What is the Difference Between ADD and ADHD?
If you’re reading this, you may be on a quest to find the official difference between ADD and ADHD. The thing is, there isn’t one. ADD is, in fact, an outdated term for ADHD. That is, in the medical field, if you have the symptoms of what used to be called ADD, your diagnosis will be one of three ADHD types:
- Combined Presentation: someone has this if enough symptoms of both criteria—inattention and hyperactivity-impulsivity—were present for the past 6 months (from the checklist).
- Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months.
- Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months. 
*Please note that some doctors will still use the term ADD for the sake of understanding.
Since we already discussed the brain of someone with ADHD, possible causes, and tips for helping them, in this post we’ll take a quick look at the history of the term, why this is significant, and how we apply this knowledge at Pathfinders.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the authority on diagnosing any mental, or neurological, disorder, so the history of the term is best found in looking at the changes that the DSM has given it .
- From 1980-1987 the DSM-III (third edition) used the term Attention Deficit Disorder (ADD), and there were two subtypes—with hyperactivity and without hyperactivity.
- From 1987-1994 the DSM-III R (third edition, revised) changed the term to Attention Deficit Hyperactive Disorder (ADHD) because hyperactivity became a more predominant trait.
- From 1994-2013 the DSM-IV (fourth edition) still used the term ADHD, but with a small addition—AD/HD. This slash implies that some people might be more hyperactive or more inattentive, or have a mix of the two. The three types mentioned above describe each category—more hyperactive, more inattentive, or both—only in the DSM-IV, they were called “types” instead of presentations.
- The new edition, DSM-V (released in 2013), has little changes from the DSM-IV. In fact, the only difference is that it is now called a presentation instead of a type.
So, to sum it all up, the traits of what used to be called ADD are now under the term AD/HD. It is evident from the history above that the term has developed a more comprehensive approach. According to the DSM-III, you either had hyperactivity or you didn’t. Today, you can primarily have hyperactivity, or inattentiveness, or both. The newest category acknowledges the nuances of ADHD.
Some people think that ADD and ADHD should remain separate diagnoses because not all people appear to have hyperactivity. To answer this, the newest term, AD/HD, covers all the symptoms of what used to be ADD as well as new and emerging symptoms with the hyperactivity element. Having a new term that covers both allows for a keener understanding of this complex condition.
Moreover, many people think that hyperactivity is a black and white subject—either someone is very hyper or they aren’t. This is a common misconception. In fact, the reason that ADD was changed to ADHD in the DSM-III R is because hyperactivity became an observable trait in people who were getting diagnosed with ADD, it just presented itself in less obvious and different ways. It is helpful to see hyperactivity as not simply a physically observable trait. For instance, girls portray hyperactivity differently than boys. While boys might have the more notorious traits of being rambunctious and physically impulsive, girls (though some will portray these traits as well), usually display internal traits, like anxiety and low self-esteem [3, 4]. It is the same for adulthood. Children with ADHD commonly become adults with ADHD, but they often find that their symptoms have changed—the over-display of activity in childhood becomes extreme restlessness, they may develop a reliance on drugs, and they may be more disorganized .
Additionally, traits will differ from person-to-person regardless of gender. So, while some boys will be more boisterous and display obvious hyperactivity, others might be more impulsive.
Why is this significant?
The more we understand about ADHD and how it is displayed in different people, the more effective treatments can be made. If we don’t understand that some people struggle with ADHD in different, less noticeable ways, we can’t accurately help them overcome it. Language and terms are constantly in flux because we are always learning new things about the brain. And on top of that, changes in culture, food, and lifestyle affect the malleable brain. So there’s always something new to learn for the sake of helping those affected by ADHD.
At Pathfinders, we acknowledge this by tailoring training to each child through comprehensive programs and one-on-one training. We acknowledge that not every child is the same, even if they have the same diagnosis. We come alongside parents to provide tips for home-life and improvement. For a list of tips, please see our post on ADHD.
- Centers for Disease Control and Prevention. (2017). Attention Deficit/Hyperactivity Disorder. Retrieved from https://www.cdc.gov/ncbddd/adhd/diagnosis.html
- Low, Keath. (2017, February 14). Is ADD the Same Thing as ADHD. Retrieved from https://www.verywell.com/is-add-the-same-thing-as-adhd-20467
- Yagoda, Maria. (2013, April 3). ADHD is Different for Women. Retrieved from https://www.theatlantic.com/health/archive/2013/04/adhd-is-different-for-women/381158/
- Kinman, Tricia. (2016, March 22). Gender Differences in ADHD Symptoms. Retrieved from https://www.healthline.com/health/adhd/adhd-symptoms-in-girls-and-boys#1
- Gentile, J. P., Atiq, R., & Gillig, P. M. (2006). Adult ADHD: Diagnosis, Differential Diagnosis, and Medication Management. Psychiatry (Edgmont), 3(8), 25–30.