Psychosocial Interventions for ADHD-Inattentive Type

Attention Deficit Hyperactivity Disorder-Predominantly Inattentive Type (ADHD-I) is characterized by serious and persistent impairment. Evidence also points to significant distinctions between inattentive and combined ADHD subtypes. ADHD-I and ADHD-C have been characterized by significant differences in demographic features, attentional/cognitive profiles, academic and social impairment, comorbidity, and motivation. Recently published longitudinal studies indicate that attention problems and impairment associated with ADHD-I persist over time. It was the most stable subtype in a large sample of girls over a 5 year period and in a mixed gender sample, 75% of boys and girls with ADHD-I continued to meet criteria 78 years after initial diagnosis. In addition, deficits across most areas of impairment (academic performance, social skills, peer relations, self-perceptions) and neuropsychological functioning have been found to persist over 5 years and also into adulthood. In fact, academic deficits (controlling for IQ) have been found to be significantly greater for children with ADHD-I than those with ADHD-C or comparison children over 8 years following initial diagnosis. In addition to consistent evidence of impairment in clinic samples, numerous studies document impairment for ADHD-I problems in representative community samples and cross-culturally. Academic and social impairments are routinely reported for ADHD-I and these impairments occur at school, at home and with peers. A host of additional impairments are also found—including adjustment problems, shyness and passivity, and fewer social activities. In fact, very few (11%) ADHD-I children from a report of a non clinic-referred sample were not impaired -over 3/4 showed academic impairment and over half showed social and behavioral impairment. Across all types of ADHD, it is the persistent inattention that most clearly contributes to the poor academic outcome and educational attainment.