ADD vs ADHD: Evolution of Diagnosis

By: Shravya Reddy (Grade 10)

Although often confused with one another, ADD and ADHD are two neurodevelopmental disorders with subtle differences. Both are terms that describe attention-deficit disorders but have important distinctions.

Historically, ADD or “Attention Deficit Disorder” referred to individuals who had difficulty focusing, were easily distracted, or had trouble staying organized — without hyperactivity. However, it was often associated with ADHD. In more recent diagnostic guidelines, beginning in the 1980s, ADHD or “Attention Deficit Hyperactivity Disorder” became the official term to refer to individuals with inattentive symptoms, hyperactive-impulsive symptoms, or both.

Inattention Symptoms, common in both ADD and ADHD include:

➢ Trouble paying attention to details or making careless mistakes.

➢ Difficulty sustaining focus during tasks or activities.

➢ Struggles to listen while being spoken directly to.

➢ Finds it hard to keep organized.

➢ Avoids or dislikes tasks that require continuous mental effort.

Meanwhile, hyperactivity-impulsivity symptoms, more common in ADHD patients, include:

➢ Fidgeting or difficulty staying seated.

➢ Running or climbing in unsuitable situations.

➢ Talking excessively and unceasingly.

➢ Interrupting with difficulty while waiting for a turn.

Today, ADHD is the official medical term and includes multiple subtypes:

1. Predominantly Inattentive Presentation

2. Predominantly Hyperactive-Impulsive Presentation

3. Combined Presentation.

The Predominantly Inattentive Presentation is most closely related to what was previously coined as ADD. Patients within this subtype primarily struggle with attention, focus, and organisation, without a display of hyperactivity and/or impulsiveness. ADHD, On the other hand, the Predominantly Hyperactive-Impulsive Presentation features hyperactivity and impulsiveness as primary symptoms, with less emphasis on attention difficulties. The Combined Presentation subtype is a case in which both inattentive and hyperactive-impulsive symptoms are showcased.

To summarise, ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) differ primarily in their symptoms: ADD involves difficulty with attention, while ADHD includes both inattention and hyperactivity. Although ADD was initially considered a separate diagnosis, it is now viewed as a subtype of ADHD, specifically referred to as ADHD, Predominantly Inattentive Presentation.