The answer is nothing一there is no real difference. ADD is simply an earlier name for the disorder psychologists now call ADHD. More precisely, what most people refer to as "ADD" is just one of the three presentations of ADHD medical professionals recognize today.
For example, a child who would have been diagnosed with ADD in 1986—the year before the term "ADD" was phased out in favor of ADHD—-would be diagnosed with ADHD in the year 2000. Medical professionals no longer use the term "ADD", but it has remained a to be a popular layman’s term.
Some might think that, because their child presents symptoms of ADHD with no hyperactivity, their child has ADD and not ADHD. However, this is not the case: if your child presents symptoms of what was once called ADD, they would still be diagnosed with ADHD.
What about if your child presents with inattentiveness and distractibility but no hyperactivity?
Again, this does not mean your child has ADD: it simply means that your child has what is called the "inattentive/distractible ADHD", which is one of the three ADHD presentations psychologists recognize today.
Still confused? We'll delve more into the current medical understanding of ADHD in a bit.
But first, to understand the journey of ADD from a separate disorder to one of the three presentations of ADHD today, it is important to know a little bit about the history of each term.
The History of ADD vs. ADHD
The first appearance of the disorder that would become ADHD emerged in 1968, published in the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II). Called Hyperkinetic Reaction of Childhood (HRC), it was characterized by what we would now consider inattention, impulsivity, and hyperactivity.
In 1980, the name was changed to ADD and it was defined as a chronic condition that included developmentally inappropriate levels of inattention, but not necessarily hyperactivity or impulsivity.
In 1987, the name was changed again to ADHD and it has been known by that name ever since.
In 1994, psychologists expanded the definition of ADHD to include three "subtypes":
- Inattentive and distractible ADHD - Individuals with this subtype tend to have more trouble with focus and concentration.
- Impulsive and hyperactive ADHD - Individuals with this subtype tend to be more fidgety and have trouble sitting still. T
- Combined ADHD - This is the most common subtype. Individuals with combined ADHD have symptoms of both inattention and impulsivity/hyperactivity.
ADHD subtypes were believed to be more static than dynamic. Showing symptoms for a specific ADHD subtype, for example, meant that psychologists would expect those symptoms to stay relatively consistent over time.
ADHD subtypes were controversial even then. Recent research vindicates what many clinicians have long suspected: that ADHD subtypes are far more fluid than they were once believed to be. It's not uncommon for ADHD symptoms to wax and wane as children (and adults) move through different developmental stages, environments, and circumstances.
In the latest edition of the DSM (DSM-5)—published in 2013—ADHD "presentations" replaced ADHD subtypes. There are two ways that ADHD presents itself: inattentive/distractible ADHD and hyperactive/impulsive ADHD. We'll get more into what these presentations look like in a minute.
First, though, what's important to remember is that ADHD is best thought of as a spectrum disorder. This means that there are varying degrees of severity when it comes to symptoms.
The current view on ADHD
To sum up, the term ADD refers to a specific presentation of ADHD characterized by symptoms of inattention, but not necessarily hyperactivity or impulsivity. Today, an ADHD diagnosis covers both inattentive/distractible and hyperactive/impulsive presentations. The former is what most people think of when they hear the obsolete term "ADD."
Note that individuals with ADHD don't have to be just one or the other. Unlike the now-defunct ADHD subtypes, which were either/or, presentations can be combined. An individual with ADHD can present with symptoms of either inattentive/distractible or hyperactive/impulsive ADHD—or even both.
Next, we'll take a look at the symptoms of ADHD in more detail.
The Symptoms of ADHD
The new guidelines recognize that ADHD symptoms exist on a continuum from mild to severe. Symptoms may also vary depending on the individual's age, environment, and other factors.
Recall the two presentations of ADHD as understood today. People who confuse ADHD for ADD are generally thinking of inattentive/distractible ADHD when they use the term ADD. Inattention and distractibility are the defining symptoms of this presentation. But what does that actually look like?
Here are some common signs and symptoms of inattentive/distractible ADHD:
- Has trouble with details and makes careless mistakes
- Has trouble sustaining attention during tasks or conversations
- Appears not to listen when spoken directly
- Struggles to follow instructions and complete tasks
- Has difficulty with organization
- Avoids or procrastinates on tasks that require sustained mental effort
- Loses things like homework, books, keys, etc.
- Is easily distracted
- Is forgetful
On the other hand, these are the common signs and symptoms of hyperactive/impulsive ADHD:
- Excessive fidgeting, squirming, or tapping
- Excessive or inappropriate talking
- Difficulty remaining seated
- Running or climbing at inappropriate times
- Blurting out answers without waiting to be called on
- Difficulty waiting in a line or taking turns
- Interrupting others
- Seemingly boundless energy
- Difficulties keeping quiet
It's important to remember that not all children (or adults) with ADHD will experience all of these symptoms. And, as mentioned, symptoms may vary depending on age and other factors.
For example, a child who is hyperactive and impulsive may become less so as they enter adolescence or adulthood. However, they may still experience symptoms of inattention—such as difficulty sustaining focus or being easily distractible.
These are just a few of the symptoms that someone with ADHD might experience. It's important to remember that everyone experiences these things from time to time. The key is that the symptoms are frequent and interfere with everyday life.
The Causes of ADHD
Though the exact causes of ADHD are still not fully understood, we do know that it is a complex condition with a variety of possible factors. Just to be clear, psychologists today understand these more as risk factors than actual causes. This means that they may increase the likelihood of developing ADHD, but they do not directly cause the disorder.
Researchers have long known that ADHD has a genetic component. The current thinking is that ADHD runs in families and is passed down from generation to generation.
A landmark genomewide study in 2019 utilized data from roughly 20,200 individuals diagnosed with ADHD and around 35,200 controls without ADHD. Participants hailed from five continents: Europe, Scandinavia, China, Australia, and the United States.
Interestingly, the study found that the genetic risk variants for ADHD are largely shared between populations across the globe. This suggests that there is a common biological basis for the disorder, regardless of ethnicity or geography.
The study's results confirm that ADHD is polygenic—meaning that many genes each have a small effect on the risk of developing the disorder. This is in contrast to monogenic disorders, which are caused by a single gene mutation. Individuals with a higher polygenic risk profile for ADHD are much more likely to be diagnosed with the disorder than those with a lower risk profile.
Some genetic risks for ADHD may also play a role in other mental disorders, such as schizophrenia, bipolar disorder, or depression, as well as somatic disorders like obesity. But the current scholarly consensus is that ADHD appears to have a unique genetic risk profile.
How ADHD is Diagnosed
To receive a diagnosis for ADHD, individuals 18 years old and younger must exhibit at least six symptoms from one of the two lists for at least six months. These symptoms must be interfering with their ability to function at home or at school. Those aged 18 years and older, on the other hand, must exhibit at least five symptoms.
If you suspect that your child has ADHD, the first step is to talk to your child’s pediatrician or family doctor, who can refer you to a mental health professional with experience diagnosing and treating ADHD.
They will take several factors into account during the diagnosis, including:
- A thorough medical examination to rule out other possible causes of the symptoms
- A review of your child’s or teen’s symptoms
- Information from parents, teachers, and sometimes, other adults who have observed your child or teen in different settings
- A questionnaire about your child’s or teen’s behavior
- Conversing directly with your child
- Observing how your child behaves in their office
Once a medical professional confirms an ADHD diagnosis, they can start working with the patient on what treatment options are available. There is no “cure” for ADHD, but there are many ways to manage the symptoms and enable the person to lead a productive and successful life.
Most treatments will involve a combination of medication and behavioral therapy. These will likely be based on the specific symptoms that the individual is experiencing, as well as any other underlying conditions. The medication is used to help control the symptoms, while the therapy is focused on helping the person learn new coping and organization skills.
Children with ADHD—younger than six years—generally respond best to behavior therapy. This type of therapy is often provided by a trained specialist, such as a psychologist or counselor. It teaches children specific skills, such as how to stay focused, control impulsive behavior, and follow instructions.
Older children and adults with ADHD may also benefit from this type of therapy, but they may benefit more with medication. The most common type of medication used to treat ADHD are stimulants like amphetamines and methylphenidate. Adults with ADHD tend to respond better to amphetamines, while children respond better to methylphenidate.
These medications help improve focus, attention, and impulsivity. They are usually taken once or twice a day, and they work best when they are part of a comprehensive treatment plan that also includes behavioral therapy.
Non-stimulant medications are also available and may be a good option for people who cannot tolerate stimulants or who do not respond well to them. Some examples are atomoxetine, guanfacine, and clonidine.
Finding what works best
Work with your doctors to create a plan that is tailored to your child's needs. Don't be afraid to ask questions or to speak up if something isn't working. You know your child better than anyone; engage with their treatment and be an advocate for what you think will help them succeed.
Note that it may take some time to find the right combination of medication and therapy, but it’s important to stick with it and be patient. Forgoing treatment may seem like an easier option, but it can lead to long-term problems, such as academic difficulties, social isolation, and employment issues. Self-medication may also pose issues for older individuals with ADHD that was left untreated in childhood.
With an early diagnosis and proper treatment, you can expect your children with ADHD to lead happy and successful lives. So, if you think your child may have ADHD, don’t wait to get help. The sooner you get a professional diagnosis and start treatment, the better.
Living With ADHD
It's normal to be a little bit scared and confused when you first find out that your child has ADHD. After all, it's not a common condition, and it can be hard to understand what it means for your family. But the good news is that there are lots of resources available to help you learn more about ADHD and how to manage it effectively.
It can be difficult to watch your child struggle with focus, impulsivity, and organization. You may feel helpless and alone, not sure where to turn for help. But you won’t have to face it alone. Folks with ADHD learn to manage their symptoms with the help of medication, therapy, and other treatment options.
Remember that ADHD is a medical condition, not a personal failing. It's not your child's fault, and it's not something that they can just "snap out of" with a little effort. It also isn't your fault as parents. You didn't do anything to cause it, and you can't do anything to cure it. But what you can do is learn everything you can about ADHD and how to best manage it.
Tips for parents of children with ADHD:
- Educate yourself and your family about what ADHD is and what it isn't. The more you know about ADHD, the better equipped you will be.
- Create a support system of friends, family, and professionals who understand and can help you manage the condition.
- Develop a routine for taking medications, managing symptoms, and tracking progress. Having a set schedule can help your child feel more in control of their life and can make it easier to manage their symptoms.
- Encourage healthy habits. Help your child develop healthy habits, such as regular exercise, eating a balanced diet, and getting enough sleep. These things can help improve focus and energy levels.
- Support groups for parents of children with ADHD are a good way to learn more about the disorder, meet other families dealing with the same issues, and form new relationships.
How Marker Learning Can Help
If you believe that your child may have ADHD, the first and most important step is to get them a professional evaluation. A trained practitioner will be able to accurately diagnose ADHD and rule out other possible causes of symptoms.
At Marker Learning, we understand the challenges most parents face when it comes to their child’s education. We know what it’s like to search for answers and feel lost and alone in the process. And that doesn't even cover how difficult and costly it can be to get professional help.
A standard in-person evaluation for ADHD can be very expensive, often costing thousands of dollars. Many parents simply cannot afford this, while those that can often have to wait months or even years to get an appointment.
We believe that every child deserves to have access to quality care, which is why we offer professional ADHD evaluations at just 1/4 the price of a standard in-person evaluation. We understand that some parents may be hesitant to trust an online evaluation, but our board-certified team of psychologists has years of experience and are more than qualified to provide an accurate diagnosis wherever you are in the United States.
In just two weeks, you will receive a comprehensive report that includes a diagnosis and action plan—absolutely no waiting lists! Get your child the help they need and give yourself the peace of mind you deserve. Give us a call (1-888-291-3587) or drop us an email to schedule a free consult, today.