The developmental functioning, social, and environmental backgrounds of a community-based, epidemiological sample of 7-year-old children with pure inattentive behavior (I-subtype, n=31, 1.3% of sample) were compared to that of children with pure overactive behavior (HI subtype, n=31) ADHD-Combined type (n=31) and a control group at the Maudsley Hospital, London, UK. A 2-item inattention subscale was derived from the Conners’ (1969) questionnaire, namely “Fails to finish things” and “Inattentive, easily distracted.” A cutoff score of 3 or more on these items was employed as the definition of inattentiveness. Other measures included parent and teacher interviews, general psychometric tests, Digit Span subtest of the WISC-R, Continuous performance task, paired-associates learning task, a Matching Familiar Figures Test, and objective measures of attentive behavior.

Inattentive behavior was significantly correlated with low self-esteem and need for repeated instructions in school, lower verbal IQ and general cognitive functioning, poor reading scores, and lower language related skills. Whereas the HI and Combined-ADHD groups showed more conduct and social-interaction problems, these outcomes were not encountered in the inattentive group. The fathers of inattentive children were more likely to have a low occupational status. [1]

COMMENT. In this study conducted only in boys, inattentive behavior is a developmental risk factor for impairment of general cognitive functioning, poor reading and language skills, and a low self-esteem in school. In contrast to boys with hyperactivity and combined ADHD, pure inattentive behavior is not associated with increased susceptibility to conduct problems or disturbed family relationships. Early recognition of ADD-inattentive subtype should allow prompt interventional treatment. Although boys outnumber girls with a 4:1 ratio for ADHD-HI subtype, the sex ratio is lower (2:1) for the ADHD-Inattentive type. Inattentiveness is relatively more prevalent among girls with ADHD, and any sex-related cognitive and social risk factors would be of interest.

Parent-rated psychosocial correlates in preschool ADHD children.

In a study of 25 children with ADHD (21 males, 4 females; mean age 4.8 years), compared to 25 normal controls, at the IWK-Grace Health Centre, Halifax, Canada, parents rated their ADHD children as significantly more aggressive, more demanding, less socially skilled, and less compliant. In contrast, the children perceived themselves as equally competent and as socially accepted as their peers. The parents viewed themselves as less competent parents [2]. Presumably, these children had ADHD-combined type. No distinction of subtypes was made.