How can someone who is good at paying attention to some activities be unable to pay attention to other tasks that they know are important? When I pose this question to patients with ADHD, most say something like: “It’s easy! If it’s something I’m really interested in, I can pay attention.
Others are musicians who push themselves for hours at a time to learn a new song or to compose a new piece of music. Others are childhood engineers, constructing marvels with Lego blocks and, in later years, repairing engines or designing computer networks. Some are artistic, and they sketch intently. Inconsistent InattentionĮveryone I’ve ever evaluated for ADHD has some domains of activity where they can pay attention without difficulty. The term is used to refer to brain circuits that prioritize, integrate, and regulate other cognitive functions. The term refers not to the activities of corporate executives, but to the brain’s cognitive management functions. Increasingly, researchers are recognizing that ADHD symptoms overlap with impairments in what neuropsychologists call executive dysfunction. In recent years, there’s been another major shift in our understanding of ADHD. That change - from an exclusive focus on hyperactivity and impulsive behavior to a focus on inattention as the principal problem of the disorder - was the first major paradigm shift in understanding this syndrome. This discovery paved the way for changing the name of the disorder in 1980 from “hyperkinetic disorder” to “attention deficit disorder” and to recognizing that some children suffer from chronic inattention problems without significant hyperactivity.
In the 1970s, the number of ADHD diagnoses rose when doctors recognized that hyperactive children also had significant problems paying attention to tasks or listening to their teachers. Not much more was known about ADHD or how it affected the brain. For decades, the syndrome now known as attention deficit hyperactivity disorder (ADHD or ADD) was seen simply as a childhood behavior characterized by chronic restlessness, impulsivity, and an inability to sit still.
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