What is Inattention?
The Why
Welcome back to “The Things We Didn’t Get To,” where we slow down and unpack the topics that rarely fit neatly into a standard appointment slot.
How much do you really know about the “inattention” in ADHD? Today, we’re digging into the thick of it with the clinical word inattentive and what it really means in the context of ADHD. This is meant to serve as a quick overview on topics like inattention that we did have time to fully cover in session.
The Info
The DSM-IV in 1994 established a subtype of Attention-Deficit Disorder titled “inattentive subtype.” As ADHD had historically been labeled a disorder of hyperactivity, the inclusion of attentional challenges was a hot take at the time. The diagnostic criteria further evolved into three presentations including Predominantly Inattentive Presentation, Combined presentation, or Predominantly Hyperactive-Impulsive Presentation. I have personally enjoyed my time with clients, presentations and case studies to better understand the Inattentive Presentation as the language of the title itself is quite misleading.
First, I think it’s important to focus on the term “Inattentive.” This label implies that there are broad attentional issues or a lack of attentiveness. In my practice and in my life, I have found the opposite to be true the majority of the time. It is not a presentation of inattention but rather a struggle to attend to the pressing task at hand (usually assigned the priority by someone else’s brain).
Case Consult Below (fictional):
Holland is 13yr who is currently interested in writing her own fantasy novels and spends hours at a time dedicated to writing her chapters. She also has a math test that is due tomorrow so she takes a break from her creations to go stuck for the algebra test. While spending 2 hours attempting math, she has drawn 1 fan pic for her book with equations scribbled around it, reread the math problem 3 times because she forgot what she just read, and then gives up on studying math for the night because she can’t focus. She writes her evening off as entirely unproductive, unfocused and feels shame and embarrassment as she rolls over to go to bed, thinking about the math test she will fail tomorrow. She completed 3 chapters in her novel equating to 8 pages of writing that night and still went to bed feeling bad about her abilities.
In practice, the common sentiment is “well my son can focus so well on legos and video games, so I know he can focus. He just chooses not to.” My response is something to the effect of “Correct. It is a misnomer to call it inattention because folks with ADHD can have very strong attention spans. The challenge and impairment is around regulating attention. ADHD brains are driven by interest (and pressure like tight timelines) and can engage in a state of hyperfocus when “locked in.” Starting mundane tasks, transitioning out of interesting ones and confronting tasks that are too overwhelming are when inattention can arise. So if you hear “Oh she can’t have ADHD, she’s really good at her job” burn those words and celebrate that someone with ADHD has found a job that aligns with how their brain and interests work.
Discussion
Inattention in the context of the ADHD diagnosis is a misnomer; it doesn’t actually represent the attention difficulties that surface in this population. ADHD brains can focus but for short spurts or marathons for hyperfocus interest. ADHD brains are slowed down by the mundane tasks, the tasks their brain has unintentionally deemed nonsignificant or alternatively, too overwhelming to engage with. Some thoughts on how to better approach this (take them or leave them)
For kids & teens, emphasize the areas of studies they are interested in and go full on with that content. For example, if a kid really likes Godzilla, she can learn to read Godzilla, learn spelling and letter sounds through G-o-d-z-i-l-l-a, math by counting the number of spikes on his tail. For areas of struggle, provide steady consistent support largely with presence (body doubling) and combining it with higher reward activities (using squishies, stickers, fancy markers).
For Adults, start your life off right by choosing the things you know you enjoy. This could be choosing a college major that actually interests you over one that may be considered “more competitive." Pair mundane tasks with high rewards like only using Tiktok or social media when doing the weekly laundry.
Ask yourself: Can I not focus right now or do I not like what I’m doing?
Yes we all have to do things we dislike, a whole other post will be dedicated to exploring it. But first, if you are avoiding a task, take a hard look at the why so we can come up with a more effective approach.
ADHD Quick Takeaways
Inattention is the wrong descriptor. People with ADHD can pay attention. The challenge is controlling that attention and focusing it on specific tasks at any given time.
Attention issues often improve when you are doing something you are interested in. That’s not because you suddenly don’t have ADHD. Your brain is wired with a stronger propensity to focus on tasks and topics that interest you in a very intense way sometimes.
Sometimes it can be hard to disconnect when you’re hyperfocused. Again, not inattention but difficulties with attention regulation.
Inattentive Type ADHD comes with a lot of shame and blame, “I focus on the time, why can’t I just do the thing now?”
Disclaimer
This blog is intended for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Please consult with a licensed medical or mental health professional before making any changes to your care, medications, or treatment plan. Every individual’s mental health journey is unique, and personalized guidance is essential.
Terms
DSM-IV – Diagnostic and Statistical Manual of Mental Disorders
ADHD – Attention-Deficit Hyperactivity Disorder
