician or family practitioner may also refer you to a specialist (a psychologist, psychiatrist or neurologist) in order to avoid a misdiagnosis or if there are other concerns (anxiety, a learning disability, Tourette syndrome or depression).

The initial tests used for diagnosing ADHD include Conner’s Parent and Teacher Rating Scale (for children) and Brown Attention Deficit Disorder Scale (BADDS) for adolescents and adults. In order to assess inattention and impulsivity, timed computer tests such as the Conners’ Continuous Performance Test (CPT) and the Integrated Visual and Audio (IVA) will be used. A learning disability evaluation will also be performed, as well as several neurophysiological tests necessary for assessing the patient’s executive function.

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