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What Else Could It Be Besides ADHD?

Bored young schoolgirl sitting in class

Is your child having difficulties in school? Have you wondered whether it might be ADHD? Perhaps your child’s school psychologist, doctor, therapist, or neuropsych evaluator has diagnosed your child with this disorder.

According to a Centers for Disease Control and Prevention (CDC) study, the percentage of children with an ADHD (Attention-Deficit/Hyperactivity Disorder) diagnosis continues to increase. It is an issue that requires our attention, and now.

ADHD is a diagnosis that is frequently given to children who are struggling in school. Whether your child has some of the symptoms that we associate with this disorder, or whether you accept or dismiss this diagnosis, I urge parents and clinicians to continue to open the door to additional possibilities, rather than have any diagnosis, ADHD or otherwise, close doors to further inquiry.

As both a clinician and mother, I’ve observed and assessed children in the clinical setting, at home, and at school. I can attest to the fact that children can behave very differently given their circumstances. I’ve seen children’s behavior influenced by various factors on any given day.

Medical and mental health professionals can arrive at diagnoses in many ways. The clinician will usually use a combination of observation and a questionnaire, and sometimes a test for the child to take. The DSM 5 (the manual used to diagnose mental health issues) states that a child must exhibit, “in most situations,” at least six symptoms from either (or both) of the following lists in order for an ADHD diagnosis to be made:

List One

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or during other activities.
  • Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
  • Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
  • Often does not follow through on instructions and fails to finish school work, chores, or duties.
  • Often has difficulty organizing tasks and activities (difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
  • Often avoids or is reluctant to engage in tasks that require sustained mental effort (e.g. schoolwork or homework.)
  • Often loses things necessary for tasks or activities (e.g., doesn’t come home from school with his jacket.)
  • Is often easily distracted by extraneous stimuli.
  • Is often forgetful in daily activities.

List Two

  • Often fidgets with or taps hands or squirms in seat.
  • Often leaves seat in situations when remaining seated is expected.
  • Often runs about or climbs in situations where it is inappropriate.
  • Often unable to play or engage in leisure activities quietly.
  • Often “on the go” acting as if “driven by a motor.”
  • Often talks excessively.
  • Often blurts out answers before questions have been completed.
  • Often has difficulty awaiting turn.
  • Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities. May start using other people’s things without getting permission).

You may know some children who have at least six of these behaviors. Perhaps they indeed have ADHD, but perhaps not.

Some examples of issues that have similar symptoms to ADHD are:

Auditory Sensitivities

Auditorily-sensitive children may act differently in a noisy restaurant or classroom. They suddenly cannot sit still, are jumpy, or may start climbing on things. Just a few moments earlier, when they were outside, they were fine. Sometimes the classroom may change – construction might’ve begun outside the window, or new, louder students joined the group. Imagine trying to concentrate on something while someone is playing a tambourine in your ear. A child with sensitivities can experience what we perceive as moderate sounds in this way.

Some auditorily-sensitive children may get more fidgety or fearful when in a car or plane. Their symptoms could be that they suddenly “talk excessively” and “butt in on” a conversation. The underlying cause could be a sensitivity to movement combined with auditory issues. This is called vestibular hypoacusis and is often overlooked.

Visual Sensitivities

Have you ever felt kind of “off” walking through a brightly-lit grocery store? Or noticed a…

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