What is inattentive ADHD in children and adults?

ADHD is a neurodevelopmental disorder that may present with challenged attention spans, hyperactivity, and low impulse control. Health professionals typically diagnose it during childhood, but symptoms often persist into adulthood.

According to experts, there are three main types of ADHD, which have the following symptoms:

• Hyperactive-impulsive ADHD: This type involves low impulse control, difficulty keeping quiet, speaking out of turn, and a tendency to jump from one task to the next without completing either. Distractibility isn’t a main feature.
• Inattentive ADHD: Symptoms include distractibility, challenged attention and focus, difficulty following a train of thought, difficulty following instructions, and difficulty multitasking. Low impulse control and fidgeting aren’t main features.
• Combined ADHD: This type includes features from the other two types of ADHD and is the most common ADHD presentation.

ADHD responds well to treatment, which is often similar for all presentations.

Features and symptoms of inattentive type ADHD

Living with inattentive ADHD, you may have trouble with organization, focus and attention, and staying on task.

Inattention in ADHD may involve any of these symptoms:

• missing details or making mistakes that appear careless
• being easily distracted or unable to follow through on instructions
• not responding when spoken to because your mind is somewhere else
• difficulty following the train of conversations or when reading
• persistent loss of essential items like tools, keys, or paperwork
• not completing tasks because random thoughts or external stimuli take your attention somewhere else
• challenges when organizing or planning tasks, meeting deadlines, or managing time
• purposefully avoiding tasks that require sustained mental effort, like homework, paperwork, or reports
• forgetting to do chores, like grocery shopping, and missing important appointments

To receive a formal diagnosis of inattentive ADHD, you must experience five or more of these symptoms across different situations and be over the age of 16 years. Children up to the age of 16 years must present six or more symptoms.

In all cases, the diagnosis is confirmed if symptoms have been present for at least 6 months and can’t be explained by any other cause, such as a brain injury.

Treatment for inattentive ADHD

For both adults and children, medication and psychotherapy are the mainstays of ADHD treatment.

Except for children under the age of 6 years, medication is the first line of ADHD treatment. 

Behavioral therapy

ADHD responds well to psychotherapy. Cognitive behavioral therapy (CBT) is among the most effective types for adults.

CBT for ADHD focuses on achieving short- and long-term goals, developing specific skills, and working under a structured framework.

Your therapist may help you work on those skills and tasks that appear more challenging. For example, remembering and meeting deadlines, organizing your calendar, and following conversations at work.

For children under 6 years, a therapist may work with parents, helping them develop skills that support behavior management. That way, they can learn to reinforce and deter specific behaviors that help the child build focus and specific skills.

For children 6 years and older, therapy may also involve parent training in behavior management. However, the therapist may also focus on helping the child develop organizational and interpersonal skills, mainly when functioning in the classroom. In some cases, therapy may also involve teachers and other guardians.

The Food and Drug Administration (FDA) recently approved a video game for children ages 8 to 12 years with ADHD. The game may be particularly effective for inattentive ADHD because it targets brain regions involved in alertness and attention skills.

If you need help covering the cost of ADHD medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Medications 

ADHD medications come in two general types: stimulants and nonstimulants.

According to the Centers for Disease Control and Prevention (CDC), 70–80% of children who take stimulant medication have fewer ADHD symptoms. Stimulant ADHD drugs act quickly, while nonstimulant ADHD medications may take longer to work, but their effect lasts longer.

Some insurance companies require prior authorization to cover the cost of ADHD meds for children under 6 years. Parents may need to pay for these drugs out of pocket, using pharmacist loyalty programs or free discount cards and coupons.

Common stimulant medications for ADHD with inattentive features may include:

• methylphenidate (Ritalin)
• amphetamine dextroamphetamine (Adderall XR)

Stimulant medications for inattentive ADHD are also available in different forms, including: 

• extended-release methylphenidate capsules for night use (Jornay PM)
• quick-acting dextroamphetamine dermal patch (Xelstrym)
• extended-release amphetamine tablet or oral suspension (Dyanavel XR)

Some medications, like Jornay PM, may take hours to work and effects may not be seen until the following day.

Stimulant ADHD meds work by increasing the levels of dopamine in the brain. Dopamine is known as the “feel good” hormone and plays a role in mental focus and attention.

Nonstimulant medications are preferred for ADHD when stimulant drugs don’t work, or you don’t tolerate them well. Nonstimulants may sometimes be combined with a stimulant medication. 

Nonstimulant meds for inattentive ADHD may include:

• atomoxetine (Strattera) and viloxazine (Qelbree), serotonin-norepinephrine reuptake inhibitor antidepressants (SNRIs)
• clonidine (Catapres) and guanfacine (Intuniv), alpha 2 receptor agonists

SNRIs block the body’s reabsorption of the neurotransmitters serotonin and norepinephrine, so there’s more available for use by the brain. This increases alertness.

Alpha 2 receptor agonists lower heart rate and blood pressure and are classified as anti-hypertensive medications. They help you feel more at ease so you can focus on a task. 

Summary

Inattentive ADHD refers to difficulty staying on task and following your or someone else’s train of thought. Distractibility and forgetfulness characterize this ADHD presentation.

Psychotherapy and medication are the first line of treatment for ADHD in adults and children over the age of 6 years.

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