If your child has trouble sitting still and paying attention in school. or if they’re constantly losing things, interrupting, and talking in an “outside voice,” don’t just assume that they have attention deficit hyperactivity disorder (ADHD).
It might seem like an obvious diagnosis, but before you start forming opinions, you should know that it’s not that simple. A doctor has to identify ADHD through observing your child’s behavior. There are no blood tests or brain scans to give a definite diagnosis.
And many other disorders have the same, or similar, symptoms as ADHD, so it’s important for your doctor to look for all possibilities before coming to a conclusion.
Conditions Similar to ADHD
Your child’s behavioral issues could be due to any number of biological, physiological, and emotional disorders that appear like ADHD. These are some of the most common.
Anxiety disorders. About one-fifth of kids with ADHD also have some type of anxiety disorder, including separation anxiety, social anxiety, or general anxiety. And children with ADHD are more likely than others to get anxiety. The type of medication they take for ADHD makes a big difference if they also have anxiety. Stimulants can make anxiety worse, but antidepressants can help with it.
Depression. About 1 in 7 children with ADHD are also diagnosed with depression. Experts think it could be made worse by the stress from having ADHD. To complicate things even more, certain ADHD medications have side effects that can look like symptoms of depression, including changes in eating and sleeping habits.
Autism spectrum disorder. Like ADHD, this is a condition that affects brain development. The two disorders sometimes happen together, but experts aren’t sure why. Both can cause children to hyperfocus on one thing. But kids who are on the autism spectrum may avoid eye contact and may not want to play with other kids. Their speech tends to develop slowly or not at all.
Oppositional defiant disorder. Kids who lose their temper a lot, refuse to follow rules, argue with adults, and say mean things to other people are often diagnosed with oppositional defiant disorder (ODD). ODD is more common in boys than girls. It goes away within 3 years in about 60% of kids. As with ADHD, your doctor will probably wait until your child is at least 4 years old to diagnose ODD. This kind of behavior can be “normal” at 2 or 3 years old, but it becomes a problem if it continues as your child gets older. They’ll want to wait to make a firm diagnosis until your child’s behavior is more extreme than what is age-appropriate.
Call your doctor if you notice that your child acts this way around at least one person, other than a sibling, for at least 6 months -- especially if it’s affecting their schoolwork and your home life.
Conduct disorder. About 30% to 50% of children with ADHD and ODD may get conduct disorder (CD), a more serious pattern of antisocial behavior. These children often lie or steal and tend to disregard the welfare of others. They risk getting into trouble at school or with the police.
Learning disabilities. Around half of children with ADHD also have a learning disability. Many kids with learning disabilities also get into trouble at school for not listening, not finishing work, or being disorganized. Like ADHD, a learning disability doesn’t affect intelligence, but it can make kids lag behind others in school and at work. For example, dyslexia, a type of reading disorder, is often seen in children with ADHD. A diagnosis of learning disabilities requires specific academic testing, which is done by a psychologist.
Bipolar disorder. Studies have shown that symptoms of bipolar disorder often overlap with those of ADHD, making it hard to diagnose both of these disorders. Bipolar disorder is marked by mood swings between periods of intense emotional highs and lows. The bipolar child may have elated moods and grandiosity (feelings of importance) alternating with periods of depression or chronic crankiness.
Sensory processing disorder. This condition causes severe sensitivity to things like touch, sound, or light. Children may act out in response, causing ADHD-like symptoms such as trouble with attention, behavior, or learning.
Seizure disorders. A type of epilepsy called absence seizures is often misdiagnosed as the inattentive kind of ADHD. Both conditions make children zone out or stare into space. With ADHD, you can get them to focus again by touching them or making a loud noise. But with absence seizures, they may seem entirely out of reach.
Hearing or vision loss. If your child can’t see or hear properly, they can have trouble at school. They might not be able to see the board or hear their teacher. These issues can lead to poor grades and bad conduct, which might seem like ADHD symptoms when they’re not.
Tourette's syndrome. Very few children have this syndrome, but many people with Tourette's syndrome also have ADHD. Tourette's syndrome is a neurological condition that causes nervous tics and repetitive mannerisms. Some people may blink often, clear their throats a lot, snort, sniff, or bark out words. Sometimes, these tics can be made worse by ADHD medication.
Sleep disorders. These conditions are very common in children and adults who have ADHD. But they can sometimes get mixed up, too. When children are tired, they often do things that can look like ADHD, such as being hyperactive or impulsive, being aggressive, or acting out.
Substance abuse. About half of children have tried an illicit drug at least once by their senior year in high school. It’s important to consider this possibility if your child starts showing ADHD symptoms in their teen years.