ADHD Misdiagnosis

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:

sleep disorders

Image via Google search.

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.

Child depression

Image via Google search

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.

Arnsten figure

Arnsten Figure. Image via PrimaryPsychiatry.com

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.

Related:
Horton, Jilita. “ADHD Misdiagnosis in Kids: Conditions That Mimic ADHD.” Yahoo!News. Associated Content, 30 Sept. 2010. Web. 1 Oct. 2010.

Advertisements

5 comments so far

  1. Sleep Apnea on

    I was treated for depression for about 6 years (without success) before they finally began to treat me for the right ailment. I think diagnosis are like precedents in court. Once you’re labeled it is difficult for other doctors to look for what is really wrong with you. In my case it was a tumor.

  2. ADHD - Not on

    That is what I am currently worried about, teachers are saying that my 6 year old has ADD – label him now, label him forever ….

    • DSS of GCCC on

      There is something to be said for early diagnosis of any learning disability. The younger an individual is diagnosed, the more time you as the parent and the child have an opportunity to try out the best learning strategies that will help your young student to best cope and work with their disability. Starting early will also allow you the benefit of establishing the accommodations and needs that your child will come to need for their education within the school system for which your child is learning. Cooperation of teachers, aids, and administration can only benefit your child.

      Still, it is a little frightening the possibility that misdiagnoses may hinder your child rather than help. First and foremost, YOU are your child’s best advocate. Take an active role in learning how your child learns best so that you have an educated opinion in the potential options that educational professionals, such as your child’s teachers, may offer you. In some cases, placing a child in special education classes can best help the student to learn and remain at the same academic level as the rest of their class. At other times, the school may be following a general policy in handling students with disabilities rather than looking at individual needs and that can hinder a child who may only require extended time for assignments and a quiet place rather than an entire special needs program. Accept the suggestion that education professionals are giving you, weigh its merit based on your individual child, and then determine your answer. Learn what the policies are for your specific school district regarding your child’s rights in public education and then exercise your child’s rights in implementing what YOU believe is the best option for your child.

      With that said, every parent has the right to have their child tested for learning disabilities. The school will most likely provide your child with a battery of tests to determine if he/she has a learning disability. Find out what tests were used and how your child scored and then seek a second opinion. Look for a psychologist in your local area who specializes in educational psychology and have your child tested. This will provide you with an impartial partisan who is a specialist in the field. This testing can be expensive, but many psychologists offer payment plans and/or may have grant options that you may qualify for. There are also local organizations who may be able to help you, and you may even be able to get your local school board to help you with the cost. Call around; talking is always free.

      You are your child’s best advocate! A diagnosis of ADD, ADHD, or any other disability for that matter isn’t a label! That is a mindset that we have to move past in order to continue educated advocacy in disability and disability rights. Being diagnosed properly allows an individual to understand why their brain works the way it does. Having that diagnoses recorded on paper allows professionals working with that individual to understand how best to help that person. This can only benefit, not hinder. Misdiagnoses is bad in any situation, but a proper diagnoses can never be a bad thing; it is knowledge and knowledge is power. Advocate for your child to be properly diagnosed and then advocate for your child’s best rights from there, whichever side of the fence your situation happens to fall.

      We hope this helps you to find a path to best help your child. Though we can only merely offer you advice, there are people in every community who are able to help you. You have already started your journey with your child’s teachers. Seek the expertise of a local psychologist, speak with your local disability advocates, search the internet, even talk with your child’s pediatrician. All these people are out there to help you, your child, and others like you. There is always help.

      Good luck.

    • me on

      That is right! It is a preconceived notion and all humans are subject to it. My boys have “autism” and my girls I have heard everything from OCD, ADHD, mood disorders, bad parenting etc. Actually docs feel it is genetic and we are being screened. I believe my kiddos have a learning disability/ sensory processing disorder.

      • DSS of GCCC on

        Even with diagnosis, in many disorders, they are a label used to identify a set of symptoms — meaning, you will still be taught by professionals to tackle the individual symptoms within the disorder. There’s no reason you can’t begin to do so at home while doctors continue to duke it out over a clinical diagnosis. This is by no means saying that this is an easy task and that anybody can do it — it’s not, or else there wouldn’t be a need for professionals in these fields. But parents are often more intuitive about their children than they even realize. By watching your child as they are in the process of learning, asking them questions about how or why they chose to answer or perform an activity a certain way, discussing in detail what the child is thinking when they are performing their school work or other activities, and taking notes over the course of time, you will begin to see patterns emerge. Having such information will not only allow you to be able to understand your child and better help them in their own learning, but this information can be invaluable in helping doctors and educational professionals better help your child. Having this sort of team effort going on will give your child the benefit of coming up with learning strategies that they can use forever, and teaching them young is always an advantage.

        And don’t be afraid to use the internet — not as a diagnosing tool, of course, but there are parents all over the world dealing with the same exact thing, both asking questions and sharing helpful strategies that have worked for their child. This is a long process of trial and elimination, but never failure. Just because a particular learning strategy didn’t work doesn’t mean it was a failure or a set back, it means you are eliminating one strategy for the purpose of finding a better one that works for your individual child. And each child is different. Don’t get frustrated if a particular learning strategy works for one of your children but not for another. Even if they were to be diagnosed with the same exact disorder, this does not mean that their brain functions the same way. Learning disabilities are as individual as your children are. Think of learning strategies as facets of their personality.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: