Can you have ADHD without being hyperactive?
- Dr Harry Woodward
- Jan 16
- 3 min read
AI generated image
If you picture ADHD as a child bouncing off the walls, interrupting everyone, and wearing their school chair like a hat… you’re not alone.
But here’s the important (and often surprising) truth:
Yes — you absolutely can have ADHD without being hyperactive.
And many children (and adults) do.
In fact, some of the children I meet who are struggling the most are the ones who don’t stand out at all.
Let’s gently unpack what that means — and why it matters so much for families.
ADHD isn’t just about hyperactivity
ADHD stands for Attention Deficit Hyperactivity Disorder, which is a slightly unfortunate name, because it suggests that hyperactivity is always part of the picture.
It isn’t.
ADHD is really about how the brain manages attention, organisation, impulse control, and mental effort — what we often group together as executive function skills.
Hyperactivity is just one possible feature, not a requirement.
According to the NHS, ADHD presents in different ways, depending on the individual child.
The three main types of ADHD
Clinically, ADHD is usually described in three presentations:
1. ADHD – Hyperactive/Impulsive type
This is the version most people recognise:
Constant movement or restlessness
Talking a lot (sometimes all at once)
Acting before thinking
2. ADHD – Inattentive type (often missed)
This is where hyperactivity is minimal or absent, and children may:
Appear quiet, dreamy, or “in their own world”
Struggle to concentrate or follow instructions
Lose things, forget tasks, or seem disorganised
Work very hard but achieve less than expected
This used to be called ADD, a term many parents still use — and honestly, I don’t mind it if it helps the conversation.
3. ADHD – Combined type
A mix of the inattentive and the hyperactive/impulsive traits.
The key point?
Hyperactivity is optional. ADHD is not.
What does ADHD without hyperactivity look like day to day?
Children with inattentive ADHD are often described as:
“Well-behaved but not reaching their potential”
“Bright, but doesn’t apply themselves”
“Anxious or overwhelmed by schoolwork”
“Slow to start tasks and slow to finish them”
They may sit still beautifully — but inside, their mind is racing, drifting, or quietly exhausted.
These children are often overlooked, especially in busy classrooms where louder needs get noticed first.
The CDC highlights that inattentive ADHD is particularly under-recognised, especially in girls.
Is this more common in girls?
Short answer: yes — or at least more commonly missed in girls.
Girls with ADHD are more likely to:
Have inattentive symptoms rather than hyperactive ones
Internalise their struggles (worry, perfectionism, low self-esteem)
Mask difficulties by working extremely hard
This can delay diagnosis until the teenage years — or adulthood.
By then, many have spent years thinking they’re “just bad at coping”, rather than neurodivergent.
ADHD, attention, and executive function
One of the biggest myths about ADHD without hyperactivity is that it’s “just a focus problem”.
In reality, it often affects:
Planning and organisation
Starting tasks (even ones they want to do)
Managing time
Holding information in mind
Regulating effort and motivation
NICE guidance recognises these executive function challenges as a core part of ADHD, regardless of hyperactivity.
When should parents consider an assessment?
It may be worth exploring ADHD if your child:
Is bright but consistently underperforming
Becomes overwhelmed by homework or routines
Needs constant reminders despite trying hard
Struggles with focus but is not disruptive
Has growing anxiety or low confidence linked to school
A thorough assessment looks at how your child thinks, learns, and copes — not just how active they are.
A final reassuring thought
ADHD without hyperactivity is real, valid, and common.
It doesn’t mean your child is lazy, unmotivated, or “not trying hard enough”.
It means their brain processes attention and effort differently — and with the right understanding and support, they can thrive.
Quiet struggles deserve just as much attention as noisy ones.
And if this blog has made you think, “Oh… that sounds like my child” — you’re not alone, and you’re not imagining it.
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