Yahoo! News recently published an article on misdiagnosis of ADHD in children. The article, written by Jillita Horton, examined other conditions that mimic ADHD. Misdiagnosis of psychological and neuropsycholigical conditions often occurs because of their borderline or overlapping symptoms. Also, psychological and neuropsychological testing by a psychologist who specializes in the testing is often the only way to accurately diagnose these conditions, however, many conditions only require a general physicians diagnosis to begin treatment.
What was most interesting about the Yahoo! article were the listing of many other disorders which could be the culprit, rather than ADHD. These conditions include:
Sleeping disorders such as sleep apnea. According to the article, it has been estimated that 25-30% of children diagnosed with ADHD actually suffer from sleep apnea. Suffering from sleep apnea also causes the classic symptoms of poor concentration, restlessness, distractibility and moodiness. This is caused by interference of oxygen to the brain during sleep. Some medical professionals advise that if your child has been diagnosed with ADHD, have him/her undergo testing for sleep apnea. Polysomnography, or Sleep Study Labs, can be found in most local communities — in Panama City, FL., the Bay Clinic can provide these tests. Ask your family physician for recommendations.
With new technology sleep apnea tests can be conducted by you in your home. However, these tests are not advised for testing children or individuals 65 or over, and the results yeilded are often inconclusive. Also, if your child has been diagnosed and is being treated for ADHD, your diagnosis of sleep apnea through use of one of these home sleep apnea tests does not legally allow you to end your child’s treatment nor does it count as a viable diagnosis. Polysomnography is covered under many insurances. And like any testing, sleep study is best left up to the professionals.
Hearing Impairment. What seems like an inattentive child may actually be simply not hearing. One sign that this may in fact be the culprit is if your child has a history of ear infections or excessive fluid buildup in the ears. Have your child’s hearing checked by an audiologist. There are several audiologists located in the Panama City area.
Posttraumatic stress disorder. Certainly not a pleasant culprit to think about, however, if your child has suffered a recent trauma — or even not so recent — the lingereing effects can mimic ADHD.
Generalized anxiety disorder. Often not thought about, children can — and do — suffer from anxiety just like adults. What may seem like silly childhood drama — we’ve all been told by our own parents that billy joe or sally sue punched us in the gut on the playground in front of the whole school because really they have a crush on us — but that drama may, in fact, be a serious stressor for your child. Like adults, children handle stress in different ways; some children are even prone to or have a naturally anxious disposition. Problems with peers, siblings, parents, teachers, and even the effects of your own relationships with the people in their lives, can all cause anxiety in your child. Speak with professionals; see if there are deeper roots that may be causing your child’s ADHD symptoms before simply accepting the diagnosis.
Depression. Another potential culprit that is unpleasant to consider, but children can also be affected by and/or suffer from depression. Keep in mind, while depression could be a possibility, feeling a little glum is just part of the human condition — one we learn and grow from, therefore should not be stifled no matter how much we want to keep our children from ever feeling pain. Depression is a possibility for the ADHD symptoms that your child is experiencing, but do not be quick to resolve that your child is suffering from depression. Speak with your family physician and other recommended professionals on the matter.
Bipolar disorder. Frightening how these conditions seem to be getting worse? Remember, psychological and neuropsychological conditions often share or mimic some of the same symptoms. It is only fair that we explore all the possibilities, no matter how unpleasant they may seem. Previously referred to as “manic-depression” the highs and lows of this disorder strongly mimic the hyperactivity (highs) and depression (lows) often associated with ADHD. Bipolar disorder is a serious condition, so attention to determining if this is the possible culprit to your child’s ADHD tendencies should be taken.
Learning Disabilities. The term “learning disability” often gets a bad rap because of misunderstanding of the term. While many professionals argue that the term is sort of a mad-hatters catch-all to the various legitimate conditions that exist, it is currently the best term afforded to describe the condition. A learning disability is a condition in which someone has difficulty learning, however, this is NOT due to low I.Q. or below-normal intelligence; rather inability to learn because of low I.Q. or below-normal intelligence is a condition understood and referred to as “intellectual disability,” previously referred to as “mentally challenged.” A learning disability is marked by how the brain processes information. These deficits can affect reading, speaking, listening, math and reasoning, and can mimic ADHD symptoms.
b>Auditory processing deficits (APD). This condition is often superficially misunderstood as a hearing impairment, but auditory hearing deficits (APD) really has nothing to with the ability to hear. APD is a complex condition in which something adversly effects the way the brain recognizes and interprets sounds, most notably the sounds composing speech. Essentially what this means is that these children can’t process the information they hear the same way as others because their ears and their brain don’t fully coordinate. The child is unable to recognize the subtle differences between sounds in words despite volume and clarity. The problem typically occurs in background noise, which is a natural listening environment. This means children with APD have a basic difficulty of understanding any speech signal presented under less than ideal conditions. [Source]
Because a child with APD has difficulty discerning sounds, they display symptoms that mimic the inattentive type of ADHD. They may have difficulty following directions in a series, showing comprehension problems in conversation or poorly discriminating between similar sounding words. Just think, if on your best days you still have problems with using the proper there, their, and they’re, imagine how a child with APD feels!
Speech-language delays. One of the more difficult conditions to diagnose. Often caused by chronic ear infections during early childhood, children with speech-language delays are slow in mastering language acquisition. Because they are behind in their ability to understand spoken language, the condition is often misdiagnosed as the child not paying attention, and hence as having ADHD. You can learn more about speech-language delays here at kidshealth.org, and here at the University of Michigan Health System website.
Traumatic brain injury. This one sounds like a no brainer (ok, that probably wasn’t the best saying to use), but parents often associate a traumaric brain injury with a visible wound or immediate sypmtoms like headaches, stumbling, and vomiting. But think of it in these terms, Shaken Baby Syndrome (this is abuse, in case you were questioning) is essentially a traumatic brain injury that leaves no external evidence of trauma. As a child is growing an developing the brain sits in a lot of cranial fluid that keeps the brain moist and protected, but it also means there’s more room than you think for the brain to easily slosh around inside the head. As with shaken baby sybdrom, if the brain is somehow jolted — say in a sporting event or minor traffic collision — hard enough, the force of the tissue banging back and forth inside the head easily creates a traumatic brain injury with no external evidence that trauma has occured.
As for those symptoms you think should happen when a traumatic brain injury occurs — stumbling, headache, vomiting — those symptoms can and do occur with brain injury, however, not always.
As with a lot of psychological and neuropsychological conditions recognized as a disability, ADHD is a group of symptoms. A diagnosis of ADHD means that your child has been identified as exhibiting a minimal number of symptoms that fit the criteria for an ADHD diagnosis. But, as we’ve seen above, there are many conditions that mimic and/or share the same symptoms as ADHD. The key here is, if your child is diagnosed with ADHD, take careful consideration to all the possible conditions that may be contributing to your child’s symptoms. Speak with your physician and other specialists about the diagnosis and other potential conditions. Many of the conditions described in this post can be easily determined with simple tests, such as testing for a sleeping disorders, auditory testing, and testing by a speech pathologist or psychologist for speech-language deficits and learning disorders . Others of the conditions discussed here require a bit more, so speak with your professional.
Horton, Jilita. “ADHD Misdiagnosis in Kids: Conditions That Mimic ADHD.” Yahoo!News. Associated Content, 30 Sept. 2010. Web. 1 Oct. 2010.