the   next   version   of   the   Diagnostic   and   Statistical   Manual.      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.   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 Attention Deficit Disorder Otherwise Known as Attention Deficit Hyperactivity Disorder, Predominanlty Inattentive Type   From Wikipedia, the free encyclopedia Attention   deficit   disorder   (ADD)   is   one   of   the   three   subtypes   of   attention-deficit   hyperactivity   disorder   (ADHD).   The   term   was formally   changed   in   1994   in   the   new   Diagnostic   and   Statistical   Manual   of   Mental   Disorders,   fourth   edition   (DSM-V)   to   "ADHD predominantly   inattentive"   (ADHD-PI   or   ADHD-I),   though   the   term   attention   deficit   disorder   is   still   widely   used.   ADD   is   similar   to the    other    subtypes    of    ADHD    in    that    it    is    characterized    primarily    by    inattention,    easy    distractibility,    disorganization, procrastination,   and   forgetfulness;   where   it   differs   is   in   lethargy   -   fatigue,   and   having   fewer   or   no   symptoms   of   hyperactivity   or impulsiveness   typical   of   the   other   ADHD   subtypes.   Different   countries   have   used   different   ways   of   diagnosing   ADD.   In   the   United Kingdom,   diagnosis   is   based   on   quite   a   narrow   set   of   symptoms,   and   about   0.5–1%   of   children   are   thought   to   have   attention   or hyperactivity   problems.   The   United   States   used   a   much   broader   definition   of   the   term   ADHD.   As   a   result,   up   to   10%   of   children   in the   U.S.   were   described   as   having   ADHD.   Current   estimates   suggest   that   ADHD   is   present   throughout   the   world   in   about   1–5%   of the   population.   About   five   times   more   boys   than   girls   are   diagnosed   with   ADHD.   Medications   include   two   classes   of   drugs, stimulants   and   non-stimulants.   Drugs   for   ADHD   are   divided   into   first-line   medications   and   second-line   medications.   First-line medications   include   several   of   the   stimulants,   and   tend   to   have   a   higher   response   rate   and   effect   size   than   second-line medications.   Although   medication   can   help   improve   concentration,   it   does   not   cure   ADHD   and   the   symptoms   will   come   back once the medication stops. Differences from other ADHD subtypes ADHD-I   is   similar   to   the   other   subtypes   of   ADHD   in   that   it   is   characterized   primarily   by   inattention,   easy   distractibility, disorganization,   procrastination,   and   forgetfulness;   where   it   differs   is   in   lethargy   -   fatigue,   and   having   fewer   or   no   symptoms   of hyperactivity   or   impulsiveness   typical   of   the   other   ADHD   subtypes.[1]   In   some   cases,   children   who   enjoy   learning   may   develop   a sense   of   fear   when   faced   with   structured   or   planned   work,   especially   long   or   group-based   that   requires   extended   focus,   even   if they   thoroughly   understand   the   topic.   Children   with   ADD   may   be   at   greater   risk   of   academic   failures   and   early   withdrawal   from school.[2]   Teachers   and   parents   may   make   incorrect   assumptions   about   the   behaviours   and   attitudes   of   a   child   with   ADD,   and may   provide   them   with   frequent   and   erroneous   negative   feedback   (e.g.   "you're   irresponsible",   "you're   immature",   "you're   lazy", "you don't care/show any effort", "you just aren't trying", etc.).[3] The   inattentive   children   may   realize   on   some   level   that   they   are   somehow   different   internally   from   their   peers.   However,   they   are also   likely   to   accept   and   internalize   the   continuous   negative   feedback,   creating   a   negative   self-image   that   becomes   self- reinforcing.   If   these   children   progress   into   adulthood   undiagnosed   or   untreated,   their   inattentiveness,   ongoing   frustrations,   and poor    self-image    frequently    create    numerous    and    severe    problems    maintaining    healthy    relationships,    succeeding    in postsecondary   schooling,   or   succeeding   in   the   workplace.   These   problems   can   compound   frustrations   and   low   self-esteem,   and will   often   lead   to   the   development   of   secondary   pathologies   including   anxiety   disorders,   sexual   promiscuity,   mood   disorders, and substance abuse.[2] It   has   been   suggested   [1]   that   some   of   the   symptoms   of   ADHD   present   in   childhood   appear   to   be   less   overt   in   adulthood.   This   is likely   due   to   an   adult's   ability   to   make   cognitive   adjustments   and   develop   coping   skills   minimizing   the   frequency   of   inattentive or   hyperactive   behaviors.   However,   the   core   problems   of   ADHD   do   not   disappear   with   age.[2]   Some   researchers   have   suggested that   individuals   with   reduced   or   less   overt   hyperactivity   symptoms   should   receive   the   ADHD-combined   diagnosis.   Hallowell   and Ratey   (2005)   suggest[4]   that   the   manifestation   of   hyperactivity   simply   changes   with   adolescence   and   adulthood,   becoming   a more generalized restlessness or tendency to fidget. In   the   DSM-III,   sluggishness,   drowsiness,   and   daydreaming   were   listed   as   characteristics   of   ADD   without   hyperactivity.   The symptoms   were   removed   from   the   ADHD   criteria   in   DSM-V   because,   although   those   with   ADHD   were   found   to   have   these symptoms,   this   only   occurred   with   the   absence   of   hyperactive   symptoms.   These   distinct   symptoms   were   described   as   sluggish cognitive tempo (SCT). A   meta-analysis   of   37   studies   on   cognitive   differences   between   those   with   ADHD-Inattentive   type   and   ADHD-Combined   type found   that   "the   ADHD/C   subtype   performed   better   than   the   ADHD/I   subtype   in   the   areas   of   processing   speed,   attention, performance   IQ,   memory,   and   fluency.   The   ADHD/I   subtype   performed   better   than   the   ADHD/C   group   on   measures   of   flexibility, working   memory,   visual/spatial   ability,   motor   ability,   and   language.   Both   the   ADHD/C   and   ADHD/I   groups   were   found   to perform   more   poorly   than   the   control   group   on   measures   of   inhibition,   however,   there   was   no   difference   found   between   the   two groups. Furthermore the ADHD/C and ADHD/I subtypes did not differ on measures of sustained attention." [5] Some   experts,   such   as   Dr.   Russell   Barkley,   have   argued   that   ADD   is   so   different   from   ADHD   that   it   should   be   regarded   as   a distinct   disorder.[6][7]   However,   Barkley   currently   maintains   that   the   "other   attention   disorder"   is   sluggish   cognitive   tempo   (SCT), that   there   are   no   meaningful   "subtypes"   of   ADHD,   and   that   the   term   ADD   should   no   longer   be   used   to   avoid   confusion.[8]   ADD   is noted   for   the   almost   complete   lack   of   conduct   disorders   and   high-risk,   thrill-seeking   behavior,   and   additionally   have   higher rates of anxiety.[5][9][10] Further research needs to be done to discover differences among those with attention disorders.[6] [edit]Symptoms DSM-V criteria The   DSM-V   allows   for   diagnosis   of   the   predominantly   inattentive   subtype   of   ADHD   (under   code   314.00)   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 developmental level: 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.[11] An   ADD   diagnosis   is   contingent   upon   the   symptoms   of   impairment   presenting   themselves   in   two   or   more   settings   (e.g.,   at school   or   work   and   at   home).   There   must   also   be   clear   evidence   of   clinically   significant   impairment   in   social,   academic,   or occupational   functioning.   Lastly,   the   symptoms   must   not   occur   exclusively   during   the   course   of   a   pervasive   developmental disorder,   schizophrenia,   or   other   psychotic   disorder,   and   are   not   better   accounted   for   by   another   mental   disorder   (e.g.,   mood disorder, anxiety disorder, dissociative disorder, personality disorder). Examples of observed symptoms Life Period Example Children[12] Failing to pay close attention to details or making careless mistakes when doing school-work or other activities Trouble keeping attention focused during play or tasks Appearing not to listen when spoken to (often being accused of "daydreaming") Failing to follow instructions or finish tasks Avoiding tasks that require a high amount of mental effort and organization, such as school projects Frequently losing items required to facilitate tasks or activities, such as school supplies Excessive distractibility Forgetfulness Procrastination, inability to begin an activity Adults[13] Often making careless mistakes when having to work on uninteresting or difficult projects Often having difficulty keeping attention during work, or holding down a job for a significant amount of time Often having difficulty concentrating on conversations Having trouble finishing projects that have already been started Often having difficulty organizing for the completion of tasks Avoiding or delaying in starting projects that require a lot of thought Often misplacing or having difficulty finding things at home or at work Disorganized personal items (sometimes old and useless to the individual) causing excessive "clutter" (in the home, car, etc.) Often distracted by activity or noise Often having problems remembering appointments or obligations, or inconveniently changing plans on a regular basis [edit]Prevalence in children It   is   difficult   to   say   exactly   how   many   children   worldwide   have   ADHD   because   different   countries   have   used   different   ways   of diagnosing   it,   while   some   do   not   diagnose   it   at   all.   In   the   UK,   diagnosis   is   based   on   quite   a   narrow   set   of   symptoms,   and   about 0.5–1%   of   children   are   thought   to   have   attention   or   hyperactivity   problems.   In   comparison,   until   recently,   professionals   in   the U.S.   used   a   much   broader   definition   of   the   term   ADHD.   As   a   result,   up   to   10%   of   children   in   the   U.S.   were   described   as   having ADHD.   Current   estimates   suggest   that   ADHD   is   present   throughout   the   world   in   about   1–5%   of   the   population.   About   five   times more   boys   than   girls   are   diagnosed   with   ADHD.   This   may   be   partly   because   of   the   particular   ways   they   express   their   difficulties. Boys   and   girls   both   have   attention   problems,   but   boys   are   more   likely   to   be   overactive   and   difficult   to   manage.   Children   from   all cultures   and   social   groups   are   diagnosed   with   ADHD.   However,   children   from   certain   backgrounds   may   be   particularly   likely   to be   diagnosed   with   ADHD,   because   of   different   expectations   about   how   they   should   behave.   It   is   therefore   important   to   ensure that a child's cultural background is understood and taken into account as part of the assessment. [14] Treatment Recent   studies   indicate   that   medications   approved   by   the   U.S.   Food   and   Drug   Administration   (FDA)   in   the   treatment   of   ADHD tend   to   work   well   in   individuals   with   the   predominantly   inattentive   type.   These   medications   include   two   classes   of   drugs, stimulants   and   non-stimulants.   Drugs   for   ADHD   are   divided   into   first-line   medications   and   second-line   medications.   First-line medications   include   several   of   the   stimulants,   and   tend   to   have   a   higher   response   rate   and   effect   size   than   second-line medications.[15]   Some   of   the   most   common   stimulants   are   Methylphenidate   (Ritalin,   Concerta),   Adderall   and   Vyvanse.   Second- line   medications   are   usually   anti-depressant   medications   such   as   Zoloft,   Prozac,   and   Wellbutrin.   These   medications   can   help with   fidgeting,   inattentiveness,   irritability,   and   trouble   sleeping.   Some   of   the   symptoms   the   medications   target   are   also   found with ADD patients.[16] Although   ADHD   has   most   often   been   treated   with   medication   there   are   questions   as   to   the   efficacy   of   these   medications. Medications   do   not   cure   ADHD   they   are   used   solely   to   treat   the   symptoms   associated   with   this   disorder.[17]   The   symptoms   will come back once the medication stops. Also, medication works better for some patients while it barely works for others.[18] Many   studies   have   shown   the   use   of   psychostimulants   to   be   an   effective   treatment   for   ADHD,   as   well   as   ADD,   however   these studies   have   shown   a   number   of   methodological   flaws.   Firstly   they   measure   behaviour   changes   from   the   perspective   of   the parents,   or   teachers   involved   and   assume   that   this   change   in   behaviour   is   helping   the   child   without   ever   consulting   with   the child.[19]   This   has   led   to   a   questioning   of   who   the   medication   is   actually   helping,   and   if   the   medication   is   being   used   simply   to eliminate   unwanted   childhood   behaviours   rather   than   to   actually   help   the   child.   Although   most   studies   focus   on   children   with ADHD   the   side   effects   and   potential   misuse   of   stimulant   medications   is   identical   for   ADHD   as   many   of   the   same   medications   are used (e.g. ritalin). These   studies   have   often   failed   to   look   at   long-term   efficacy   and   side   effects.   The   psychostimulants   used   to   treat   ADHD normally   start   to   lose   efficacy   after   a   very   short   period   (often   less   than   six   weeks,[19]   and   as   this   efficacy   decreases   the   dosage given   to   the   child   must   be   increased,   leading   to   a   continuous   cycle   of   more   and   more   medication.   These   medications   do   work very   quickly   once   administered   and   so   may   affect   behaviour   almost   immediately,   although   this   has   again   led   to   the   idea   that   the medication may be getting used as a way to remove unwanted behaviours in a short-term situation. Some   have   expressed   concerns   that   educators   may   place   undue   pressure   on   students   and   their   parents   to   use   stimulant medication.[20] Along    with    medication,    behavioral    therapy    is    recommended    to    improve    organizational    skills,    study    techniques    or    social functioning.[citation needed] Research A   study   at   the   Mount   Sinai   AD/HD   Center,   supported   by   grants   from   the   National   Institutes   of   Health   (NIH),   will   examine   the   use of functional Magnetic Resonance Imaging in identifying unique patterns of brain activation in children with ADD.[21] [edit]Strategies for parents of afflicted children Parents   are   recommended   to   learn   about   this   disorder   in   order   to   first   be   able   to   help   themselves   and   then   their   children. Behavioral   strategies   are   of   great   help   and   they   include   creating   routines,   getting   organized,   avoiding   distractions,   limiting choices, using goals and rewards, ignoring behaviors.[22] Children   with   ADHD   can   be   extremely   disorganized.   Parents   should   work   with   them   to   find   specific   places   for   everything   and teach   kids   to   use   calendars   and   schedules.   Parents   are   advised   to   get   children   into   sports   to   help   them   build   discipline, confidence,   and   improve   their   social   skills.   Physical   activity   boosts   the   brain’s   dopamine,   norepinephrine,   and   serotonin   levels and   all   these   neurotransmitters   affect   focus   and   attention.   Some   sports   may   be   too   challenging   and   would   add   frustration. Parents   should   talk   with   their   children   about   what   activities   and   exercises   most   stimulate   and   satisfy   them   before   signing   them up for classes or sports.[23] It   is   important   to   establish   close   communication   with   the   school[24]   in   order   to   develop   an   educational   plan   to   address   the child’s   needs.   Accommodations   in   school,   such   as   extended   time   for   tests   or   more   frequent   feedback   from   teachers,   are beneficial for these individuals.[25] 1   a   b   Quinn,   Patricia   (1994).   ADD   and   the   College   Student:   A   Guide   for   High   School   and   College   Students   with   Attention   Deficit Disorder. New York, NY: Magination Press. pp. 2–3. ISBN 1-55798-663-0. 2   a   b   c   Triolo,   Santo   (1998).   Attention   Deficit   Hyperactivity   Disorder   in   the   hood:   A   Practitioner's   Handbook.   Philadelphia,   PA: Brunner-Routledge. pp. 65–69. ISBN 0-87630-890-6. 3   Kelly,   Kate;   Peggy   Ramundo   (2006).   You   Mean   I'm   Not   Lazy,   Stupid   or   Crazy?!   The   Classic   Self-Help   Book   For   Adults   with Attention Deficit Disorder. New York, NY: Scribner. pp. 11–12. ISBN 0-7432-6448-7. 4   Hallowell,   Edward   M.;   John   J.   Ratey   (2005).   Delivered   from   Distraction:   Getting   the   Most   out   of   Life   with   Attention   Deficit Disorder. New York: Ballantine Books. pp. 253–5. ISBN 0-345-44231-8. 5   a   b   Lane,   B.   (2004).   The   differential   neuropsychological/cognitive   profiles   of   ADHD   subtypes:   A   meta-analysis.   Dissertation Abstracts International, 64, Retrieved from PsycINFO database. 6   a   b   Barkley,   Russell   A.   (2001).   "The   Inattentive   Type   of   ADHD   As   a   Distinct   Disorder:   What   Remains   To   Be   Done".   Clinical Psychology: Science and Practice 8 (4): 489–501. doi:10.1093/clipsy/8.4.489. 7   Milich,   Richard;   Balentine,   Amy   C.,   Lynam,   Donald   R..   "ADHD   Combined   Type   and   ADHD   Predominantly   Inattentive   Type   Are Distinct and Unrelated Disorders". Clinical Psychology: Science and Practice 8 (4): 463–488. doi:10.1093/clipsy/8.4.463. 8   Barkley,   R.   A.   (2012).   Distinguishing   sluggish   cognitive   tempo   from   attention-deficit/hyperactivity   disorder   in   adults.   Journal of Abnormal Psychology, 121(4), 978–990. doi:10.1037/a0023961 9   Murphy,   K.,   Barkley,   R.,   &   Bush,   T.   (2002).   Young   adults   with   attention   deficit   hyperactivity   disorder:   subtype   differences   in comorbidity,   educational,   and   clinical   history.   The   Journal   Of   Nervous   And   Mental   Disease,   190(3),   147-157.   Retrieved   from MEDLINE database. 10   Bauermeister,   J.,   Matos,   M.,   Reina,   G.,   Salas,   C.,   Martínez,   J.,   Cumba,   E.,   et   al.   (2005).   Comparison   of   the   DSM-V   combined and    inattentive    types    of    ADHD    in    a    school-based    sample    of    Latino/Hispanic    children.    Journal    Of    Child    Psychology    And Psychiatry, And Allied Disciplines, 46(2), 166-179. Retrieved from MEDLINE database. 11http://behavenet.com/attention-deficithyperactivity-disorder reference for all nine symptoms as described 4 nov. 2012 12What we know National Resource Centre on AD/HD 13WHO adult AD/HD inattentive symptoms [1] National Resource Center on ADHD 14"What is ADD". Retrieved 2011-01-10. 15"ADHD treament can take on a range of types and methods.". Retrieved 2010-04-08. 16Pharmaceutical treatments for ADHD-Medications. Retrieved 2011-04-09 17"Attention deficit hyperactivity disorder". National Institute of Mental health. 18"Are ADHD Drugs Right for You or Your Child?". Archived from the original on 11 April 2010. Retrieved 2010-04-08. 19a   b   Visser,   john;   Jehan   (June   2009).   "ADHD:   a   scientific   fact   or   a   factual   opinion?   A   critique   of   the   veracity   of   attention   deficit hyperactivity disorder". Emotional and behavioural difficulties 14: 127–140. 20Davis, Rowenna. "Are drugs the solution to the problem of ADHD among young people". 21"Inattentive AD/HD: Overlooked and Undertreated?". Retrieved 2010-04-08. 22"ADHD Fact Sheet". Archived from the original on 17 April 2010. Retrieved 2010-04-08. 23"The Best Summer Sports for ADHD Kids". Archived from the original on 20 April 2010. Retrieved 2010-04-08. 24"Ten Tips for the Parents of an ADHD Inattentive Child". Archived from the original on 12 April 2010. Retrieved 2010-04-08. 25 "AD/HD Predominantly Inattentive Type (WWK8)". Archived from the original on 6 April 2010. Retrieved 2010-04-08.
The Invisible 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   is   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   easily.      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   originally   listed   in   early   versions   of   the   DSM. These   criteria   were   eliminated   because   of   erroneous   preconceptions   about   the   nature   of   ADHD   and   are   now   under   revision   for
Robert D. Smith, PhD Diagnosis & Treatment for Dyslexia, ADD & Learning Disorders IQ Optimization Children & Adults