What Are the 3 Types of ADHD?
The DSM-V identifies three types of ADHD: primarily hyperactive-impulsive, primarily inattentive, and combined type. Each presentation is distinguished by a distinct set of behavioral symptoms that physicians use to diagnose the condition. Here, learn those criteria, and what those symptoms look like — severe to mild.
What Are the 3 Types of ADHD?
- Primarily Hyperactive-Impulsive ADHD
- Primarily Inattentive ADHD (formerly called ADD)
- Combined Type ADHD
Attention deficit hyperactivity disorder was once diagnosed as ADD or ADHD. Previously, inattentive symptoms like trouble listening or managing time were diagnosed as “ADD.” Hyperactive and impulsive symptoms were associated with the term “ADHD.” Today, the condition is simply called ADHD — according to changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)1 — and patients are diagnosed with one of three presentations.
What Do the 3 Types of ADHD Mean?
- Primarily Hyperactive-Impulsive Type ADHD
People with hyperactive ADHD feel the need for constant movement. They often fidget, squirm, and struggle to stay seated. They appear to act as if “driven by a motor” and often talk and/or run around excessively. They interrupt others, blurt out answers, and struggle with self-control. This is more common in children and men.
- Primarily Inattentive Type ADHD
People with inattentive ADHD make careless mistakes because they have difficulty sustaining attention, following detailed instructions, and organizing tasks and activities. They are forgetful, easily distracted by external stimuli, and often lose things. This is more common in adults and girls, and was formerly known as ADD.
- Combined Type ADHD
People with combined-type ADHD demonstrate six or more symptoms of inattention, and six or more symptoms of hyperactivity and impulsivity.
|ADHD, Primarily Inattentive||ADHD, Hyperactive-Impulsive||ADHD, Combined Type|
|Inattentive/ Poor Attention Span||X||X|
|Impulsive and/or Hyperactive||X||X|
Medical professionals today test for the ADHD symptoms explained below, and further define ADHD diagnoses by quantifying the severity as mild, moderate, or severe, and by labeling the presentation.
How Do Physicians Diagnose the 3 Types of ADHD?
Physicians use the symptoms described in the DSM-V to identify ADHD. The DSM-V lists nine symptoms that suggest ADHD Primarily Inattentive, and nine that suggest ADHD Primarily Hyperactive-Impulsive.2 A clinician may diagnose a child with ADHD only if he or she exhibits at least six of nine symptoms from one of the lists below, and if the symptoms have been noticeable for at least six months in two or more settings — for example, at home and at school. What’s more, the symptoms must interfere with the child’s functioning or development, and at least some of the symptoms must have been apparent before age 12. Older teens and adults may need to demonstrate just five of these symptoms in multiple settings.
Primarily Inattentive Type ADHD
A physician will diagnose patients with this type of ADHD if they fit 6 of the 9 descriptions below:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, turns in inaccurate work).
- Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
- Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
- Often has difficulty organizing tasks and activities (e.g., struggle to manage sequential tasks, keep materials and belongings in order, organize work, manage time, and meet deadlines).
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, this may include preparing reports, completing forms, reviewing lengthy papers).
- Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
- Is often easily distracted by extraneous stimuli (for older adolescents and adults, this may include unrelated thoughts).
- Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, this may include returning calls, paying bills, keeping appointments).
Primarily Hyperactive-Impulsive Type ADHD
A physician will diagnose patients with this type of ADHD if they fit 6 of the 9 descriptions below:
- Often fidgets with or taps hands or feet or squirms in seat.
- Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the workplace, or in other situations that require remaining in place).
- Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, this may manifest as feeling restless.)
- Often unable to play or engage in leisure activities quietly.
- Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to remain still — in restaurants or meetings, for example — for any extended time without significant discomfort; others may say the patient is restless, fidgety, or difficult to keep up with).
- Often talks excessively.
- Often blurts out an answer before a question has been completed (e.g., completes people’s sentences).
- Often has difficulty waiting his or her turn (e.g., while waiting in line, while speaking in conversations).
- Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
Combined Type ADHD
A physician will diagnose patients with this Combined Type ADHD, of they meet the guidelines for Primarily Inattentive ADHD and Primarily Hyperactive-Impulsive ADHD. That is, they must exhibit 6 of the 9 symptoms listed for each sub-type.
What Do the 3 Types of ADHD Look Like in Daily Life?
The criteria in the DSM-V help physicians evaluate which patients have ADHD, but they sometimes fail to capture all the ways that symptoms manifest in daily life. Use these descriptions to understand what each type of ADHD looks like in children and adults with the condition.
Daily Symptoms – Primarily Inattentive Type ADHD
The stereotypical ADHD patient is a 9-year-old boy who loves to jump off dangerously high things and never remembers to raise his hand in class. In reality, only a fraction of people with ADHD fits this description. Children with hyperactive ADHD symptoms are difficult to ignore. The ones bouncing out of their chairs or clowning around behind the teacher’s back are the first to be evaluated for and diagnosed with ADHD.
Meanwhile, the students with inattentive ADHD (predominantly girls) are quietly staring out the window at a bird while their work lays unfinished. According to the National Institute of Mental Health, inattentive symptoms are far less likely to be recognized by parents, teachers, and medical professionals, and individuals with inattentive type ADHD rarely get the treatment they need.3 This leads to academic frustration, apathy, and undue shame that can last a lifetime. This is a big problem.
Inattentive ADHD is often written off as spacey, apathetic behavior in children, or mood disorders/anxiety in adults. People with this form of ADHD often lose focus, are forgetful, and seem to have trouble listening.
Inattentive ADHD Symptom 1: Careless Mistakes
A child with inattentive ADHD may rush through a quiz, missing questions he knows the answers to or skipping whole sections in his haste. An adult may fail to carefully proofread a document or email at work, drawing unwanted attention and embarrassment. If you tell yourself to slow down and pay attention, but find it mentally painful and physically uncomfortable to do so, this may be a sign of inattentive ADHD. Your brain is aching to jump to the next thing, and ultimately you just have to give in.
Inattentive ADHD Symptom 2: Short Attention Span
Unfinished classwork, half-done art projects, and incomplete reading assignments are all hallmark signs of attention problems in students. Adults with inattentive ADHD despise boring work meetings 10 times more than their colleagues do, and need to be chewing gum, sipping coffee, or even standing during meetings in order to sustain their attention throughout.
Inattentive ADHD Symptom 3: Poor Listening Skills
Students with inattentive ADHD typically get about half the instructions relayed to them verbally — if that. Their notebooks are filled with more doodles than notes, and they may need to record and listen to lectures several times to absorb all of the information. Adults don’t do well at cocktail parties. They interrupt others’ stories with their own anecdotes, never remember names, and zone out about halfway through every conversation. If you’re constantly being asked, “Weren’t you listening?” or, “Why am I wasting my breath?” that could be a sign you have inattentive ADHD.
Inattentive ADHD Symptom 4: No Follow-Through
For children and adults alike, inattentive ADHD can manifest as a million small projects — started but never finished — laying around the house in states of disarray. The vegetable garden that got planted but never watered. The new organization system that was assembled but never used. The abandoned sheet music for the piano lessons started and then ditched after a few tough months. If you love to plan and start projects but get sidetracked and leave a trail of unfulfilled promises in your wake, that could be a sign of inattentive ADHD.
Inattentive ADHD Symptom 5: Disorganization
Lost your phone again? Your keys? That report that’s due tomorrow? Since we’re often thinking about something else when we’re putting down important things, inattentive adults are prone to the worst of ADHD’s hallmark symptoms of disorganization. Our homes, cars, and workspaces often look like a tornado just hit them — which can fill inattentive adults with a crippling amount of shame when they compare them to others’.
Inattentive ADHD Symptom 6: “Laziness” or “Apathy”
“He could pay attention if he tried.” “She’s just not dedicated — that’s why she misses so many deadlines.” Unfortunately, inattentive symptoms sometimes make us look lazy or uncaring, especially if the ADHD is undiagnosed or hasn’t been disclosed. Without treatment, we’re prone to losing jobs and friends — or even developing a hard and bitter persona as a defense mechanism. If everyone’s pinned you as lazy your whole life, it’s easy to start to see yourself that way, too.
Inattentive ADHD Symptom 7: Bermuda Triangle Syndrome
Everyone misplaces car keys or a cell phone from time to time. People with inattentive ADHD trade stories about finding their glasses in the freezer, and the frozen peas in their purse. They tend to misplace the essential things they need for living — keys, wallet, backpack, sports equipment — on a daily basis. If you have found that you need a “launch pad” near the door to ensure you don’t forget your cell phone, and couldn’t live without the locator device attached to your key ring, that could be a sign.
Inattentive ADHD Symptom 8: Distractibility
Inattentive ADHD adults are dreamers, doodling on their notes during a big meeting or studying a fly on the wall while their spouses are asking about bills. Often nicknamed “space cadets” or written off as flaky, many people misinterpret the inattentive individual’s lack of focus as lack of interest — and can get frustrated by their inability to pay attention, especially when it’s important that they do so.
Inattentive ADHD Symptom 9: Forgetfulness
How many times have you missed a scheduled doctor or dentist appointment in the last year? Inadvertently stood up friends for lunch? Joined a conference call 20 minutes late because you forgot all about it? These are all common occurrences for adults with inattentive ADHD, who struggle to pay bills on time, return friends’ messages, and send out birthday cards on time. This may be perceived as rudeness or laziness, but this behavior is rarely done on purpose.
Daily Symptoms – Primarily Hyperactive-Impulsive Type ADHD
Hyperactive-Impulsive Type ADHD is the stereotype most people imagine when they think of ADHD: a young boy, bouncing off the walls, and interrupting the teacher mid-sentence. This type of ADHD is pretty easy to spot.
Hyperactive ADHD Symptom 1: Fidgety
A child with Hyperactive-Impulsive ADHD often fidgets with or taps hands and feet, or squirms in his seat. This child may fall out of his chair more often than his peers. He often feels the need to pick up everything and play with it. An adult may be shifting in her chair or fidgeting with papers during work meetings. If you tell her to ‘sit still,’ she may find it mentally painful and physically uncomfortable to do so — her brain is ready to jump to the next thing.
Hyperactive ADHD Symptom 2: Frequently Moving
Even when expected to remain seated, kids and adults with ADHD often get up and move around. For example, an individual with Hyperactive-Impulsive ADHD may walk away from his classroom desk in the middle of a lesson, or an adult might leave his office or assigned post at work before he is supposed to.
Hyperactive ADHD Symptom 3: Restless
A young child with Hyperactive-Impulsive ADHD is often running around, crashing into walls and furniture, or climbing on things she shouldn’t. She’s often described as a ‘jumper’ or as acting like the well-known Winnie-the-Pooh series character, Tigger. In teens and adults, this restlessness is more likely an internal feeling than an outward, physical hyperactivity.
Hyperactive ADHD Symptom 4: Noisy
Children and adults with Hyperactive-Impulsive ADHD are often singing or humming, or even talking to themselves. They may be loud talkers and often can’t be active quietly.
Hyperactive ADHD Symptom 5: Always on the Go
Is your child difficult to keep up with? Constantly on the go as if driven by a motor? An individual with Hyperactive-Impulsive ADHD will have a hard time sitting still for any length of time. An adult may find it difficult to sit through meetings, and a child could struggle to sit through a meal at home or at a restaurant.
Hyperactive ADHD Symptom 6: Talkative
“He never stops talking!” An individual with Hyperactive-Impulsive ADHD might talk almost constantly and be known as a “motor mouth.”
Hyperactive ADHD Symptom 7: Impulsive Reactions
Children with Hyperactive-Impulsive ADHD could be the one blurting out answers in the classroom before being called on, retaliating immediately against a playground slight, or finishing other people’s sentences.
Hyperactive ADHD Symptom 8: Struggles to Wait Their Turn
Individuals with ADHD have trouble waiting their turn in a variety of situations — conversation, playing games, answering a question in class, and beyond.
Hyperactive ADHD Symptom 9: Disruptive
Children and adults alike interrupt or intrude on others when they have Hyperactive-Impulsive ADHD. They seem to talk over others and insert themselves in conversations or activities to which they didn’t belong. A child might start playing with someone else’s toy without seeking permission first, for example.
Daily Symptoms – Combined Type ADHD
People with combined type ADHD have at least six of the daily characteristics of inattentive and hyperactive-impulsive types.
If you think that you have one of the above three types of ADHD, you should see a medical professional for an official diagnosis. Learn more in our comprehensive diagnosis guide.
1 Symptoms and Diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. American Psychiatric Association (2013). https://www.cdc.gov/ncbddd/adhd/diagnosis.html
2 Symptoms and Diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. American Psychiatric Association (2013). https://www.cdc.gov/ncbddd/adhd/diagnosis.html
3 Attention Deficit Hyperactivity Disorder. National Institute of Mental Health (2008). https://education.ucsb.edu/sites/default/files/hosford_clinic/docs/adhd_booklet.pdf
Updated on January 20, 2020