Is ADHD a spectrum disorder?

ADHD is a disorder that presents differently in everyone. While the core symptoms of inattention, hyperactivity, and impulsivity are present, they manifest in varying degrees. The DSM-5 recognizes three subtypes of ADHD: predominantly hyperactive-impulsive presentation, predominantly inattentive presentation, and combined presentation. Each of these subtypes can be further classified as mild, moderate, or severe impairment.

So, is there an ADHD spectrum?

Some scientists believe that ADHD is far more nuanced and that some people with ADHD can experience a broad range of symptoms for different subtypes at the same time.[i]

For decades, the Drake Institute has used advanced treatment technologies to create customized treatment protocols for patients with ADHD, autism, and other brain-based conditions. We use brain map-guided neurofeedback and neurostimulation to help our ADHD patients reduce their symptoms and lead better lives.

For more information about how the Drake Institute treats ADHD and several other brain-based conditions, please fill out the consultation form or call us at 800-700-4233.

What is ADHD?

ADHD (Attention Deficit-Hyperactivity Disorder) is a neurodevelopmental disorder that can impact attention, impulsivity, and hyperactivity in both children and adults. Depending on the severity, symptoms can lead to problems at work, in school, or socially.

It often appears to others that individuals with ADHD are lazy or aren’t trying hard enough to pay attention or sit still. Individuals with ADHD can be mischaracterized as being willfully lazy and underachieving. However, these difficulties arise from brain dysregulation. These individuals don’t have optimal neurophysiologic functioning to manifest successful life experiences.

ADHD is most likely caused by a combination of genetic and environmental factors.[ii] Some possible causes include brain injury, complications during labor and delivery, premature birth, low birth weight, alcohol and tobacco exposure during pregnancy, and exposure to toxins.[iii]

ADHD isn’t diagnosed by blood or laboratory tests, but by a history of symptoms causing significant impairment in at least two settings of the person’s life[iv]. The Drake Institute goes further by identifying brain dysregulation linked to ADHD symptoms through Quantitative EEG Brain Mapping.

What are the subtypes of ADHD?

The individual’s ADHD subtype is determined by which set of symptoms are present[v]. Individuals with ADHD inattentive presentation only have attentional symptoms.  Individuals with hyperactive impulsive presentation only have symptoms of hyperactivity and impulsivity. Individuals with combined presentation have the symptoms of hyperactivity and impulsivity, and inattention symptoms:

Predominantly inattentive presentation

Those with inattentive presentation have symptoms related to sustaining attention or focus in various settings. These individuals may make careless mistakes, frequently lose things, or be easily distracted by external stimuli or distracting irrelevant thoughts.

Predominantly hyperactive-impulsive presentation

Predominantly hyperactive-impulsive presentation has symptoms surrounding impulsive behavior. These individuals may constantly fidget or tap their hands or feet. They may be seen as “always on the go” or unable to remain still for extended periods. Interrupting others and talking excessively can also be hallmarks of this subtype of ADHD.

Combined presentation

The combined presentation subtype of ADHD is represented by a combination of all three core symptoms, including hyperactivity, impulsivity, and inattention.[vi] It obviously can cause the most disruption in one’s life, and can also be the most challenging subtype to treat. If left untreated, this subtype can lead to other comorbid conditions such as Oppositional Defiant Disorder and possibly Mood Disorders.

ADHD severity levels

All ADHD subtypes may present in different levels of severity. These levels are described as mild, moderate, and severe. The severity levels designate how much impairment the symptoms cause in typical school, work, or social settings, and also how much additional support the patient may require along with treating their ADHD core symptoms. The level of a person’s ADHD severity may change over time.


A mild severity of ADHD symptoms means that there is only a milder impairment in different settings, and it’s relatively less disruptive to the individual’s development.


Symptoms of functional impairment fall somewhere between mild and severe. A child with moderate ADHD will likely require more intervention and/or accommodation than individuals with mild ADHD.


A severe level of ADHD symptoms can cause significant impairment in multiple settings and require more comprehensive interventions.

Is there an ADHD spectrum?

If there are different subtypes and severity, is ADHD a spectrum disorder like autism?

Not all ADHD individuals experience the disorder the same way - even if their symptoms fall into the same subtype or severity level. Every ADHD experience will be somewhat unique. Because of this wide variety in severity of ADHD presentation, some medical professionals believe that ADHD does exist on a spectrum. However, the ADHD spectrum isn’t yet fully established.

At the Drake Institute, we feel that looking at the spectrum of severity of ADHD symptoms is very helpful in designing and implementing our successful treatment program. This is why the Drake Institute develops customized treatment protocols for each patient based on brain functioning, symptoms, and comorbid conditions.

Is ADHD on the autism spectrum?

While ADHD and autism spectrum disorder share some characteristics, and while there may be an ADHD spectrum, they are two distinct disorders. Most children we have helped with ASD also have symptoms of ADHD. We typically treat the emotional dysregulation first because by helping the child emotionally stabilize, their quality of life can improve rather quickly and it facilitates being able to help other symptoms.

Both ADHD and ASD can involve difficulties with social interaction, but these difficulties manifest differently. In ADHD, social challenges often stem from impulsivity, leading to impaired social interactions. Children with ASD can also have impaired social interactions from impulsivity, but in addition, may struggle significantly with social cues, nonverbal communication, understanding social norms, and misreading the intentions of others.

With ADHD impulsivity, the child with feedback from the parent may understand after the fact that they did something impulsively inappropriately, they just were unable to filter and inhibit the impulse. In contrast, with ASD, the child will may not understand the inappropriateness of what they did impulsively due to their lack of understanding of social context.

So, is ADHD on the autism spectrum? No. Autism and ADHD are different neurodevelopmental disorders with different diagnostic criteria, but they frequently run together.[vii]

How the Drake Institute Treats ADHD

Over the last 40 years, the Drake Institute has clinically pioneered the use of advanced treatment technologies to treat a variety of brain-based medical disorders such as ADHD, Autism Spectrum Disorder, PTSD, anxiety, panic disorder, depression, insomnia, and more. Using a combination of brain map-guided neurofeedback and sometimes neurostimulation, our Medical Director creates customized treatment protocols to address each patient's needs.

Brain Mapping

To develop our individualized treatment plans, we first complete a qEEG brain map analysis for each patient. Brain mapping helps us identify which specific regions or networks of the brain are dysregulated and linked to symptoms.

To collect this data, 19 sensors are placed around the scalp in areas of the brain responsible for language, focus, memory, executive functioning, social/emotional understanding and behavioral/emotional regulation. The 19 sensors measure and record brainwave activity that is processed through a normative database of neurotypical individuals.

When we compare the patient's results with those of neurotypical individuals, we can identify regions or networks of the brain that are dysregulated and causing symptoms. This information also allows us to determine how these areas are dysregulated so that we can develop specific treatment protocols that help improve brain functioning and reduce symptoms.


During neurofeedback training/treatment, sensors are once again placed on the scalp. The sensors record and display instantaneous brainwave activity visually in real-time on a computer screen with simultaneous auditory feedback as well.

During neurofeedback sessions, the patient is seeing the results of how their brain is working and with this information, they learn to improve their brainwave activity by guiding it toward healthier, more appropriately functional brainwave patterns.

We do not administer any drugs or perform invasive procedures during this process. Instead, the patient is improving their own brain functioning, guided by visual and auditory feedback.


As an adjunct to neurofeedback, we may also use neurostimulation guided by qEEG brain map findings to gently stimulate the brain into healthier functional patterns. In our experience, some patients may benefit even more from neurofeedback if we also use neurostimulation. We have found this particularly helpful for lower-functioning children on the Autism Spectrum.

Contact The Drake Institute Today!

In the last forty years, Drake has helped thousands of patients with various disorders such as autism, ADHD, PTSD, anxiety, panic disorder, depression, insomnia, migraine headaches, irritable bowel syndrome, and hypertension reduce or resolve their symptoms and thereby achieve a better quality of life. Call us at 1-800-700-4233 or fill out the free consultation form to get started.









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“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Neurophysical Medicine and received his initial training in biofeedback/neurofeedback in Neurophysical Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Neurophysical Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Neurophysical Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”

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