ADHD is a common behavioral disorder that affects an estimated 8 to 10 percent of school-age children, and is being increasingly diagnosed in both children and adults. This disorder is characterized by poor attention skills, impulsive behavior, and, in some cases, hyperactivity. ADHD is believed to be a neurobiological disability, but no single cause has been identified. Research evidence indicates that it is one of the most inheritable disorders of childhood, and many children diagnosed with this disorder have a close family member who also has ADHD.
Most cases of ADHD are diagnosed and treated by pediatricians or primary care physicians, but because there is not yet a test to determine the presence of ADHD, a diagnosis depends on a complete medical and psychological evaluation. Numerous other problems and disorders must be considered and ruled out before a diagnosis of ADHD can be given. It is crucial to distinguish ADHD from other conditions with similar symptoms because their long-term course and treatment may be quite different.
Several of the following conditions often have symptoms similar to those frequently misdiagnosed as ADHD.
A number of inattentive children with hyperactive behavior are actually suffering from a depressive disorder. Unlike depressed adults, who often exhibit symptoms such as motor retardation, many children may experience hyperactivity and insomnia instead.
Anxiety and Stress:
Anxiety or post traumatic stress disorder may present as ADHD in children. Children who live in a stressful home situation or deal with unusual school pressure may show symptoms of ADHD, such as distractibility and inattention. Even levels of mild stress can produce ADHD symptoms, and stimulant medications used to treat ADHD can often make the anxiety more pronounced.
Child Abuse or Neglect:
ADHD symptoms are also seen in some cases in victims of sexual abuse, physical abuse, or neglect. Children may continue to show symptoms that are difficult to distinguish from ADHD even after the abuse or neglect has stopped.
Childhood-Onset Bipolar Disorder:
Bipolar disorder is being more frequently identified and diagnosed in children. The symptoms of ADHD and bipolar can be very similar and often include impulsivity, hyperactivity, inattention, irritability, tantrums, trouble sleeping and difficulty waking in the morning.
Seizures / Epilepsy:
Certain types of seizures can make a child appear to be overactive, quarrelsome, impulsive, or inattentive. A particular type of seizure, called absence seizures or petit mal, can cause a child to lose track of what is going on in the classroom and seem inattentive.
Chronic Ear Infections:
Chronic middle ear infection can cause problems with sleep as well as lead to irritability. Partial hearing loss often caused by these infections often makes a child seem distracted and uncooperative, and may present as problems with inattention if the child is unable to hear well.
Children with various types of learning disabilities often have difficulty staying focused in class. Frustration may lead to uncooperative behavior and hyperactivity in the classroom. Gifted children may also appear to be suffering from ADHD, as boredom in the classroom often shows as inattention and may make it very difficult for the student to remain seated and stay on task.
The most common medical cause of ADHD symptoms is medication used to treat other conditions. Allergy medicines are well known for causing hyperactive behavior in children. Over-the-counter medicines can often have this effect as well.
A child who is overtired much of the time may appear to have ADHD. Lack of sleep often presents as hyperactivity in children, and can lead to distractibility and trouble focusing.
Other medical disorders such as thyroid problems, lead poisoning, sensory integration dysfunction, and Tourette’s syndrome may also produce ADHD like symptoms.
Before a diagnosis of ADHD can be made, a full medical check must be performed and carefully evaluated by someone experienced in diagnosing and treating ADHD. Treating ADHD in children requires medical, educational, behavioral and psychological interventions.