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Inattentive AD/HD: Overlooked and Undertreated?

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By Mary V. Solanto, Ph.D. and CHADD


Like all good psychological assessments of children, the assessment for AD/HD begins with parental interviews concerning the details of the child's current difficulties, including time of onset, frequency, duration and severity. Behavioral questionnaires, completed by parents and teachers, are also very helpful in determining the nature of the child's difficulties and their seriousness when compared to the behavior of other children of the same age and gender in the general population. During this interview, the parents will also be asked about the child's physical, mental and emotional development from birth to the present. A good assessment will also inquire about the development of the family in order to identify any stressors or other problems that may affect the child's functioning.

The child is interviewed individually in order to get the "child's-eye" view of the challenges, satisfactions and stressors in his or her life at school, home and with peers. It also provides an opportunity to informally observe and assess the child's attention, language, self-control, self-confidence and relational skills.

When there are concerns about a child's  general learning ability or specific "information-processing" skills (as is often the case in all types of AD/HD), a set of tests may be administered to more precisely examine the child's intellectual functioning, as well as his or her current level of educational achievement in major subject areas. Neuropsychological tests- which assess brain-based functions in the areas of memory, language, attention and motor skill - may also help to identify underlying causes of the child's difficulties. Because inattention is the primary symptom of IN and the tell-tale signs of impulsivity and hyperactivity are absent, a good clinician will take particular care to rule out other "silent" problems, such as anxiety and depression, which can also impair concentration and effort, before diagnosing IN.


Studies involving treatment plans that are specifically effective for children with the IN type of AD/HD are limited. Research is underway at the Mount Sinai AD/HD Center, supported by grants from the National Institutes of Health (NIH), to investigate the effectiveness of stimulant medications in children with IN. Other research in this program is investigating the unique difficulties children with IN have with orienting and focusing, immediate and short-term memory and in "executive" functions, such as self-stopping, organization and planning. The most recently funded study will examine the use of functional Magnetic Resonance Imaging in identifying unique patterns of brain activation in children with IN. It is hoped that a better understanding of these differences will lead to the development of educational and psychological treatment approaches that address the specific needs of children with IN.

AD/HD by Other Names and Acronyms

While Attention-Deficit/Hyperactivity Disorder (AD/HD) is the official term and acronym used by today's mental health care professionals, it is sometimes referred to by other names and abbreviations. For example, it is sometimes called:

  • ADHD (without the "slash" in the middle)
  • Attention Deficit Disorder (ADD)
  • Attention Disorder

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Comments from readers

"I am 19 years old and i was diagnosed with severe ADHD-IN when i was 14. My parents however, did not tell me this until i was graduating from high school in a very academically rigorous program with really good grades. I feel that if given the right motivation anyone can overcome their disorder and get their stuff done. My motivation was that my parents spent time and money on me and my education, time and money that they did not have, and i knew that i would be extremely unhappy and guilty if i they did all that for nothing. So when it came down to it i did what needed to be done and bucked up. I feel as if america today is becoming a coward nation with more and more people pushing off responsibility on something else when really like in the case of ADHD you need to roll up your sleeves take the reigns and get your shit straight. Yes it will be hard but i've seen many of my friends become drones and change drastically to become something not nearly as beautiful as they were! before. I think that America needs to pony up and stop using the excuses for every damn inconvenient thing that makes it hard for them to work. I can just as easily do the harder calculus problems as any other person and focusing on it might be more difficult in nature but that's just the way it is."
"I'm a 17 year old girl and believe I have inattentive ADHD. I've always gotten grades ranging from A to F (but mostly around D or F, depending on my level of interest in the subject), and my teachers have always commented on my my lack of attention or commitment. It feels awful because I try, with no affect. I simply can't help but 'daydream' or forget my homework. I'm also a procrastinator..something about thinking about one particular thing for a long time makes me dread it, like homework. Another thing is that I'm somewhat socially impaired.. I've always felt behind my classmates on that front, and I've always been lonely. Upon discovering that this type of ADHD exists, I feel wronged because no one in my life has ever recognized it in me (I understand however that it's hard to recognize because we're better behaved than hyperactive kids thus less conspicuous); instead I've gotten negative feedback all my life for things I can't help. I don't want to take medication becau! se I actually like the way I think. I just don't like the consequences of it."
"Hello everyone! My son was diagnosed with adhd when he was 5 1/2 years old. His kindergarten teacher gently suggested some testing, but I had always had a 'feeling', if that makes any sense. His father and I were very adament that he NOT be on medication (his father was put on it as a child and had bad side affects) so we tried different techniques and behavior charts ... with no success. My swwet little boy was turning into someone that I didn't know. He was moody and mean and very depressed. I finally decided to just TRY the medication and if we didn't like it, to stop. Well, I have to tell you.... we saw a dramatic difference within about 2 hours after he took it! He wasn't moody or agressive anymore and was just... happy. He's now 7 years old and after trying a few different dosages we have settled on the ADHD patch. It was too difficult for him to swallow pills and the patch has had less side affects on him. I have to say, I NEVER though that I would be one of 'those' ! parents who 'medicates' their child... but you know what, my son is happy, he is making friends, he is self confidant... and that's all I've ever wanted for him. I hope this helps some of you out. You are NOT alone. We are all bonded by our love for our children and our drive to help the succeed. God bless."
"Thank God I saw this article!!! AFTER YEARS OF MY SON'S TEACHERS TELLING ME HE WASN'T PAYING ATTENTION IN CLASS AND HIM GETTING IN TROUBLE AT HOME FOR EITHER COMPLETELY FORGETTING WHAT I TOLD HIM, OR HAD SHOWN HIM JUST SECONDS BEFORE. After 11 years of this ( I have raised him alone since 2yrs old), I am finally resigned to start him on medication. My regret is that I didn't start him sooner. He has had problems making friends and good grades, and I don't want him to end up uneducated and alone. I Pray that I am doing the right thing. Is there anyone out there that knows what happens on the'other side' of the medication? I feel so alone. I know my son does too."
"In elementary school and throughout middle school I was given the comments on my report card as being inattentive. Otherwise, my behaviour was fine and I did get along well with others. Even though I always had the comments from teachers as being inattentive nothing was ever done about it. I wasn't concerned because, the word inattentive did not sound like a bad word. Maybe, they should say this child does not pay attention as opposed to this child is inattentive. "
"So what is or some of the suggested treatment of Inattentive AD/HD? What are my options? Thanks for any help."
"Excellent information. Thank you for sharing this information."
"Thank you for such a great article. Paticularly you touched on the area of social interaction problem, which is sometimes not mentioned in IN AD articles. My son is having difficulties making friends and your article FINALLY gave me some understanding as to why this is happening. I've observed my son silently sitting on the sidelines while other kids play in a group. He might possibly be interpeting it as children not wanting to play with him, when really it's him not knowing how to join in. "
"Do you have any sugestions for me I have a boy in 6 grade.That can't remenber anything forgets homework or don't finsh it. I have a daughter that is in 4 grade and is failing and can't seem to stay focus and finsh her work and is very spacie. I do NOT want tham to take Meds. They all have bad side affectes and I am not willing to take that chance. Thank you Tammy"