Primary inattention tends to appear when the ADD child is involved in tasks that require continuous performance, vigilance and rapid reaction time, visual and perceptual search, systematic and sustained listening, and undivided attention. Inattention and impulsivity restrict development of academic skills, thinking and reasoning strategies, motivation for school, and adjustment to social demands. Children with hyperactivity often were described as hyperexcitable and were difficult to manage as toddlers and preschoolers. In school these signs persist. Difficulty with tasks such as copying and printing may become apparent.
Careless errors are frequent.
They often seem to lack intrinsic motivation and do not consider long-term consequences of their behavior. In general, school-aged children with ADD are a more homogeneous group than those referred before age 6 yr. Many ADD signs expressed during the preschool years indicate communication disorders, anxiety, and conduct disorders. Commonly, they are not aggressive or oppositional but often become noncompliant or defiant. Academic difficulties often do not begin until middle school years, and bright children with primary inattention can often compensate.