Inattentive ADHD in children, previously termed ADD (Attention Deficit Disorder), indicates that the child does not suffer from the hyperactivity side of ADHD (Attention Deficit Hyperactive Disorder). Many children go undiagnosed because they are not the ‘stereotypical’ ADHD child, buzzing around like Tigger. However, Inattentive ADHD is serious and debilitating, and, frustratingly, often overlooked.

What is ADHD?

There are three subtypes of ADHD:

· Hyperactive and Impulsive

· Inattentive (ADD)

· Combined type ADHD

ADHD is a neurological condition that varies in severity from child to child, often making ADHD diagnosis difficult. My son and daughter both have ADHD, but my daughter’s ADHD is more severe than my son’s. My daughter is in a specialist school, my son is in a mainstream school. Children diagnosed with Hyperactive and Combined ADHD tend to act out in class and are easily spotted in a classroom. Or should I say running away outside a classroom or under the desks, in the case of my daughter? Signs of Hyperactive and Combined type ADHD include:

• Being unable to sit still becoming restless in most situations and will constantly fidget
• Talking excessively, interrupting conversations, shouting out
• Unable to concentrate on tasks
• Little or no sense of danger
• Very impulsive and acting out and speaking out without thinking
• Difficulty waiting for their turn in queues, conversations etc

These are all very visual signs and are generally hard to miss.

What is Inattentive ADHD?

Inattentive ADHD is a form of ADHD. Children with Inattentive ADHD tend not to be disruptive in school and may sit quietly, almost unnoticeable to the teacher. They do not have the hyperactivity or impulsive element so are less likely to draw attention to themselves. This does not mean that they are not having problems and are not struggling to stay focused. They just present in a different way. Which is why they can be overlooked. And again, not one child with Inattentive ADHD will appear the same.

Inattentive ADHD symptoms

· Difficulty organising tasks
· Changing tasks or activities frequently
· Short attention spans
· Easily distracted
· Careless mistakes
· Forgetful and losing things
· Appears to be unable to listen or carry out instructions
· Unable to stay focused on tasks that are boring or time-consuming

Signs of Inattentive ADHD in Children

These children may easily look bored to the outside world. Totally disinterested in the class activity. ‘Away with the fairies’. They are prone to daydreaming.

A child with Inattentive ADHD may look very disorganised, their desk may be a huge muddle, they are likely to have forgotten things they needed, or be unable to hand in homework on time (that’s if they have completed it). Children and teenagers like this may be labelled lazy or uninterested.

Often children with Inattentive ADHD will hear only half the instructions before zoning out. They can be doodlers and need to hear the instructions again, and again and again.

Unfortunately, these children will constantly have heard, ‘If only she tried harder’, ‘He could pay attention if he just focused’, ‘She just doesn’t care’, ‘Why weren’t you listening?’. Imagine what this must feel like, hearing this and knowing you are trying your hardest! Of course, it is going to impact your self-esteem and your confidence. The child will start believing they are lazy!

And not just in school. Older kids may forget they planned with friends to go somewhere or do something. If they keep forgetting their plans they are likely to lose friends because of their ‘flaky’ behaviour.

Diagnosis of Inattentive ADHD

This can be much harder for those who are not presenting any problems in school. I was ‘lucky’ because both of my children with ADHD were very hyperactive and impulsive. You couldn’t miss them in a classroom setting. I do, however, have friends who have children with Inattentive ADHD, so I know how the schools often look at the parents of these children, like they are mad! ‘Little Amy is as good as gold, she doesn’t have ADHD? She can’t because she sits still and is so quiet. Wouldn’t even know she was there half the time!’

That my friend is because she is struggling so hard!

Whilst ADHD affects about 3-5% of children and is diagnosed more often in boys than girls (4:1 ratio), it is now believed that this is only because more girls have the Inattentive ADHD subtype and therefore less easy to spot. Makes perfect sense now! That’s not to say that boys aren’t also diagnosed with Inattentive ADHD.

Having worked in classroom settings, I can see first-hand how these children get missed. Classrooms are chaotic. More and more children are being diagnosed with learning disorders in a classroom setting and require 1:1 support. If there is a child who is not behaving badly and is not disrupting the class, they are assumed to be ok. If they are keeping up with the majority of the class, what’s to worry about? But this makes me sad. Because imagine if they could get the help that makes them not just ‘get by’ but allows them to reach their full potential?

Firstly talk to your child’s teacher. Ask them what they are like in class. Bear in mind the signs and symptoms of Inattentive ADHD. Not all teachers are trained to spot this type. The earlier the intervention is, the better it will be for your child.

Go to your doctor with your notes to back up what you believe.

For a diagnosis of Inattentive ADHD to be given to your child they must have:

· Six or more symptoms, listed above
· Had these symptoms continuously for at least 6 months
· Started showing symptoms before the age of 12
· Shown symptoms in at least two different settings eg home and school
· Symptoms that make their lives considerably more difficult on a social, academic or occupational level
· Symptoms that are not just part of a developmental disorder or difficult phase and are not better accounted for by another condition

*Taken from NHS website on ADHD

Treatments for Inattentive ADHD in Children

As with ADHD, there is no ‘cure’ for Inattentive ADHD, but as always early intervention is key to help the child manage their symptoms. It also prevents other issues to arise such as low self-esteem, anxiety, and depression, due to the child blaming themselves and not understanding why they can’t ‘just listen’.

Treatment often involves medication and behavioural interventions, dependent on the age of the child and the severity.

Medication
· Stimulants – these medications affect the neurotransmitters in the brain and can help to boost energy and alertness. Extended or slow-release are preferable
· Non-Stimulants – these medications affect a different neurotransmitter, norepinephrine, and may help to regulate emotions.
· Antidepressants – again these medications affect the neurotransmitters and improve mood and attention.

Behaviour Therapy

My 10-year-old requires timers on most things. Getting ready in the mornings for school can be so painful. I get him to race against the sand timers, I have varying sizes!

If your child is older, then therapy and coaching may be the way forward to help with concerns like time management and planning.

Physical exercise and yoga have been shown to be beneficial.

I read that playing high-energy music before a task or maybe a school exam or something that your child finds boring can help them ‘get going’. My two are so hyper I wouldn’t dare use this before school, but I write what I find!

Ensuring your child has eaten is key. Keeping their sugar regulated, without giving them raw sugar! Mine thankfully love porridge, obviously sweetened, before school. But that’s a lovely slow-release carbohydrate so that works well. My son takes a snack for break time.

Bless him, there are certain snacks he won’t take like apples because he is such a slow eater and gets distracted that he never finishes them! At home, I have to constantly remind him to keep eating when he’s having his dinner as you can see his brain wander off.

Helping your child with Inattentive ADHD

• · Ensure that you make eye contact and have their attention before you speak. There is no point rambling on at them if their mind is occupied with another thing.
• · Just because they nod when you have finished talking does not mean that they have fully or even partially understood what you are saying. Try to get them to repeat back by using reflective listening, so they say, ‘Ok so I’m going to clean my teeth then come back downstairs to put my shoes on’ or whatever the instruction might be.
• · For older children help them start a diary, and not just on their phone. This way you can prompt them when they have things they are supposed to do, and places they should be!
• · Ask them what lessons they have that day etc to remind them to pack this and that. Never too old for a checklist I say!

In Class

• · Ask for your child to be sat away from windows or distraction areas.
• · Get the teacher to prompt your child to keep going and stay focused, in an encouraging manner, when they appear to be going off track
• · Make sure they are given longer in tests. There is no point in doing a timed test against an NT (Neurotypical Child). Instead of finding out what they know, you’ll simply be proving they have Inattentive ADHD
• · Make sure the teacher understands the need for eye contact and reflective listening for your child. It will help everyone.

If you think your child has any of these signs please go to their school and then to your doctor. Take evidence. Don’t let anyone tell you that your child is lazy, absent-minded or just disinterested. Go with your gut feeling.