Focus on Inattentive ADHD: The Under-Diagnosed, Under-Treated Subtype (with Mary Solanto, Ph.D.)

I find this to be so true, that those who are predominantly inattentive are often overlooked. I am seeing this happen currently for my son, who is also predominantly inattentive. As long as they are “smart enough” and “not disruptive,” teachers and many healthcare providers think nothing needs to be done to support them.

This was very helpful to me. The psych dept. in my healthcare network did not take the time to get to know me or explore comprehensive treatment options with me when I discussed my symptoms. They were quick to recommend medication, and when I refused they suggested an emotional well-being class (I'm doing fine emotionally) and to try meditating. Meditating is helping so far, but I have a need for being understood and for being well-informed. I can relate to everything that Dr. Solanto said about PI. I thought that my slow information processing was some kind of rare learning disorder. It's nice to know that it's part of my PI ADHD. The comment at the end about inflection points was highly relatable. My symptoms became more apparent as the demands in my life increased, but until a few months ago, I thought these were just "me" problems that I simply had to struggle through. The more I learn about ADHD, the freer I become. Knowledge truly is power.

I'm a male diagnosed with inattentive adhd at age 53 and I found this very interesting. As the speaker said, I didn't disrupt the class by bouncing off the walls so I was mostly overlooked. (The sole exception was my beloved chemistry teacher who made me turn off my bunsen burner while she was talking because she noticed I didn't pay attention to her while it was on!)

If your like me, you can skip the intro and get right to it at 5:00 mark.

"Focus on inattentive" sounds just funny 😂. Thank you for all your videos!!! 🎉

This presentation was mislabled. It was not focused on Inattentive, but rather a comparison of Inattentive ADD to Combined presentation. The one slide at the end which listed the "2 most helpful strategies" was the only thing useful for me. And I have Combined. But, as a 52 y.o. woman, I had already developed physical calendar (planner) management since my mid 20's (1990's), long before I was diagnosed. So, this was mostly a waste of time. What I think the ADHD medical community should focus on, concerning the under-diagnosis of women, is the interaction of starting a girl's period (estrogen) and symptoms. After researching ADHD and perimenopause, it has been proven that fluctuating estrogen in perimeno, exacerbates ADHD in women. So, why couldn't or wouldn't a girl starting menses also affect or exacerbate ADHD? It seemed my ADHD really started to show most prominately in high school. I started my period at 14, during my freshman year, which also puts me outside of the age of diagnosis. How many other women are like me (is this why many women are missed at a younger age)? The age of diagnosis for older women is ageist and sexist, because when I turned 12 in 1982, there had only been one single study done (according to Stephen P. Hinshaw) which asked the question: "can girls even have ADHD?" It was not even settled science then, and she never even mentioned that fact in her first slide showing the history of ADHD. But I am not surprised. As a woman she should know better---the medical community has largely pushed women aside and continues to do so in the research of ADHD.

That middle school thing... The elementary school teachers saw that I was smart and so they didn't make me turn in my work. Junior high (yes, I'm that old) came along, and I did my work but didn't turn it in. Nearly failed Social Studies and had to endure an hour-long lecture from my parents.

Really looking forward to the webinar on perfectionism. Hopefully, I’ll be able to make myself follow at least one tip and stop procrastinating so much!

1798 is the first mention of a "disease of the attention", by Scottish physician Sir Alexander Crichton. He wrote a three volume series of books on mental illness. Chapter Two of Book Two is entitled, "On Attention and its Diseases.

This was an excellent presentation. I learned a lot and definitely recommend this webinar.

🎯 Key Takeaways for quick navigation: 00:18 🧐 Understanding Inattentive ADHD - Inattentive ADHD is characterized by symptoms of inattention rather than hyperactivity or impulsivity. - The DSM-5 distinguishes between three presentations of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined. - The symptoms for each presentation type are outlined and discussed, highlighting the importance of recognizing inattention as a significant component of ADHD. 05:16 🕰️ Historical Overview of ADHD - ADHD has a long history, with descriptions dating back to 1900. - Changes in terminology and understanding of ADHD have evolved over the years. - The diagnostic criteria for ADHD have been refined, leading to the current recognition of three presentations in the DSM-5. 09:13 🔄 Stability of ADHD and Subtypes Over Time - Research shows that ADHD can persist into adulthood, but the specific subtype may change. - Predominantly inattentive type ADHD is more stable over time compared to predominantly hyperactive-impulsive type. - The DSM-5 uses the term "presentations" instead of "subtypes" to acknowledge the potential for changes in symptom profiles over time. 15:16 ⚖️ Inattentive vs. Hyperactive-Impulsive Symptoms - Inattentive symptoms are associated with executive function difficulties and academic underachievement. - Hyperactive-impulsive symptoms can lead to social difficulties and disruptive behavior. - Sluggish Cognitive Tempo (SCT) is a related concept that may co-occur with ADHD and respond to stimulant medication. 22:02 👫 Gender and ADHD Subtypes - The prevalence of ADHD subtypes varies by gender, with the inattentive type being more common. - For children, the combined type has a higher male-to-female ratio, while the inattentive type is more evenly distributed. - In clinical settings, both males and females seek help for ADHD, but the combined type may be slightly more prevalent among males. 25:18 🧠 Understanding Gender Differences in ADHD Subtypes - Women are more likely to have the inattentive subtype of ADHD compared to men. - In childhood, the diagnosis of ADHD often shows a significant gender imbalance, but in adulthood, the gender ratio becomes closer to one-to-one due to self-referral for evaluation. 27:25 📚 Comorbidity in ADHD Subtypes - The combined subtype of ADHD is more likely to be associated with comorbid conditions like oppositional defiant disorder, conduct disorder, and substance abuse. - The predominantly inattentive subtype is less likely to have these comorbidities. 30:13 🧠 Cognitive and Executive Function Differences - The combined subtype of ADHD tends to have greater deficits in inhibitory control and emotional regulation. - The predominantly inattentive subtype may struggle more with processing speed and visual-motor tasks. 33:13 🧒 Social Functioning Differences - The predominantly inattentive subtype may appear slow to respond interpersonally, with deficits in social knowledge. - The combined subtype may struggle with aggression and impulsivity in social situations. 35:21 🗂️ Social Skills Interventions - Tailored social skills interventions are needed for different ADHD subtypes, considering their unique social challenges. - Existing interventions should be more widely disseminated and adapted for specific subtype-related difficulties. 37:37 🧬 Heritability and Family Genetics - ADHD has a strong genetic component, with heritability estimated at 70-80%. - While ADHD tends to run in families, specific subtypes may not necessarily be inherited in the same way, suggesting variable expression of subtypes within families. 42:14 🧐 Assessing ADHD in Adults - Assessing ADHD in adults requires a comprehensive evaluation, including a detailed developmental history. - Symptoms may manifest differently in males and females, depending on the context and roles they juggle in life. 46:07 💊 Response to Treatment - Response to stimulant medication may vary between subtypes, with some studies suggesting different optimal doses. - Behavioral therapy programs should be tailored to subtype-specific challenges, but both subtypes can benefit from behavior therapy. 48:55 📅 Most Helpful Strategies in Treatment - Planner use and chunking are two highly effective strategies for managing time and organization, beneficial for individuals with ADHD and without. - These strategies can significantly improve daily functioning and task management. 50:05 📚 Characteristics of the Pi Subtype of Inattentive ADHD - The Pi subtype doesn't have difficulties associated with inhibitory control or emotional dysregulation. - They exhibit core inattention symptoms with less difficulty in behavioral inhibition and self-control. - Pi subtype individuals may have slower processing speed and unique social difficulties. 52:37 🧠 Stereotypes and Lack of Diagnosis in Women and Older Adults - Stereotypes about ADHD, such as blaming parents or thinking it's a children-only condition, can discourage diagnosis. - Women and older adults may not have been identified with ADHD in childhood due to atypical symptoms. - There's a misconception that nothing can be done about ADHD in adulthood, which is untrue. 56:14 ⏰ Inflection Points and Challenges in ADHD Symptoms - Situational demands change as individuals transition from grade school to middle school, high school, and adulthood. - Middle school, high school, and parenthood bring increased challenges for executive function. - Symptoms may become more apparent during these inflection points, leading to referrals for evaluation and treatment. Ma

This was very helpful, thank you! Could you put the link to the menopause video in the description? I can’t find it on your channel. Thank you

excellent!

Seems that this would mostly be interesting to medical professionals, maybe to some parents or an adult who is new to adhd. As an inattentive adult this was not helpful for me. One slide at the end had some helpful ideas.

Sluggish cognitive tempo!! THATS IT...FIRST TIME SOMEONE NAMED IT

With regards to the social interaction differences between ADD and ADHD, has there been any research or study on the relevance of the personality types? Could being introverted or extroverted have any impact on the type of ADHD, or could it be the other way around? The type of ADHD drives the personality type? I am very much introverted, always have been. And now at 50, have been diagnosed with ADD type. Looking back on my life, it is pretty clear I've been this way ever sine I was a child. Oh how life might have been different if this was a know thing when I was in school!!

"Focus on Inattentive ADHD" sounds like a good pun to me. I expect the matter can use some light-heartedness upfront given the "under-treated" a bit later in the title.

There's a lot of unnecessary setup for an ADHD video, I wanted to give up on this many times during the introduction. Painful.

I wonder who's the audience for these videos.. certainly not the targeted audience

Just out of interest - did anyone find the WHO brief screener mentioned at 40:48? I searched and couldn't find it.