Speech Pathology Associates



Is It ADD Or AD/HD? What's The Difference?

The difference is mainly one of terminology, which can be confusing at times. The "official" clinical diagnosis is Attention Deficit Hyperactivity Disorder, or AD/HD. In turn, AD/HD is broken down into three different subtypes: Combined Type, Predominantly Inattentive Type, and Predominantly Hyperactive-Impulsive Type.

Many people use the term ADD as a generic term for all types of AD/HD. The term ADD has gained popularity among the general public, in the media, and is even commonly used among professionals. Whether we call it ADD or AD/HD, however, we are all basically referring to the same thing.

Who Has AD/HD?

Attention-Deficit/Hyperactivity Disorder is the most common psychiatric condition among children in the United States. Differing estimates suggest that 3 percent to 10 percent of school-age children have AD/HD.

AD/HD usually persists throughout a person's lifetime. It is NOT limited to children. AD/HD expert Russell Barkley, Ph.D., of the Medical University of South Carolina, estimates that about 5 percent of American adults suffer from the condition. Some of these people may have had AD/HD since childhood. Studies suggest that between 30 percent and 70 percent of children with ADHD continue to show symptoms of the disease as adults.

What Is AD/HD?

AD/HD is a diagnosis applied to children and adults who consistently display certain characteristic behaviors over a period of time. The most common core features include:

  • distractibility (poor sustained attention to tasks)
  • impulsivity (impaired impulse control and delay of gratification)
  • hyperactivity (excessive activity and physical restlessness)

In order to meet diagnostic criteria, these behaviors must be excessive, long-term, and pervasive. The behaviors must appear before age 7, and continue for at least 6 months. A crucial consideration is that the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work, or social settings. These criteria set AD/HD apart from the "normal" distractibility and impulsive behavior of childhood, or the effects of the hectic and overstressed lifestyle prevalent in our society.

According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), there are three patterns of behavior that indicate ADHD including:

  • often fails to give close attention to details or makes careless mistakes
  • often has difficulty sustaining attention to tasks; often does not seem to listen when spoken to directly
  • often fails to follow instructions carefully and completely; losing or forgetting important things
  • feeling restless, often fidgeting with hands or feet, or squirming
  • running or climbing excessively
  • often talks excessively; often blurts out answers before hearing the whole question
  • often has difficulty awaiting turn

Please keep in mind that the exact nature and severity of AD/HD symptoms varies from person to person. This means that there are three subtypes of ADHD recognized by professionals. These are the predominantly hyperactive-impulsive type (that does not show significant inattention); the predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) sometimes called ADD – an outdated term for this entire disorder; and the combined type (that displays both inattentive and hyperactive-impulsive symptoms).

What Does The Research Tell Us About AD/HD?

AD/HD IS NOT caused by poor parenting, family problems, poor teachers or schools, too much TV, food allergies, or excess sugar. One early theory was that attention disorders were caused by minor head injuries or damage to the brain, and thus for many years AD/HD was called "minimal brain damage" or "minimal brain dysfunction." The vast majority of people with AD/HD have no history of head injury or evidence of brain damage, however. Another theory, which is still heard in the media, is that refined sugar and food additives make children hyperactive and inattentive. Scientists at the National Institutes of Health (NIH) concluded that this may apply to only about 5 percent of children with AD/HD, mostly either very young children or children with food allergies.

AD/HD IS very likely caused by biological factors which influence neurotransmitter activity in certain parts of the brain, and which have a strong genetic basis. Studies at NIMH using a PET (positron emission tomography) scanner to observe the brain at work have shown a link between a person's ability to pay continued attention and the level of activity in the brain. Specifically researchers measured the level of glucose used by the areas of the brain that inhibit impulses and control attention. In people with AD/HD, the brain areas that control attention used less glucose, indicating that they were less active. It appears from this research that a lower level of activity in some parts of the brain may cause inattention and other AD/HD symptoms.

There is a great deal of evidence that AD/HD runs in families, which is suggestive of genetic factors. If one person in a family is diagnosed with AD/HD, there is a 25% to 35% probability that any other family member also has AD/HD, compared to a 4% to 6% probability for someone in the general population.

How Can AD/HD Be Treated?

Clinical experience has shown that the most effective treatment for AD/HD is a combination of medication (when necessary), therapy or counseling to learn coping skills and adaptive behaviors, and ADD coaching for adults.

Medication is often used to help normalize brain activity, as prescribed by a physician. Stimulant medications (Ritalin, Dexedrine, Adderall) are commonly used because they have been shown to be most effective for most people with AD/HD. However, many other medications may also be used at the discretion of the physician.

Much of this information comes from the Attention Deficit Disorder Association.

The Listening Programs

The Listening Programs are auditory therapy programs that are easy to do at home, are enjoyable and also very successful in strengthening auditory and related abilities. The Listening Programs are programs that can benefit anyone, but specifically individuals who have difficulties in the areas of auditory perception, processing and memory.

Behavior therapy and cognitive therapy are often helpful to modify certain behaviors and to deal with the emotional effects of AD/HD. Many adults also benefit from working with an AD/HD coach to help manage problem behaviors and develop coping skills, such as improving organizational skills and improving productivity.

We often recommend The Listening Programs, Sensory Integration CDs and The Sound Health Series. Many times these programs can reduce or eliminate the need for medications. These products can be found at the bottom of this page.

AD/HD is recognized as a disability under federal legislation (the Rehabilitation Act of 1973; the Americans With Disabilities Act; and the Individuals With Disabilities Education Act). Appropriate and reasonable accommodations are sometimes made at school for children with ADHD, and in the workplace for adults with ADHD, which help the individual to work more efficiently and productively.