Robert D. Smith, PhD Testing & Treatment for Children & Adults  © Robert D. Smith, PhD Made with Xara Dyslexia, ADHD, Learning Disabilities, Therapy 35 years experience serving mid-Michigan 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 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 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