ADHD: Combined Type
With thousands of scientific studies over the past 100 years, combined type is the most common ADHD type—60% of clinical cases—and involves all five of the following ADHD symptoms:
Early onset of the symptoms. Many first show ADHD symptoms in early childhood, from as early as 4 years to half by age 6-7 to nearly all cases by 14-16 years.
Executive function (EF) or self-regulation deficits. Many individuals with ADHD have cognitive problems retaining information that directs behavior toward tasks or goals (working memory), self-motivation and problem-solving. This sign of impaired EF is part of a larger complex of mental faculties that involves coordination of processes—and can contribute to poor self-control and difficulty with future-directed actions.
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- Studies indicate childhood EF predicts academic and occupational functioning, regardless of intelligence and social class.
- A cohort study following 1,000 children from birth to age 32 demonstrated childhood EF predicted physical health, substance dependence, personal finances and criminality.
- Read more about the components of executive function and the underlying theory of mind).
Highly variable or inconsistent performance of tasks over time. In school or work, individuals show wide swings in how much they produce, as well as more variability in quality, correctness and speed. Group settings or repetitive, familiar activities tend to cause the most problems. Individuals do better one to one, particularly with authority figures, or when activities are new, engaging or involve immediate consequences for completing them.
Trouble following directions, instructions or rules. Difficulty following through on instructions or assignments, particularly without supervision. This difficulty is not due to poor comprehension, defiance or memory impairment.
Relatively chronic course. Although symptoms do improve with age, most with ADHD remain behind their age group in ability to sustain attention, inhibit behavior and control activity levels.
Read more about symptoms and CFI’s treatment options for ADHD.