The Difference Between ADHD and ADD

As a former ADHD coach and special education teacher who has been diagnosed with attention deficit hyperactivity disorder, I'm often embroiled in discussions about the difference between ADHD and ADD.

Attention deficit hyperactivity disorder has a multitude of names. Some people prefer to write it attention-deficit/hyperactivity disorder, ADHD, AD/HD, ADD with hyperactivity, ADD/H, or ADD/WO. So which one is correct? Well, once upon a time they were all correct. Today, it's a matter of opinion. Although, most consider the term "Attention-Deficit/Hyperactivity Disorder" or "ADHD" as the official term.

In order to explain the confusion, allow me to explain a little bit about ADHD. The only medical definition of ADHD is found in the Diagnostic and Statistical Manual of Mental Disorders (better known as the DSM followed by the version number), which is released every so often by the American Psychiatric Association, or APA. Ever since ADHD or ADD has been around, they have defined it with three major symptoms, hyperactivity, impulsivity, and inattention.

Based upon the symptoms that the person has, they can be categorized as having one of the following subtypes:

• ADHD Predominately Inattentive Type has six or more of the symptoms listed under inattention.
• ADHD Predominately Hyperactive-Impulsive Type has six or more of the symptoms listed under hyperactivity and impulsivity.
• ADHD Combined Type has symptoms of both the Predominately Inattentive Type and the Predominately Hyperactive-Impulsive Type.

The most current edition of the DSM is the DSM-IV-TR, or Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. This is important to understand because it is the DSM that has caused some of the confusion between the terms.

In the first and second editions of the DSM, neither the term attention deficit disorder nor attention deficit hyperactivity disorder existed. In fact, the first edition was published in 1952 and only included 112 mental disorder. The second edition, published in 1968 included the category "Behavior Disorders of Childhood and Adolescence," but still lacked the terms ADHD or ADD. Instead, it included the term "hyperkinetic reaction of childhood." This was considered a type of hyperactivity that was characterized by a short attention span, hyperactivity, and restlessness.

By 1980, the third revision of the DSM came out. This time they had changed "hyperkinetic reaction of childhood" to the term attention deficit disorder, or ADD. This edition listed only two subtypes of ADD: attention deficit disorder with hyperactivity (ADD/H), and attention deficit disorder without hyperactivity (ADD/WO).

That is the only time the term ADD had a medical definition. By the time the revised edition of the third edition came out in 1987 (DSM-IIIR), the added the term "Undifferentiated Attention Deficit Disorder," which referred to someone who had characteristics of hyperactivity, impulsivity, and inattention. By 1994, the APA was released the fourth edition of the manual. This time they changed the term from "attention deficit disorder" to "attention deficit hyperactivity disorder."

However, they never informed the general public about the difference between the terms. Many people had gotten used to the letters ADD/H referring only to someone who was hyperactive. So, the term ADD quickly became connected to someone who had the predominatelyinattentive subtype and ADHD was used to refer to someone who had the predominatelyhyperactive-impulsive subtype.

Sometimes, since I only use the term ADHD, people will correct me and tell me that the child has "ADD" not "ADHD." I then have to decide if I should bother to correct their misconception or allow them to think that I was incorrect in my statement. Since I hate being wrong, you can guess what I do.

I will keep using the term ADHD and gently educate people on the correct term and gently as I can. I don't expect to term ADD to ever disappear or even fall into disuse. Perhaps when the fifth edition of the DSM comes out they will change the name again. If they do, I'd like it something that doesn't have both the words "disorder" and "deficit" in it. I mean, we have enough issues without being told are deficits have made us disordered.

Sources:
ADHD: The Diagnostic Criteria
http://www.pbs.org/wgbh/pages/frontline/shows/medicating/adhd/diagnostic.html">http://www.pbs.org/wgbh/pages/frontline/shows/medicating/adhd/diagnostic.html

Symptoms of ADHD
http://www.cdc.gov/ncbddd/adhd/symptom.htm