ADD Vs. ADHD: What's the Difference?

Our understanding of ADHD and neurodiversity has been evolving for at least 30 years. Attention deficit disorder (ADD) with and without hyperactivity was added to the DSM-III (Diagnostic and Statistical Manual of Mental Disorders) in 1980, but it had been conceptualized differently in previous editions. In 1987, the two types of ADD were removed from the DSM-III-R. In this edition, the disorder received its current name, attention deficit-hyperactivity disorder (ADHD).

While the concepts and diagnostic criteria we use to talk about ADHD have changed over the years, certain patterns have persisted. In this blog post, we’ll outline the differences and similarities between the outdated concept of ADD and the ways these symptoms show up in current ADHD subtypes.

What’s the difference between ADD and ADHD?

There’s no real difference between ADD and ADHD. ADD is an outdated term for a set of symptoms that are now included as ADHD subtypes. It was once thought that some children with inattentive symptoms had an absence of hyperactivity. Now we know that all of these symptoms exist on a spectrum. There are many possible combinations of ADHD symptoms. Each person with this condition has a unique set of behaviors, symptoms, and superpowers. Scientists have also found that some symptoms of hyperactivity are more subtle than others.

Do ADD and ADHD have the same symptoms?

The symptoms that were once recognized as ADD have been absorbed into the wide spectrum of ADHD symptoms. The three general presentations of ADHD include inattentive type, hyperactive-impulsive type, and combined. People who once had a diagnosis of ADD may now have an updated diagnosis of ADHD inattentive type. 

It’s also possible that people with a former ADD diagnosis had symptoms of hyperactivity that were more internalized. Many children with hyperactive-impulsive type ADHD show their hyperactivity by fidgeting, tapping, or squirming. They may have trouble sitting still or waiting their turn. Those with inattentive type may experience hyperactivity below the surface of their ADHD iceberg. The iceberg metaphor can be a helpful way to understand the difference between outward presentations of ADHD symptoms and the ways individuals experience them. Restlessness, racing thoughts, or echolalia can all be internal symptoms of hyperactivity. Echolalia is the automatic, involuntary repetition of words and phrases. 

ADHD inattentive type

This ADHD subtype is characterized by symptoms of inattention and distractibility with little to no signs of hyperactivity or impulsivity. It’s more common among girls, and there are several reasons why these symptoms aren’t noticed as much as other ADHD symptoms. First, girls are socialized to be obedient and less disruptive compared to boys. Many young girls with ADHD are very intelligent and learn to mask their ADHD symptoms from a young age. If they have a tendency to interrupt when others are speaking, for example, girls with ADHD are more likely to stop doing this after a few corrections. They may also come up with coping mechanisms to compensate for their ADHD symptoms, like becoming overly organized or fixating on details.

Outdated yet enduring ADHD stereotypes are another reason girls with ADHD are underdiagnosed. Unwanted ADHD symptoms in girls are more often treated as character flaws, earning them labels like “drama queen” and “bossy.” In the absence of obvious hyperactive symptoms, a girl’s most outstanding and noticeable symptoms may be her intelligence and talents. Teachers and parents see fantastic academic performances and don’t believe these girls can possibly have the same neurodevelopmental disorder as the boys their age. (The very presence of these skills and talents has led some to reconsider whether ADHD is a "disorder" at all.)

Some common symptoms that people with inattentive type ADHD experience are:

• Trouble with time management, decision-making, and other Executive Functions
• High distractibility
• Careless mistakes
• Difficulty staying organized
• Avoiding or procrastinating on tasks that seem boring or uninteresting
• Losing things frequently
• Forgetfulness
• Difficulty regulating emotions and mood swings

Free resource: ADHD Success Kit

Stealth stimming and hyperactivity

People with ADHD develop self-stimulating habits for several different reasons. Twirling their hair, rocking back and forth, and tapping their feet are all familiar examples. “Stimming” can be a way to satisfy hyperactive urges, deal with boredom, release energy, or self-soothe. Girls may be more likely to use quiet stimming behaviors to sit still and stay focused for long periods. 

Sometimes, stimming behaviors can become dangerous or disruptive. Some girls may bite their nails or pick at their skin, which can lead to injuries. Again, harmless behaviors can be interpreted as “bad” behavior or inattentiveness, such as doodling in class. In some instances, they can become distractions in themselves. The best approach is to work with a professional to determine what’s prompting a child’s stimming behaviors and find some alternatives that aren’t harmful or distracting — for example, squeezing a stress ball, playing with a fidget spinner, or touching a textured strip of tape or the rough side of a strip of Velcro that has been attached to the underside of the child’s desk. 

Help your child develop skills to manage their ADHD

While ADD is no longer the correct term for it, inattentive type ADHD is just as real as the other subtypes. Children with inattentive symptoms and little to no hyperactivity still struggle. Things like focus, emotional regulation, and time management can be sources of difficulty. In some cases, these problems can snowball into more serious mental health conditions and social difficulties through adulthood. But with some help from an Executive Function coach, children with inattentive type ADHD can learn strategies to manage their symptoms and thrive in their environment.

Executive Function skills are life management skills that we all need in order to be effective in planning, initiating, and achieving daily goals at home, in school, and in the workplace. They are trainable and coachable with time and the right tools.

Beyond BookSmart coaches have experience helping children with different presentations of ADHD. We have hundreds of tools that can be customized for your child’s needs and interests. We match children with coaches based on their needs, age, background, and goals. Our coach match guarantee means your child will love their coach or we’ll match them with another one for free.

Still have questions? Contact our team today for more information or to schedule an initial inquiry.