A Unique ADD Subgroup
Robert D. Smith,PhD
Sluggish Cognitive Tempo (SCT) is an unofficial descriptive term, which identifies a unique subgroup within the
officially recognized diagnosis of ADHD Predominantly Inattentive Type. It has been estimated that the SCT group
makes up 30-50% of the ADHD-PI population.
Instead of being hyperactive and extroverted the SCT group are passive, daydreamy and shy. They are “sluggish” and
"in a fog". They appear to lack motivation. Those with SCT have difficulty with verbal retrieval from long term
memory. They have deficits in working memory which has been described as the ability to keep multiple things in mind
for manipulation, while simultaneously keeping this information free from internal distraction. Consequently, mental skills
such as calculation, reading, and abstract reasoning are often more challenging for those with SCT. They also have a
more disorganized thought process, a greater degree of sloppiness, and lose things more easily.
Diagnosis
Since the symptoms of SCT are not recognized in any standard medical manuals, they receive an ADHD/PI diagnosis.
Sluggishness, drowsiness, and daydreaming were the characteristics originaly listed in early versions of the DSM. These
criteria were eliminated because of of erroneous preconceptions about the nature of ADHD and are now under revision
for the next version of the Diagnostic and Statistical Manual.
Prognosis
They tend to have a greater degree of learning disabilities, such as dyslexia. Instead of having greater difficulty selecting
and filtering sensory input, as is in the case of SCT, people with other types of ADHD have problems with inhibition.
Treatment
Ritalin is often still the first treatment tried, but medications such as Adderall are often more effective. However,
cognitive attention training is an effective alternative to those who do not respond to or cannot tolerate the side effects of
medication
Robert D. Smith,PhD
Sluggish Cognitive Tempo (SCT) is an unofficial descriptive term, which identifies a unique subgroup within the
officially recognized diagnosis of ADHD Predominantly Inattentive Type. It has been estimated that the SCT group
makes up 30-50% of the ADHD-PI population.
Instead of being hyperactive and extroverted the SCT group are passive, daydreamy and shy. They are “sluggish” and
"in a fog". They appear to lack motivation. Those with SCT have difficulty with verbal retrieval from long term
memory. They have deficits in working memory which has been described as the ability to keep multiple things in mind
for manipulation, while simultaneously keeping this information free from internal distraction. Consequently, mental skills
such as calculation, reading, and abstract reasoning are often more challenging for those with SCT. They also have a
more disorganized thought process, a greater degree of sloppiness, and lose things more easily.
Diagnosis
Since the symptoms of SCT are not recognized in any standard medical manuals, they receive an ADHD/PI diagnosis.
Sluggishness, drowsiness, and daydreaming were the characteristics originaly listed in early versions of the DSM. These
criteria were eliminated because of of erroneous preconceptions about the nature of ADHD and are now under revision
for the next version of the Diagnostic and Statistical Manual.
Prognosis
They tend to have a greater degree of learning disabilities, such as dyslexia. Instead of having greater difficulty selecting
and filtering sensory input, as is in the case of SCT, people with other types of ADHD have problems with inhibition.
Treatment
Ritalin is often still the first treatment tried, but medications such as Adderall are often more effective. However,
cognitive attention training is an effective alternative to those who do not respond to or cannot tolerate the side effects of
medication
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