Key Takeaways:
- Terminology Evolution: The term ADD (Attention Deficit Disorder) was replaced by ADHD (Attention Deficit Hyperactivity Disorder) in 1987 to include hyperactivity as a significant symptom.
- ADHD Presentations: ADHD now encompasses three main presentations: inattentive (similar to the old ADD), hyperactive/impulsive, and combined, covering a spectrum of attention disorders.
- Symptom Characteristics: Inattentive ADHD is marked by difficulties in focus and organization, while hyperactive/impulsive ADHD involves excessive energy and impulsive actions.
- Diagnosis Process: ADHD diagnosis involves a comprehensive evaluation including history, symptom checklists, cognitive testing, and sometimes medical lab tests and brain imaging.
- Treatment Approaches: Treatment for ADHD can include behavioral interventions, educational supports, medication, and mindfulness practices tailored to individual needs and symptoms.
Have you ever wondered what the difference is between ADD and ADHD? Or maybe you’ve heard the terms used interchangeably and want to know – is there a difference? This is a common question, significantly since the terminology has evolved.
ADD, or attention deficit disorder, dates back to the 1980s. Then, in 1987, the diagnosis was changed in the DSM-III-R to ADHD or attention deficit hyperactivity disorder when they added “hyperactivity” to the name. So ADHD has become the official medical term encompassing different presentations of attention disorders, whether or not hyperactivity is present.
But you’ll still hear people use ADD informally or refer to ADHD primarily as inattentive presentation – essentially what we used to call ADD. It’s one of those things in psychology where the language hasn’t entirely caught up to the technical definitions.
The good news is that we will break this down in plain English! In this article, you’ll get a crash course covering:
- The core symptoms of inattention, hyperactivity, and impulsivity
- How ADHD is evaluated and Diagnosed Accurately
- Options for treatment and management
- And the answers to some frequently asked questions on everything ADD vs. ADHD related
- The latest research findings on ADHD and its impact on adult populations
- Advancements in non-pharmacological interventions
- How to get ADHD Counselling in BC and ON
So whether you’ve been lost in the ADD vs. ADHD debate or want a refresher, read on to finally make sense of it all!
Get matched with a counsellor
Want online therapy? Start sessions instantly— Stress-free and easy to use.
ADD vs ADHD: What's the Difference?
Let’s dive into the details of ADD vs. ADHD – the difference, why the terminology changed, and how doctors distinguish between the two today.
The Change from ADD to ADHD
ADD, or attention deficit disorder was the original term for attention deficits. But in 1987, the diagnosis was officially changed in the DSM-III-R to ADHD or attention deficit hyperactivity disorder.
This change happened because they added “hyperactivity” to the name to reflect that some people with attention deficits are hyperactive.
So ADHD became the new umbrella term that covers:
- Attention deficits with hyperactivity
- Attention deficits without hyperactivity
Or, in other words – ADD and other presentations of attention disorders.
Reasons for the Terminology Shift
There were a few key reasons the experts decided to change the terminology:
- Recognize that attention deficits occur with OR without hyperactivity – The old term ADD made it sound like you could only have attention problems alone.
- Reflect on the additional challenges of hyperactivity – For people with hyperactive symptoms, the challenges went far beyond attention deficits. The new term ADHD captured the heightened energy and impulsivity.
- Align with an underlying neurological cause – Research was starting to show that ADD and ADHD have a shared neurological basis. The terminology needed to reflect that standard biology vs. implying completely separate disorders.
- Standardize language – One umbrella term helped standardize definitions across research and clinical practice.
The ADD vs. ADHD shift was meant to better represent the full spectrum of attention disorders, not define two completely different conditions.
ADD vs. Current ADHD Presentations
Today, there are 3 main presentations of ADHD defined in the DSM-5:
- Inattentive presentation – Characterized by difficulty staying focused, forgetfulness, disorganization, etc. This aligns closest with what we historically called ADD.
- Hyperactive/Impulsive presentation – Characterized by excessive energy, fidgeting, and impulsive behaviour. This aligns with the stereotype of ADHD.
- Combined presentation – Exhibits symptoms of both inattentive and hyperactive/impulsive equally.
It’s also important to note that the DSM-5 now includes specific adult criteria, reflecting the condition’s persistence beyond childhood for many individuals.
The table below summarizes some key differences:
| ADD aligns with: | ADHD aligns with: | |
|---|---|---|
| Primary Symptoms | Inattentiveness | Hyperactivity/Impulsivity |
| ** Common Characteristics** | Forgetfulness, distracted, disorganized | Fidgety, restless, interrupting |
| Energy Level | Sluggish or inconsistent | Excessively high |
| General Behavior | Quiet, passive | Disruptive, interruptive |
However, remember that these are more stereotypical traits historically used to distinguish the two. In reality, ADHD presents on a spectrum – so someone could have mild hyperactivity or inattention. The current criteria focus more on assessing all ADHD symptoms equally vs. trying to classify rigid types.
The main distinction remains whether inattentive symptoms are accompanied by hyperactivity/impulsivity. However, the terminology has evolved to reflect our growing understanding that ADD vs. ADHD exists on a continuum of attention disorders – not as separate conditions.
Moreover, it’s important to note that ADHD can co-occur with other conditions, necessitating a broader approach to treatment. Services focusing on the full range of behavioral disorders are crucial, as they provide strategies and support to alleviate the impact of these concurrent challenges and enhance overall well-being.
Understanding ADHD Symptoms
Now that we’ve covered the terminology let’s take a closer look at the core symptoms of ADHD – inattentiveness, hyperactivity, and impulsivity. Knowing how these manifest behaviorally can help identify areas for support and treatment.
Inattentiveness
The key behaviours that reflect inattentiveness include:
- ✅ Trouble staying focused – Difficulty focusing on tasks, conversations, lectures, etc. Easily distracted.
- ✅ Appearing forgetful – Forgetting daily tasks, responsibilities, and events. Losing things frequently.
- ✅ Disorganization – Messy workspaces, poor time management, trouble finishing tasks.
- ✅ Avoiding mental tasks – Reluctant to do “brain work” like reading paperwork. Prefers active or sensory tasks.
- ✅ Daydreaming – Tendency to drift into own inner world. Thoughts easily wander.
- ✅ Slow processing -Takes more time or re-reading to absorb information.
- ✅ Not listening – Needs reminders or cues to respond. Misses parts of conversations.
Someone with primarily inattentive symptoms often comes across as absent-minded, lazy, or spacey. But it’s due to these core challenges of sustaining focus and managing information.
Hyperactivity
Hyperactive behaviours reflect excessive energy and restlessness:
- ⚡️Fidgeting – Squirming, tapping feet or fingers, trouble sitting still.
- ⚡️Constant motion – Pacing, excessive talking, always needing to be “on the go.”
- ⚡️Restlessness – An internal sense of urgency or feeling wound up.
- ⚡️Impulsive activity – Bounding, climbing, running in unsuitable times or places.
- ⚡️Talking excessively – Chattering, interrupting, inability to be quiet.
Someone with primary hyperactivity often seems constantly in motion, chatty, jittery, disruptive, or noisy. It reflects an abundance of physical and mental energy.
Impulsivity
Impulsive behaviours reflect quick, unplanned reactions vs. thoughtful control:
- 💥 Interrupting – Answering before questions are asked, interjecting into others’ conversations
- 💥 Poor planning – Acting spontaneously without thinking through potential results.
- 💥 Impatience – Disliking delay or frustration. Wanting immediate rewards.
- 💥 Intrusive – Clowning around, excessive noise, “in your face” style of approach.
- 💥 Risky choices – Making decisions for short-term gains without assessing danger.
- 💥 Low frustration tolerance – Outbursts or meltdowns under stress. Limited self-control.
Impulsive behaviour seems disruptive, overbearing, or lacking in restraint. But it stems from quick-trigger reactions rather than calculated defiance.
Moreover, recent insights into ADHD’s impact on emotional regulation reveal that individuals may also struggle with managing their emotions, leading to symptoms that overlap with mood disorders. This is an area garnering increasing attention in diagnostic and treatment circles.
Getting an Accurate ADHD Diagnosis in Canada
Information Needed for Evaluation
A licensed healthcare provider like a psychologist, psychiatrist, or pediatrician will evaluate comprehensively. They will gather information from:
- 👥 Detailed history – Personal, family, medical, developmental, and academic histories
- 🖥️ Symptom checklists – From parents, teachers, spouse, self-report
- 🧠 Cognitive and achievement testing – Assesses IQ, learning disorders
- 🩺 Physical exam – Vision, hearing, motor skills, sleep, nutrition
- 📝 Rating scales – Quantify the severity of ADHD behaviours
- 🗣️ Clinical observation – One-on-one interview
The goal is to get a complete profile of symptoms, especially:
- 📆 Onset before age 12
- 📈 Occurring across multiple settings – Home, school, work
- 💢 Impacting functioning – Socially, academically, occupationally
Role of Co-Occurring Conditions
Since many conditions mimic or co-occur with ADHD, the evaluation will screen for:
- 🧠 Learning disabilities
- 😥 Anxiety, depression
- 🤕 Sleep disorders, thyroid dysfunction
- 🤕 Head injury, epilepsy
- 🍺 Substance abuse
- ⚖️ Behavioral problems
Proper diagnosis requires determining symptoms are best explained by ADHD vs. other factors.
Objective Testing Methods
In addition to checklists and rating scales, Canada uses:
- 🧪 Medical lab tests – For nutritional deficiencies, genetic disorders, and thyroid dysfunction.
- 📝 Neuropsychological tests – Measure executive functioning like working memory impulse control. It’s worth mentioning the emerging use of computer-based continuous performance tests (CPTs) that can provide objective data on attention and impulsivity. These tests are gaining traction as supplementary tools in the ADHD diagnostic process.
- 🧠 Brain imaging – MRI and EEG scans detect structural/functional brain differences.
- 📊 Cognitive assessments – Identify learning disabilities that may overlap with ADHD.
Finding a Qualified Evaluator
Look for these credentials in your diagnosing provider:
- 🧑⚕️ Psychiatrist, pediatrician, neurologist, psychologist
- 🇨🇦 Licensed to practice in your Canadian province
- 🏥 Access to comprehensive assessment resources
- 🤝 Collaborates with schools, doctors, therapists
- ➕ Extensive ADHD evaluation experience
Getting an accurate ADHD diagnosis lays the foundation for effective treatment and support. While it’s a thorough process, a suitable professional will make it as smooth and helpful as possible.
Treating and Managing ADHD
If you or your child has an ADHD diagnosis, the next step is starting treatment and management. There are various evidence-based options to improve symptoms and functioning.
Mindfulness and Meditation
Healthcare professionals increasingly recognize mindfulness and meditation for their benefits in managing ADHD symptoms alongside other treatment options. Studies suggest regular mindfulness improves attention, reduces stress, and enhances emotional regulation.
Behavioural Interventions
Behavioural therapy helps develop coping skills through:
- ⏰ Time management – Tracking time, breaking down tasks, reminders
- 🗂 Organization systems – Calendars, filing methods, decluttering
- 💭Focus strategies – Minimizing distractions, music, stress management
- 🤝 Parent/teacher training – Consistent routines, clear instructions, positive reinforcement
- 🧠 Cognitive training – Building working memory, impulse control, planning
- 🏋️Lifestyle changes – Regular exercise, proper sleep hygiene, healthy diet
Educational Supports
School accommodations can include:
- 📚 Academic adjustments – Extra time, revised assignments, note-takers
- ✂️ Learning aids – Visual schedules, headphones, fidget tools
- 🗓️ Organizational coaching – Binders with daily/weekly plans
- 🏫 Environmental modifications – Preferential seating, sensory breaks
- 👩💻 Assistive technology – Speech-to-text, read-aloud features
Medication Options
- 💊Stimulants – Methylphenidate, amphetamines, lisdexamfetamine
- 💊 Non-stimulants – Atomoxetine, guanfacine, clonidine
- 💊 Antidepressants – Bupropion, SNRIs, SSRIs (for co-occurring anxiety/depression)
Individualized Treatment Planning
- 📝 Multimodal approach – Combined behavioural therapy, meds, school support
- 📈 Regular monitoring and follow-up – Track progress, adjust as needed
- 🤝 Team collaboration – Coordinate care between providers, school, family
- ⏳ Consider developmental needs – Adjust supports from childhood through adulthood
The right treatments can significantly improve ADHD impairment. An experienced therapist or coach can help create an integrated plan tailored to your needs and priorities.
Frequently Asked Questions (FAQs)
ADD is an outdated term that historically referred to inattentive symptoms without hyperactivity. ADHD is now the accepted medical term covering all attention deficit presentations - with or without accompanying hyperactivity/impulsivity.
So, in essence, ADD would now be considered ADHD predominantly inattentive presentation. The terminology evolved to reflect our understanding that ADD vs. ADHD exists on a continuum of neurologically-based attention disorders.
Yes, ADD generally aligns with what would now be diagnosed as ADHD, predominantly inattentive presentation.
The core symptoms are the same - difficulty sustaining focus, forgetfulness, disorganization, avoidance of mental tasks, etc.
The only difference is that with ADD, those deficits occur without excessive hyperactivity and impulsivity.
Absolutely. It's pretty standard for people to exhibit significant attention deficits without hyperactive or impulsive behaviour.
The presentations provide clues about behavioural tendencies that can tailor treatment approaches. For example:
- Inattentive may benefit more from organization/time management skills
- Hyperactive may benefit more from strategies to expend energy productively
- Combined, they may need a balance of behavioural therapy and medication
However, interventions can be combined strategically based on each person's needs. The most effective treatment plans are highly individualized vs. tied strictly to subtypes.
There were several reasons the medical community decided to shift the terminology:
- Recognize attention deficits occur with OR without hyperactivity
- Reflect on the additional challenges those with hyperactivity face
- Align with research showing an everyday neurological basis
- Standardize definitions for research and clinical consistency
So the intent was not to define two completely separate disorders but rather have an umbrella term - ADHD - representing the full spectrum of attention deficit presentations, hyperactive or not.
If you notice ongoing issues with focus, impulse control, or hyperactivity, the first step is to speak with your doctor or a mental health professional.
They can do an initial assessment, screen for other potential causes, and refer you to a specialist for a comprehensive ADHD evaluation if warranted.
Early consultation is critical since effective treatment depends on an accurate diagnosis.
Some believe our broader understanding of ADHD has led to overdiagnosis. But research shows that:
- Strict DSM criteria are effective at differentiating ADHD from lookalike issues.
- Diagnoses are much more stringent than the public perceives.
- ~5% of children and 2.5% of adults are estimated to have ADHD - consistent rates over decades.
There are far more undiagnosed or misdiagnosed cases that cause lifelong challenges. Overall, careful assessment by an expert evaluator remains key to accurately identifying ADHD.
Absolutely. Children with ADHD will continue experiencing symptoms as adults in varying degrees.
However, many adults remain undiagnosed because hyperactivity tends to lessen with age. Inattentive traits can be mistaken for laziness or incompetence vs. a neurodevelopmental disorder.
Adult ADHD is best recognized by looking for lifelong patterns of impulsivity, disorganization, distraction, etc., beginning in childhood.
Some frequent myths are that ADHD is:
- Caused by bad parenting or moral weakness → It's a genetic neurodevelopmental disorder
- Limited to hyperactive boys → Girls are often missed; 30% have inattentive, non-hyperactive type
- Overcome with age → At least 2/3 of children continue having symptoms as adults
- Overdiagnosed → Strict DSM criteria prevent overdiagnosis when correctly applied
- Exclusively treated with medication → Behavior therapy is equally important for learning coping skills
Pareen Sehat MC, RCC
Pareen’s career began in Behaviour Therapy, this is where she developed a passion for Cognitive Behavioural Therapy approaches. Following a Bachelor of Arts with a major in Psychology she pursued a Master of Counselling. Pareen is a Registered Clinical Counsellor (RCC) with the BC Association of Clinical Counsellors. She specializes in CBT and Lifespan Integrations approaches to anxiety and trauma. She has been published on major online publications such as - Yahoo, MSN, AskMen, PsychCentral, Best Life Online, and more.
