As a parent, watching your child struggle in school, constantly losing focus, fidgeting in their seat, and having trouble making friends is heart-wrenching. You may wonder if it’s just a phase or if there’s something more going on, like ADD or ADHD.
You’re not alone in this concern—according to the CDC, an estimated 7 million children in the US have been diagnosed with ADHD, making it one of the most common neurodevelopmental disorders.
But what exactly is the difference between ADD vs. ADHD? Is there even a difference at all? The answer to this question is crucial for parents seeking the most effective care for their child’s unique needs.
In this article, we’ll explore the history of these terms, the current diagnostic criteria, and, most importantly, the underlying neurological factors that contribute to attention and hyperactivity challenges.
What is the Difference Between ADD and ADHD?
So, what is ADD, and what is ADHD? In the 1980s, the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) introduced the term “Attention Deficit Disorder (ADD)” with two subtypes: with or without hyperactivity. This marked the first time that attention deficits were recognized as a distinct condition separate from hyperactivity.
However, in the 1990s, the fourth edition of the DSM (DSM-IV) replaced the term ADD with “Attention Deficit Hyperactivity Disorder (ADHD)” and introduced three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined type. This change reflected the growing recognition that attention deficits and hyperactivity often co-occur and that both dimensions of signs should be considered when making a diagnosis.
The most recent edition of the DSM (DSM-5), published in 2013, maintained the term ADHD but replaced the subtypes with “presentations” to emphasize that signs can change over time and across contexts. The three presentations of ADHD in the DSM-5 are:
- Predominantly inattentive presentation (formerly known as ADD)
- Predominantly hyperactive-impulsive presentation
- Combined presentation
While the terminology has evolved, it’s important to note that the core signs of inattention, hyperactivity, and impulsivity have remained consistent across the different editions of the DSM. These symptoms, along with their impact on daily functioning, form the basis for a diagnosis of ADHD.
The Most Common Clinical Presentation: Combined Type
By far and away the most common presentation we see in clinical practice is the combined presentation, because over time one often leads to another. Many children and patients who predominantly have the hyperactive-impulsive presentation can maintain incredible focus and concentration during fast-moving activities like video games or sports, but struggle to slow down their “raging bull” brain during slow-moving activities like classroom presentations and school work. Over time this begins to manifest as inattention and lack of concentration, but for these children that secondary issues stems from the primary hyperactivity.
Additionally, we frequently explain to parents that more classic ADD inattentive children have “drunken bull” type tendencies where paying attention, concentrating, and following directions is difficult. Over time as they continue to struggle with these everyday actions, frustration brews and builds up both within themselves and with teachers, classmates, parents. This frustration can lead to emotional dysregulation and what’s called sympathetic “fight or flight” overdrive, which then can show up as “raging bull” behaviors like hyperactivity, impulsivity, and even anger or outburst.
Diagnosing Children with ADD vs ADHD
To receive a diagnosis of ADHD, an individual must exhibit a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with their daily functioning and development. Let’s take a closer look at the key signs and symptoms of ADD vs. ADHD:
Predominantly Inattentive Presentation (formerly ADD) includes:
- Difficulty paying attention and focusing on tasks
- Easily distracted by external stimuli
- Struggles with organization and time management
- Often loses necessary items (e.g., school materials, toys)
- Frequently forgets daily activities and responsibilities
- Seems not to listen when spoken to directly
- Avoids or dislikes tasks that require sustained mental effort
ADD Diagnostic Criteria:
- 6 or more signs of inattention in children up to age 16, or 5 or more in adults 17 and older
- Signs have been present for at least 6 months
- Signs are inappropriate for the individual’s developmental level
Predominantly Hyperactive-Impulsive Presentation (ADHD) includes:
- Fidgets with hands or feet, or squirms in seat
- Difficulty remaining seated when expected to do so
- Runs or climbs excessively in inappropriate situations
- Struggles to play or engage in leisure activities quietly
- Always “on the go” or acts as if “driven by a motor”
- Talks excessively and interrupts or intrudes on others
ADHD Diagnostic Criteria:
- 6 or more signs of hyperactivity-impulsivity in children up to age 16, or 5 or more in adults 17 and older
- Signs have been present for at least 6 months
- Signs are disruptive and inappropriate for the individual’s developmental level
Combined Presentation:
- Meets the criteria for both inattentive and hyperactive-impulsive presentations
The inattentive presentation (formerly ADD) can be particularly challenging to diagnose, as the signs may be less overt and disruptive compared to the hyperactive-impulsive presentation. Children with inattentive presentation may be overlooked or mistakenly viewed as simply “daydreamers” or “lazy,” leading to delayed diagnosis and intervention.
It’s also important to note that as Neurologically-Focused Pediatric Chiropractors, our network of PX Docs do not focus on standard diagnosis or treatment as do medical providers. While it can be helpful and provide additional understanding to get your child a diagnosis, it generally just leads to a prescription for stimulant medications to suppress the symptoms.
If you are looking to address the root cause of your child’s ADD or ADHD challenges, then receiving a medical diagnosis becomes far less essential.
The Neurological Roots of ADD and ADHD
While the diagnostic criteria provide a framework for identifying ADHD, it’s crucial to understand the underlying neurological factors that contribute to the development of these symptoms.
At the core of ADD and ADHD lies a complex interplay of neurological factors that influence an individual’s ability to regulate attention, behavior, and mood. To fully understand the physical and mental health challenges associated with ADD and ADHD, it’s essential to examine the role of the nervous system in these processes.
The Central and Autonomic Nervous System collectively act as the body’s command center, processing information and directing responses to internal and external stimuli. When the nervous system is functioning optimally, it allows for appropriate regulation of attention, impulse control, and emotional balance.
However, when imbalances or disruptions occur within the nervous system, it can lead to the symptoms characteristic of ADD and ADHD.
Three key neurological factors that can contribute to ADD/ADHD symptoms are:
- Subluxation: Subluxation is defined as a neurological dysfunction that occurs when misalignments, tension, and restricted mobility build up within the neurospinal system, interfering with communication between the brain and body via the nervous system.
- Nervous System Dysregulation: When subluxation and nervous system build up over time it leads to a dysregulated nervous system, which then can negatively affect everything from digestion, immune and endocrine function, behavior, emotional regulation, focus and concentration, and so much more.
- Dysautonomia: Dysautonomia is a disorder of the autonomic nervous system that affects involuntary functions like heart rate, digestion, breathing, and nervous system regulation. It leads to an increased stress response and problems with attention and behavior regulation.
- Vagus Nerve Dysfunction: The vagus nerve is essential for relaxation and stress regulation within the parasympathetic nervous system. Its dysfunction can cause excessive stress response and difficulty in regulating emotions and attention.
The “Perfect Storm” of Factors in ADD and ADHD
These neurological imbalances do not occur in isolation but rather can be triggered by a combination of factors that we at PX Docs refer to as The “Perfect Storm.” This perfect storm of factors includes:
- Prenatal stress and maternal health: Studies indicate that chronic stress and health challenges during pregnancy can impact fetal brain development and increase the risk of neurological imbalances in the child.
- Birth trauma and interventions: Complications during labor and delivery, such as prolonged labor, forceps or vacuum extraction, or cesarean section, can cause physical stress and trauma to the infant’s delicate nervous system.
- Early childhood stressors: Exposure to emotional or physical stress, early exposure to antibiotics, environmental toxins, or nutritional deficiencies during early childhood has been shown to further compromise nervous system function and exacerbate ADD and ADHD issues.
Fortunately, by understanding the neurological basis of ADD and ADHD and the factors that contribute to nervous system dysregulation, we can begin to approach these challenges from a root-cause, drug-free, neurological perspective.
The Neurologically-Focused Chiropractic Approach to ADD and ADHD
At PX Docs, we recognize the crucial role of the nervous system in the development and progression of ADD and ADHD symptoms. That’s why our Neurologically-Focused Chiropractic approach aims to address the root cause of these challenges by identifying and addressing nervous system dysfunction, dysregulation, and imbalance.
The first step in this process is a comprehensive evaluation using INSiGHT Scans, a cutting-edge technology that allows us to objectively assess nervous system function. INSiGHT scans provide valuable information about the presence of subluxations, dysautonomia, and other neurological imbalances that may be contributing to ADD and ADHD issues.
Below are a set of INSiGHT EMG Scans that show a very classic “Raging Bull” hyperactivity and impulsivity type subluxation or nervous system dysregulation pattern. All of those reds in the brainstem, upper cervical, and upper back regions lead to excessive tension and sensory “noise” that end up bombarding the brain and nervous system, leading to things like hyperactivity, impulsivity, and difficulty concentrating.
Armed with this information, our trained PX Docs chiropractors develop a personalized care plan to address each child’s specific needs. Through chiropractic adjustments, we work to restore proper nervous system regulation, reduce subluxations and neurological tension, and promote optimal nervous system communication.
Empowering Parents and Providing Hope
If you’re a parent of a child struggling with ADD and ADHD, it’s essential to know that you’re not alone and that there is hope for drug-free, root cause solutions and care options for your child!
By understanding the neurological basis of these challenges and the power of a Neurologically-Focused approach, you can make informed decisions about your child’s care and set them up for lasting success by helping them overcome these challenges naturally.
This care approach not only targets the root causes of their challenges but also promotes lasting success by naturally overcoming obstacles, rather than resorting to temporary fixes through medication. Such temporary solutions often carry risks of addiction, dependency, and other significant side effects. This drug-free, neurologically-focused approach gives your family a chance to experience a vastly improved quality of life without all those nasty side effects and concerns.
At PX Docs, we are committed to providing parents with the knowledge, support, and resources they need to help their children with ADHD or ADD thrive. Our network of trained family chiropractors is dedicated to delivering personalized, compassionate care that addresses each child’s unique needs.
If you suspect that your child may be experiencing ADD and ADHD or have been struggling to find natural, drug-free solutions, we encourage you to visit the PX Docs directory to find a chiropractor near you.
By scheduling an evaluation with a PX Docs chiropractor, you can take the first step towards uncovering the root cause of your child’s challenges and developing a personalized care plan that could transform your entire family’s life!
