Why Are We Still Failing Kids with Inattentive ADHD?

Written by Cynthia Hammer, MSW

“We are still relying on research done years ago on white, hyperactive boys. There are few studies and fewer insights on girls and women. Likewise, children with inattentive ADHD (formerly called ADD) continue to fly under the radar. Why?”

I left the world of ADHD, where I had been the founder and director of the now-defunct non-profit organization ADD Resources, more than 15 years ago. Then, during the pandemic, I began writing a memoir about living with ADD and so dove into updating my knowledge. What I learned dismayed me.

Why? Recent articles offer the same old explanation from decades ago: Children with inattentive ADHD are underdiagnosed because they are not disruptive in the classroom. In 15 years, we haven’t progressed. We still provide the same unacceptable explanation for failing to help these children. Some clinicians have sounded the alarm, but their clarion calls haven’t penetrated the public or teachers’ understanding that ADHD presents in two distinct ways — with and without hyperactivity.

To prevent children from falling through the cracks, the public, parents, and teachers need to realize that both ADHD presentations require urgent diagnosis and treatment.

I have a few suggestions that might help.

1. Elevate Inattentive ADHD: Whenever someone writes or talks about ADHD, they should first talk about the inattentive symptoms, stressing how this form of ADHD is under-diagnosed and how this needs to change because undiagnosed ADHD negatively impacts young lives. They should describe how inattentive ADHD symptoms may be recognized by parents and teachers. When I asked Dr. Hallowell if inattentive ADHD could be identified in children, he readily said, “Yes. You just need to question them about how they spent their time in school, how their day went, what they learned.”

2. Children with Inattentive ADHD are typically not aggressive; they are not bullies, and they usually aren’t disrespectful of authority or overly stubborn. In describing ADHD behaviors, speakers and writers should clearly delineate hyperactive symptoms from inattentive symptoms. When the behaviors are combined or confounded, parents or teachers of a child with inattentive ADHD may say, “That doesn’t describe my child or student.”

3. In describing inattentive symptoms, speakers and authors often say this presentation is more commonly observed in girls. To increase awareness, we need to stress that inattentive ADHD exists in boys as well as girls. I know because I have a son with inattentive ADHD.

4. We need research that separates hyperactive-impulsive or combination ADHD from inattentive ADHD. Most research lumps all forms of ADHD together, though they are not the same.

5. Knowledge and understanding about the differences are improving, but more progress is needed.