ADHD Predominantly Inattentive

When you say ADHD predominantly Inattentive it is important to review the history of ADHD, its nomenclature, and how this term relates to the other subtypes. In the chart below you see that this term is relatively new. 1980 saw the first publication that used the initials ADD, Attention Deficit Disorder and subtypes - ADD with Hyperactivity, ADD without Hyperactivity, and ADD Residual Type.

Possible Impact of Inattention

ADHD History Timeline


Event / Publication


DSM-III is published by the APA; For the First time includes Attention Deficit Disorder, including subtypes of ADD with Hyperactivity, ADD without Hyperactivity, and ADD Residual type.


DSM-III-R is published by the APA; This addition changes the name of ADD to ADHD (Attention Deficit Hyperactivity Disorder but does not name subtypes


DSM-IV-TR is published by the APA naming 3 types of ADHD, including ADHD-Combined type, ADHD predominantly Inattentive Type, and ADHD Predominantly Hyperactive/Impulsive Type.

Inattention At The Wrong Time

ADHD Three Sub-Types



Predominantly Hyperactive - Impulsive

  • Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
  • Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.

Predominantly Inattentive

  • The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree
  • Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.

Combined Hyperactive - Impulsive Inattentive

  • Six or more symptoms of inattention AND six or more symptoms of hyperactivity-impulsivity are present
  • Most children have the combined type of ADHD

Negative Comments Impact Self-Esteem

ADHD Predominantly Inattentive Defined

Sometimes abbreviated ADHD-PI, the predominantly inattentive subtype of ADHD in DSM-IV is defined as follows: ...if the individual presents six or more of the following symptoms of inattention for at least six months to a point that is disruptive and inappropriate for their developmental level:

Tasks Are Not Completed

  • Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
  • Often has trouble keeping attention on tasks or play activities.
  • Often does not seem to listen when spoken to directly.
  • Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
  • Often has trouble organizing activities.
  • Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period (such as schoolwork or homework).
  • Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
  • Is often easily distracted.
  • Is often forgetful in daily activities.
  • Often mixes up peoples' names or forgets them for short periods of time.

The ADHD Predominantly Inattentive diagnosis, just like ADHD combined, is contingent upon these symptoms being present in two or more settings and evidence that they are causing clinically significant problems or impairment in social, occupational, or academic functioning. These symptoms must not be attributable or occur during the course of any other developmental of mental disorder.

Daydreaming Instead of Schoolwork

ADHD Predominantly Inattentive differs from the other two subtypes in that you will see less than six of the hyperactive-impulsive symptoms. In fact, often in the ADHD-PI subtype these symptoms may be nearly absent altogether. These children will often fly under the radar - they don't act out, don't appear restless, may even appear to be doing work but yet are not focusing and completing their work. Unrecognized, they are the ones likely to get labels such as: Lazy, not caring, not smart and may receive forms of negative feedback. (e.g. "why don't you get this, everyone else does" , "you're irresponsible", "what, are you just lazy", "you are not even trying", "don't you care about your work", "", "I am sick and tired of you not cleaning up after yourself, that is the 4th time this week this wasn't done."). Symptoms of hyperactivity and impulsiveness are much more noticeable as relating to ADHD Combined which is often seen as disruptive and trouble makers. ADHD-PI children may appear to be getting along with others quite well.

Easily Loses Things

While the person with ADHD-PI realizes at some level that they differ from their friends, family, peers or co-workers, they are not without feelings. Negative feedback over time can create negative self - images that can almost become a self fulfilling prophecy. This can have negative consequences in relationships, succeeding in further education, and even later on succeeding in the workplace. Frustrated and with low self esteem these persons are more likely to develop anxiety and potentially other mood disorders and substance abuse potential.

In Summary...

If you or your child have ADHD Predominantly Inattentive, there is as much hope for that person as any other form of ADHD. The important factor is to have it recognized and discuss appropriate treatment and therapy. One nuance of the ADHD-PI person is that while they have a hard time keeping their minds on most tasks, and getting bored with it soon after starting, when faced with something they really enjoy they sometimes are able to display much less trouble paying attention.

Therapy Teaches Systematic Processes

However, when faced with having to focus on something deliberate, something new, organizing and then completing a task is difficult. Homework, projects, learning a new task or module for work can be extremely hard as there is no immediate enjoyment and they are not able to process the long term benefits of these tasks. Therapy can teach new skills, help create systematic methods for routine tasks all meant to help overcome the negative behaviors resulting from their ADHD-PI.

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