A 7-year-old boy is brought for evaluation of poor academic performance, difficulty sustaining attention during homework, frequently losing belongings, and making careless mistakes. He does not demonstrate hyperactivity. His symptoms have been present since age 4. Which ADHD subtype best describes this presentation?
- A ADHD, predominantly hyperactive-impulsive presentation
- B ADHD, combined presentation
- C Specific learning disorder (dyslexia) — ADHD is excluded by absence of hyperactivity
- D ADHD, predominantly inattentive presentation (formerly ADD) ✓
Explanation
DSM-5 classifies ADHD into three presentations: combined (both inattention ≥6 symptoms AND hyperactivity-impulsivity ≥6 symptoms), predominantly inattentive (inattention ≥6, hyperactivity-impulsivity <6), and predominantly hyperactive-impulsive (reverse). This child demonstrates classic features of inattention without hyperactivity, consistent with predominantly inattentive ADHD. Symptoms must be present in ≥2 settings for ≥6 months before age 12. Specific learning disorder can coexist with ADHD but the core DSM-5 ADHD criteria (inattention symptoms) are clearly met here regardless of hyperactivity.
Reference: Ghai Essential Pediatrics, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.