Other conditions with symptoms similar to attention deficit hyperactivity disorder (ADHD)

Determining exactly what is causing behavioral problems can be difficult, since symptoms of attention deficit hyperactivity disorder (ADHD) may also be caused by other problems. The main symptoms of ADHD-inattention, hyperactivity, and impulsiveness-may also result from:

• Giftedness. Some gifted children will show signs of inattention in class. Often they are not challenged and are bored, so they lose interest in normal class activities. (It is also possible for a child to be both gifted and have ADHD.)
• Undernutrition. Without proper nutrients, especially in the first year of life, a child is at risk of not developing normally. This includes compromised brain development and function.
• Abuse or neglect. Emotional problems that often result from abusive conditions can cause a child to have behavior difficulties.
• Stressful home environment. Temporary or permanent family or household situations, such as divorce or a death of a loved one, may cause a child to act differently than normal. Children can become confused and frightened when there are major changes in their lives.
• Parenting skills. Sometimes parents do not know how to effectively handle challenging-but normal-behavior in a child. If parents are inconsistent or unsure of themselves, their child may develop behavior problems.
• Alcohol or drug abuse (most common in teens and adults). It is important to screen for alcohol or drug problems, especially in adults, when evaluating behavior problems.
• Other medical conditions. Some other medical conditions have symptoms similar to ADHD. These conditions can be the primary cause of symptoms, but can also occur (coexist) with ADHD. About one-third of all children with ADHD have one or more of the following conditions along with ADHD:¹
  • Learning disabilities. Symptoms like those of ADHD, especially inattention, are common when children are in learning environments that are too difficult for them.²
  • Conduct disorder
  • Oppositional defiant disorder
  • Depression
  • Anxiety disorders
  • Tourette's disorder
  • Developmental disorders, such as autism and mental retardation
  • A lifelong childhood medical condition with bothersome symptoms, such as asthma.

In order to best treat symptoms of ADHD, a health professional must carefully investigate these other possibilities as a contributor to or cause of behavior problems.

When symptoms are primarily a result of ADHD, they develop early in life (before the age of 7) and get worse when school demands are placed on the child. Symptoms of ADHD can be expected to continue into adulthood.

Citations

1. Committee on Quality Improvement, American Academy of Pediatrics (2000). Diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics, 105(5): 1158–1170.

2. American Psychiatric Association (2000). Attention-deficit and disruptive behavior disorders. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 85–103. Washington, DC: American Psychiatric Association.