Updated December 29, 2014.

ADHD Is About So Much More Than Just Hyperactivity

ADHD symptoms differ in children depending on which of the types of ADHD an individual has. Many people automatically think of hyperactive behaviors when they hear the term ADHD, but there are actually three different types of ADHD -- one of which does not include the hyperactive component.

This type of ADHD is called the predominately inattentive type and is commonly referred to as ADD.

Children with the inattentive type of ADHD are not hyperactive, but actually present as sluggish or lacking in energy when compared to people with the other types of ADHD, or even to non-ADHD children. Their symptoms are less disruptive than those who have the hyperactive component, and so they are often overlooked.

It is important for parents and teachers to understand these differences so that they can be on the lookout for symptoms that indicate a child may have a form of ADHD. With proper diagnosis and interventions, these children can excel rather than face continued frustrations and stressors associated with their behaviors.

To help explain and demonstrate the varied way symptoms can manifest, it may help to look at one mom’s personal experiences with her own two children, son (Anthony) and daughter (Samantha).

One Family’s ADHD Experience

Mary Robertson did not know much about ADHD until her son was diagnosed in kindergarten. Anthony had been kicked out of preschool at age 4 due to non-stop “bad behavior.” His hyperactive and out-of-control behaviors screamed for attention and help.

It was obvious that something wasn’t right, and Mary sought medical assistance early on. In many ways, the diagnosis was a relief from the weighty guilt Mary and her husband had felt. The problems her son was having were not caused by poor parenting, but rather a medical condition called ADHD.

In stark contrast to Anthony, Mary’s daughter seemed happy and content from the day she was born. She didn’t spend hours screaming and crying for no apparent reason as Anthony had done. Samantha was compliant, slept well, and breezed through preschool and kindergarten without the repeated teacher calls. By the second grade, however, Mary began to receive notes of concern about her daughter’s distractibility and disorganization. Samantha struggled to turn in assignments, and when she did, they were often incomplete. Other times she simply lost them in the black holes of her desk or backpack. While Anthony tended to openly express his emotions by acting out, Samantha internalized her feelings resulting in frequent complaints of stomachaches, headaches, and other body aches.

The problems Samantha had were so vastly different from the wild-child issues Anthony displayed. Anthony’s symptoms demanded attention and interventions, while Samantha’s inattentive symptoms enabled her to sit at the back of the classroom, unnoticed, quietly failing.

Mary admits to initially turning a blind eye to Samantha’s struggles in hopes they would go away in time. But they did not. Instead, Samantha began to experience high levels of anxiety, and Mary began to accept that she needed help. Both children also experienced feelings of depression related to the ADHD that they were able to overcome as family, friends and teachers began to understand and accept the reality of ADHD.

As Adults with ADHD

Anthony is now 22. He still experiences life in overdrive. As a child, these “Tasmanian devil-like” behaviors drove everyone around him crazy. But as an adult this energy and liveliness has become an asset as he is able to successfully juggle several projects at a time. He has also found that daily exercise helps keep his head clear and energy positive.

Samantha’s energy level is just the opposite. Mary describes her as underactive, similar to the way a person feels when they are anemic -– lacking energy and slow to respond. This sluggishness has continued as a young adult. Samantha is 19. She still requires more external assistance to maintain enough motivation to complete most tasks, except for anything social. Her impulsivity tends to be more verbal. In middle school and early high school, Samantha’s impulsiveness often made it difficult to keep a secret between girlfriends. This definitely created social stress and hard feelings amongst her friends. Today, her issues with verbal impulsivity relate more to saying exactly what she is thinking even if it is brutally honest; she has learned to quickly apologize if she realizes that she has said something impulsive.

Treatment Approaches

Medication, particularly stimulant medicines, can be an integral part of treatment for each form of ADHD. During medical management, the goal is to improve the primary symptoms (activity level, attention span and impulsivity) and how they impact the individual. As a hyperactive child, Anthony needed help stopping unwanted behaviors, while Samantha needed assistance with initiating desired behaviors.

Comprehensive treatment often involves a combination of therapies, including medication, academic and home interventions, as well as psychosocial interventions. In school, Anthony’s behavioral intervention plan looked at what caused the negative behavior and developed interventions to interrupt the process before negative behavior occurred. Samantha’s plan focused on creating positive daily habits or routines that did not come naturally such as breaking down long-term projects into smaller, more manageable goals. Both have responded well to frequent feedback and rewards.

Mary suggests that because living with any form of ADHD can be difficult, parents should consider finding a counselor for their children to work with, before a crisis develops. It is helpful to have an established relationship so that time is not wasted if a situation does become a challenge or urgent.

Continued on page 2.