ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) are often thought of as separate conditions, but in reality, ADD is an outdated term that has been subsumed under the broader diagnosis of ADHD.

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What is ADD?

ADD was traditionally used to describe a condition where individuals had difficulty with attention, focus, and concentration, but without the hyperactivity or impulsivity seen in ADHD. People with ADD often appeared quiet or inattentive, but did not exhibit the hyperactive behaviours associated with ADHD. ADD is now recognised as one type of ADHD.

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Is There a Difference?

ADD is essentially now called ADHD, Predominantly Inattentive Presentation. In 1994, the term ADHD was adopted universally in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to cover all forms of attention deficit conditions, with three distinct presentations:

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Types of ADHD:

1. ADHD, Predominantly Inattentive Presentation (formerly known as ADD):

   • Symptoms: Difficulty paying attention, easily distracted, forgetful, trouble following through on tasks, often seeming "daydreamy" or disorganized.

   • Key Feature: Little to no hyperactivity or impulsiveness. Individuals may appear lethargic, unmotivated, or shy.

2. ADHD, Predominantly Hyperactive-Impulsive Presentation:

   • Symptoms: Hyperactivity, impulsivity, difficulty sitting still, talking excessively, fidgeting, acting without thinking.

   • Key Feature: Hyperactivity and impulsiveness are the primary symptoms, with fewer issues related to inattention.

3. ADHD, Combined Presentation:

   • Symptoms: A mix of both inattentive and hyperactive-impulsive symptoms.

   • Key Feature: The individual displays significant challenges with both attention and hyperactivity/impulsivity.

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The Core Differences:

• ADD is now part of the broader ADHD diagnosis, specifically under the inattentive type.

• The key difference between ADHD, Predominantly Inattentive (formerly ADD) and other forms of ADHD lies in the absence of hyperactivity and impulsiveness. Individuals with this type may still struggle with attention and focus but aren't overly active or impulsive.

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Common Misconceptions:

• People often think ADD and ADHD are entirely separate conditions because ADD lacks the hyperactivity component. However, in modern clinical terms, they are both recognised as forms of ADHD with distinct presentations.

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Symptoms of Inattentive Presentation (formerly ADD):

• Difficulty focusing on tasks, especially if they require sustained mental effort.

• Frequently losing things or being forgetful in daily activities.

• Appearing not to listen when spoken to directly.

• Difficulty organizing tasks and activities.

• Being easily distracted by external stimuli or unrelated thoughts.

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Why the Shift in Terminology?

The shift from using ADD to ADHD happened because ADHD better reflects the range of symptoms that can occur across individuals, even if hyperactivity is not always present. ADHD also captures the disorder’s broader impact on executive function, attention, and self-regulation.

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Conclusion:

ADD is no longer considered a separate condition; it is now classified as a type of ADHD, specifically ADHD, Predominantly Inattentive Presentation. This form of ADHD involves attention-related challenges without the hyperactive and impulsive behaviours seen in other types. So while the term ADD may still be used informally, the correct clinical term is ADHD.