three types of ADHD in teens

Not All ADHD Is The Same: Recognizing The Diversity of Its Three Presentations

ADHD, Kids and Teens

Do you have ADHD? Does your child or teen? What exactly is ADHD anyway?

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed neurodevelopmental conditions, and yet it’s still very misunderstood. This is due in part to the fact that our understanding of neurodiversity is continually evolving. 

If you were introduced to the condition a few decades ago, you might be used to an outdated idea of ADD/ADHD diagnosis – that there is “ADD” with or without the “hyperactivity” part. However, since 2013, we’ve come to understand that the condition isn’t always associated primarily with hyperactivity or difficulty focusing. Instead, we currently use three different presentations to better understand how it manifests in different ways for different people.

Why Recognizing ADHD’s Diversity Matters

Recognizing the diversity within ADHD is critical if we want to:

  • Celebrate the strengths of our kids with ADHD
  • Help them find solutions to the challenging parts of how their brain works
  • Better understand our children (and perhaps ourselves)
  • Decrease stigma and raise ADHD awareness

symptoms of ADHD

What We Call Conditions Matters

The symptoms of ADHD have been recognized by doctors since the 19th century although it’s been called by different names. Why does this matter? Well, the names that we use reflect the way that we understand and treat the conditions we are describing. 

Did you know that it was once called Minimal Brain Dysfunction? Obviously, we no longer believe any of the things that this implies about the ADHD brain. 

More recently, the shift from ADD vs ADHD to the three presentations of ADHD reflects our new understanding that hyperactivity isn’t the only way it presents. This is especially important because it often presents differently in female-identified children than male-identified children and historically females have gone underdiagnosed as a result. By properly identifying the different subtypes, we are able to better understand, and offer tools to, different children.

This evolving understanding has helped shift focus toward the strengths of individuals with ADHD. For instance, many people with ADHD excel in creative, dynamic environments where their energy, adaptability, and problem-solving skills shine. Recognizing these unique traits, instead of focusing solely on challenges, allows individuals to harness their potential. Building self-esteem with that approach also makes children more confident when it does come to navigating the challenges.


A therapist who understands the three presentations of ADHD can empower your child or teen with tools for their challenges and celebrations of their strengths.

Book a therapy appointment in Menlo Park, San Jose, or Palo Alto today.


The Three Presentations of ADHD

Today, we understand ADHD (as the Mayo Clinic puts it) as a chronic condition that “includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.” As aforementioned, there are three presentations (formerly called the three subtypes) of ADHD.

Each has traits common to the type, although you should remember that each person expereiences ADHD differently. Your child might have some, but not all, of the traits of one type. The way those traits manifest will also be affected by their age and developmental stage. If you are an adult with ADHD then you’ve probably seen how the presentation changes as you age and your environment changes. 

children walking to school

Predominantly Inattentive Presentation

Are you constantly wondering why your child is always losing things, like their school books or the keys they just had in their hand? Do you notice that they sit down to do homework but an hour later nothing is done and it seems that they’ve just been daydreaming. This might be a version of Predominantly Inattentive Presentation of ADHD. 

Key Traits of Predominantly Inattentive Presentation

This presentation is often characterized by difficulty staying focused, following through on tasks, and keeping things organized.

  • Appears forgetful, often missing appointments or deadlines
  • Avoids tasks that require sustained mental effort
  • Easily distracted by external stimuli, even during important activities
  • Frequently loses items like homework, keys, or jackets
  • Has trouble following through on instructions or completing tasks
  • Makes careless mistakes in schoolwork or other detailed activities
  • Often daydreams or gets lost in thought
  • Struggles to stay focused during lengthy tasks, even with good intentions
  • Tends to overlook details or forget steps in a process
  • Zoning out during conversations or losing track of what’s being discussed

types of ADHD

Predominantly Hyperactive-Impulsive Presentation

Has your teen’s teacher noticed that they struggle to stay seated during long classes or often interrupt group discussions? Do they tend to take risks impulsively, like driving too fast or making last-minute decisions with friends, without fully thinking them through? These could be signs of the Predominantly Hyperactive-Impulsive Presentation of ADHD.

Key Traits of Predominantly Hyperactive-Impulsive Presentation

This presentation is often marked by high energy levels and impulsive behaviors that can make it hard to wait their turn or stay quiet when it’s needed.

  • Acts impulsively, like climbing or jumping without thinking
  • Blurts out answers or interrupts conversations frequently
  • Difficulty waiting for their turn in games or group activities
  • Frequently fidgets with hands, feet, or squirms in their seat
  • Has trouble staying seated during tasks that require stillness
  • Interrupts others during conversations or activities
  • May talk excessively or in rapid bursts
  • Often rushes through tasks, missing important details
  • Struggles with tasks that require calm focus, like reading or watching a movie
  • Tends to act without considering consequences

what are the types of ADHD

ADHD Combined Presentation

Imagine a child who starts a homework assignment but quickly abandons it to jump up and run around the room. They might return to the task but soon get distracted by something else, like a sound outside or a sudden thought that makes them want to draw instead. Later, they’re back at their homework, but it’s unfinished because they couldn’t sit still or stay focused long enough. If you find yourself looking at the lists above and thinking, “there’s a little of this and a little of that, but my kid doesn’t really fit either category,” then it might be that they have a Combined Presentation of ADHD.

Key Traits of Combined Presentation:

This combination of inattentiveness and hyperactivity can make it challenging to recognize as it blends moments of quiet distraction with bursts of impulsive energy.

  • Alternates between being overly energetic and easily distracted
  • Balances both inattentive and hyperactive behaviors
  • Can forget important tasks like homework
  • Easily distracted but also experiences moments of hyperactivity
  • Frequently begins tasks with enthusiasm but leaves them unfinished
  • Finds it challenging to manage both attention and energy levels
  • Has trouble maintaining focus and sitting still for long periods
  • May act impulsively in some situations but not others
  • May forget details while also talking excessively or interrupting others
  • Often alternates between distraction and restlessness
  • Struggles with both attention and impulse control during tasks

empowered children

Understanding ADHD Empowers Children

Of course, these are just the common traits that we see. Each child is unique, so you might see some of these traits but not others. Figuring it all out can be really overwhelming. That’s why it’s so helpful to have a therapist who can assist you with ADHD diagnosis and help you to understand its presentations.

When we recognize that ADHD looks different for everyone, we can:

  • Adapt learning strategies to fit individual needs
  • Build self-confidence by highlighting strengths
  • Create supportive environments at home and school
  • Encourage self-awareness to help manage challenges
  • Foster success by recognizing different work styles
  • Promote flexible routines that accommodate energy levels
  • Provide personalized treatment plans and coping strategies
  • Reduce stigma by embracing ADHD diversity
  • Support skill-building in areas like organization and time management
  • Tailor communication methods to fit attention styles
  • Understand one another better and enhance overall family happiness

You want to work with a therapist who sees you and your child/ teen as unique individuals while also assisting you in understanding some of the common behaviors that you find frustrating. Many of our therapists in Menlo Park, San Jose and Palo Alto are trained in understanding the three presentations of ADHD.

Learn more about our therapy services.

 

You Might Also Want to Read: