What mental disorders mimic ADHD?

Can Your Young Child be Misdiagnosed with ADHD?

Diagnosing a neurodevelopmental disorder such as ADHD at an early age can be very helpful. When kids are diagnosed early, they get the help they need sooner and therefore experience greater academic success. Early diagnosis can also protect your child’s self-esteem; your child won’t be told he’s just “not trying hard enough” if his educators know he has ADHD. Still, parents, teachers, and medical professionals must understand that accurately diagnosing ADHD is difficult when a child is still small.

Symptoms like hyperactivity, inattention, irritability, and sleeplessness can indicate a wide range of different conditions. They can also simply be a normal part of development—Most toddlers display some of these traits, only to grow out of them a few years later.

Before you accept a diagnosis of ADHD, you should familiarize yourself with lookalike disorders. You should also understand how your child’s age may increase his risk of being misdiagnosed.

How Early is Too Early to Diagnose ADHD?

Parents, especially first-time parents, are often shocked by how volatile toddlers can be. Many small children struggle with impulse control because the prefrontal cortex (the part of the brain that governs executive functions) is poorly developed prior to age four. As a result, toddlers are prone to frequent temper tantrums and socially inappropriate behaviour (e.g., grabbing things away from other people). They also have very short attention spans and demonstrate impaired working memory. Because ADHD is such a well-known condition, parents and preschool teachers can—and often do—mistake this normal developmental phase for ADHD. In reality, however, most kids grow out of these behaviours by age five or six.

Your child’s age can influence his risk of being misdiagnosed with ADHD in other ways, too: Researchers have found that kids born in late summer are diagnosed with ADHD 30% more often than their peers. These children are almost a year younger than some of their classmates, so they appear comparatively inattentive, volatile, and less academically capable. Many of these kids do not, of course, actually have ADHD; they’re just less mature than their classmates. Before you proceed with ADHD testing at the behest of your child’s teacher, you should take your child’s birth month into account.

Note that ADHD medication is not advised for children under the age of six. Small children face an increased risk of side effects from these medications. Behavioural modification strategies are a more appropriate form of treatment for small children.

When Should You Begin ADHD Testing?

Generally, it’s a good idea to wait until your child is about six or seven to begin ADHD testing. (ADHD tests are typically optimized for seven year olds.) This limits the risk of misdiagnosis by giving your child’s brain a chance to develop more fully prior to testing. Being diagnosed by age seven is also sufficient to prevent academic and social problems, in most cases. Many children with ADHD can keep up fairly well until middle school, when both their classes and their social lives become far more complex.

Conditions that Can Mimic ADHD

Because ADHD is so well known, it’s the first condition most doctors consider when a child is displaying signs of hyperactivity, irritability, poor focus, etc. In recent years, however, a number of other conditions capable of producing these same symptoms have been identified. To protect your child from being misdiagnosed, it’s important to understand which conditions can mimic ADHD.

Auditory Processing Disorder

Auditory processing disorder (APD) affects the brain’s ability to interpret verbal information correctly. Kids with this condition can hear normally, but they have difficulty understanding speech, especially when they’re in noisy or crowded environments. If your child struggles to understand and remember verbal information but otherwise behaves normally, APD is probably more likely than ADHD.

Sensory Processing Disorder

Kids with sensory processing disorder (SPD) have trouble integrating stimuli (i.e., information received via taste, touch, sight, smell, and/or hearing). As a result, they often feel as though they’re being assaulted by sensory information. Processing something as common as the feeling of being hugged, the sound of music, and the sight of bright lights all at once can be too much for these kids: They become overwhelmed, distracted, and sometimes volatile.

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SPD often occurs in kids with Autism, but recent research suggests it can also develop as a standalone condition.

Autism

Though children with Autism are often stereotyped as being quiet, organized, and focused, many kids on the spectrum struggle with executive function issues. Some children with Autism have impaired impulse control, problems with working memory, anger management issues, and other symptoms that can be mistaken for ADHD. Their intense but limited interests can also masquerade as attentional problems. For instance, if an Autistic child is so fixated on trains that he can’t pay attention to anything else, he’ll appear distracted at school.

Mood Disorders

Most mood disorders don’t become readily apparent until adolescence or early adulthood. In some cases, however, children start showing signs of mental illness before their condition is fully developed. Early symptoms of some mental illnesses, particularly bipolar disorder, strongly resemble ADHD. Symptoms of bipolar mania include hyperactivity, irritability, racing thoughts and speech, and impulsiveness.

Parents should be aware that physical ailments and emotional stress can affect their child’s ability to focus and behave appropriately, too. Kids with food allergies that make them fatigued and uncomfortable may fidget or appear inattentive in class, for example. Children can also become highly distracted and agitated when they’re facing a major life change, such as switching schools.

Preventing Misdiagnosis

Aside from waiting until your child is old enough to be accurately diagnosed, you should consult a specialist (such as a child psychologist) in addition to a physician. Psychologists have the advanced training needed to differentiate ADHD from conditions that can present similarly. They can also provide a number of different treatment options, allowing you to experiment and find the one that’s best for your child. With patience and persistence, you can help your child thrive, regardless of which condition he’s fighting.

What is ADHD?

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

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Signs and Symptoms

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.

A child with ADHD might:

daydream a lot
forget or lose things a lot
squirm or fidget
talk too much
make careless mistakes or take unnecessary risks
have a hard time resisting temptation
have trouble taking turns
have difficulty getting along with others

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Types

There are three different ways ADHD presents itself, depending on which types of symptoms are strongest in the individual:

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are equally present in the person.

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Because symptoms can change over time, the presentation may change over time as well.

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Learn about symptoms of ADHD, how ADHD is diagnosed, and treatment recommendations including behavior therapy, medication, and school support.

Causes of ADHD

Scientists are studying cause(s) and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies link genetic factors with ADHD. 1

In addition to genetics, scientists are studying other possible causes and risk factors including:

Brain injury
Exposure to environmental risks (e.g., lead) during pregnancy or at a young age
Alcohol and tobacco use during pregnancy
Premature delivery
Low birth weight

Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.

ADHD Fact Sheet

Diagnosis

Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.

Treatments

In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with ADHD. In addition to behavioral therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:

Developing healthy eating habits such as eating plenty of fruits, vegetables, and whole grains and choosing lean protein sources
Participating in daily physical activity based on age
Limiting the amount of daily screen time from TVs, computers, phones, and other electronics
Getting the recommended amount of sleep each night based on age

Get Help!

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

The Centers for Disease Control and Prevention (CDC) funds the National Resource Center on ADHD , a program of CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their website has links to information for people with ADHD and their families. The National Resource Center operates a call center (1-866-200-8098) with trained staff to answer questions about ADHD.

For more information on services for children with special needs, visit the Center for Parent Information and Resources. To find the Parent Center near you, you can visit this website.

ADHD in Adults

ADHD can last into adulthood. Some adults have ADHD but have never been diagnosed. The symptoms can cause difficulty at work, at home, or with relationships. Symptoms may look different at older ages, for example, hyperactivity may appear as extreme restlessness. Symptoms can become more severe when the demands of adulthood increase. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health .

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More Information

National Resource Center on ADHD
National Institute of Mental Health (NIMH)

Reference

Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., . . . Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews. doi:10.1016/j.neubiorev.2021.01.022

How to Know if I Have ADHD

Are you frequently forgetful, hopelessly disorganized, easily distracted, make impulsive decisions, and experience frequent mood swings? Have you ever wondered whether ADHD is to blame for all your persistent problems? Before you jump to any conclusions, keep in mind that diagnosing ADHD in adults isn’t quite that simple.

Most people feel unfocused, scattered, or restless at times. That’s quite normal. And such symptoms of ADHD as concentration problems and restlessness can be confused with other disorders like depression, anxiety, learning disabilities, or may be caused by medical problems. Medical conditions that mimic ADHD include sleep disorders, seizure disorders, thyroid disorders, as well as cognitive impairments. Just because your symptoms look like ADHD doesn’t mean you have it, so the only way to know for sure is to see a doctor or a mental health professional.

ADHD cannot be determined by a blood test. Rating scales, symptom checklists, review of behavioral and academic history, interviews with the individual, family members, and school personnel (for those of school age) are used to determine a diagnosis and treatment recommendations.

Not sure whether you should schedule an appointment to get checked by a health professional? Let’s take a closer look at the signs and symptoms of ADHD in children and adults.

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a relatively common neurodevelopmental condition affecting people’s behavior. The disorder impacts the prefrontal cortex of the brain. This area is responsible for executive functions, emotional regulation, and impulse control, among other things. The causes of ADHD are unclear, but the condition often runs in families. It develops in childhood and can happen to anyone.

Some kids seem to outgrow the condition, but the majority of those who had ADHD in childhood will continue to have it as adults. According to some estimates, 8.4% of children and 2.5% of adults have ADHD. But many adults go undiagnosed, so the numbers may be higher.

Symptoms of ADHD, such as difficulty paying attention, hyperactivity, and impulsive behavior, tend to be noticed at an early age and may become more noticeable when children start school when ADHD leads to poor school performance or disruption in the classroom. The symptoms continue into adulthood and usually improve with age, but many adults continue to struggle with impulsiveness, restlessness, and difficulty paying attention.

Common symptoms in children and teenagers

The symptoms of ADHD in children are usually noticeable before the age of six. Children with ADHD show a persistent pattern of both inattentiveness and hyperactivity and impulsivity that interferes with their functioning or development. They may also have symptoms of just one of these types of behavior. Before ADHD can be diagnosed, the symptoms must have been present in multiple settings for at least six months and have a negative impact on a child’s life.

The main signs of inattention are:

Difficulty sustaining attention while completing long tasks
Failing to pay close attention to details
Appearing forgetful in daily activities or losing things
Difficulty organizing tasks and activities
Being easily distracted by unrelated thoughts or stimuli
Appearing to be unable to listen to when spoken to directly
Not following through with instructions and failing to finish schoolwork or workplace duties

The main signs of hyperactivity and impulsiveness include:

Constantly fidgeting with or tapping hands and feet
Difficulty sitting still for extended periods, especially in calm or quiet surroundings
Talking excessively
Interrupting or intruding on others
Having difficulty waiting for one’s turn
Answering questions before they are asked completely
Acting without thinking
Little or no sense of danger

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Most people with ADHD get a diagnosis during childhood, but sometimes, the signs and symptoms of this condition are misinterpreted or overlooked. Many adults with ADHD don’t even realize they have the disorder. They just know that completing day-to-day tasks can be a challenge, but they attribute their difficulties to their shortcomings.

If untreated, ADHD can interfere with many aspects of a person’s daily life. It makes it difficult to manage tasks that require planning, organization, and focus. ADHD has been linked to poor work performance, substance misuse issues, relationship challenges, poor self-image, issues with self-esteem, frequent accidents or injuries, etc. It’s important to recognize the symptoms of adult ADHD so you can get proper treatment.

Symptoms of adult ADHD

For decades, ADHD was considered a disorder of childhood that ends after adolescence. But a number of studies showed that ADHD can continue into adulthood. Now experts say that from 60% to 86% of children with ADHD will have symptoms as adults.

The signs of ADHD in adults are more difficult to spot. Adult symptoms also tend to be more subtle than childhood symptoms. But some adults continue to have major symptoms that interfere with daily functioning and can cause problems at work, school, in romantic relationships, and friendships.

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Adults might be less hyperactive than a child with the diagnosis, but they are struggling with paying attention, staying on task, regulating emotions, and warding off impulsive behaviors. The symptoms associated with ADHD in adults may include:

Inability to focus and prioritize
Poor time management skills
Poor planning
Carelessness and lack of attention to detail
Forgetfulness in daily activities
Getting easily distracted
Continually losing or misplacing things
Excessive activity or restlessness
Difficulty keeping quiet and speaking out of turn
Low frustration tolerance
Mood swings, irritability, and a quick temper
Extreme impatience
Trouble coping with stress
Over- or under-responsiveness to light, sound, touch

Keep in mind that ADHD exists on a spectrum of severity levels, and its symptoms can be more or less pronounced in different environments. You can be diagnosed with ADHD for the first time as an adult, but only if you have experienced significant symptoms of the disorder before the age of twelve.

Signs of ADHD in women and girls

There is a stereotype that ADHD mostly shows up in boys, and the evidence seems to back it up. According to research, males are generally more likely to be diagnosed with ADHD than females. But these stats are misleading, and they don’t necessarily mean that more boys have this condition.

In fact, ADHD frequently goes undiagnosed in women and girls because their symptoms often differ from those of men and boys and can be hard to spot. Girls have a tendency to exhibit inattentive ADHD, which doesn’t have visible behavior problems, so it doesn’t always catch the attention of parents and teachers.

This presentation of ADHD makes it hard to stay organized, focus, pay attention to details, finish assigned activities, listen, and remember things. But often, ADHD symptoms in girls, such as being shy, inattentive, or impulsive, are viewed as character traits rather than symptoms of a condition.

According to a research, women with ADHD may be more likely to develop better coping mechanisms than men to hide their symptoms, which may lead to misdiagnosis or a lack of treatment.

Girls and women may suffer more negative effects from their ADHD than boys and men. They are more likely to blame themselves when they have problems getting things done. As a result, they tend to have more mood disorders, anxiety, and self-esteem problems. Girls with ADHD are also more likely to develop bulimia or anorexia than girls without the condition.

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How is ADHD treated?

Adults with ADHD may learn to manage it successfully. There are effective treatments that can help relieve the symptoms and make the condition much less of a problem in everyday life. Standard treatment options for ADHD in adults typically involve medication, psychoeducation, skills training, and therapy. Although there is no cure for this condition, a combination of these treatments can effectively reduce symptoms and improve your quality of life.

There are two main types of medication for ADHD: stimulants and non-stimulants. Stimulants (methylphenidate or amphetamine) appear to boost and balance levels of neurotransmitters. Stimulants are the most commonly prescribed medications because they can work more quickly, but they also can be habit-forming. Other medications include the non-stimulant atomoxetine and such antidepressants as bupropion.

Psychotherapy can help people with ADHD better cope with daily challenges and control compulsive and risky behavior. You’ll learn new skills that can help you be successful and improve relationships with your family, friends, and co-workers.

Cognitive behavioral therapy (CBT) can help you reduce negative thinking, improve self-esteem, and adjust behavioral patterns that cause problems at work, school, or home. Family therapy can help you and your loved one work together to manage the stress of ADHD, practice problem-solving, improve communication, and develop conflict-resolution skills.

People with ADHD also use coaching, mindfulness-based training, exercise, yoga, and nutritional interventions to manage their symptoms. Building cognitive associations with environmental cues can be helpful in creating routines for success. Some people also find it helpful to join a support group and meet with others and share experiences and “what works.”

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Bottom line

Attention deficit hyperactivity disorder (ADHD) is commonly diagnosed in children and teens, but it can be diagnosed in adults too. ADHD can affect how people think, process emotions, and respond to their environment, and the major symptoms include inattention and hyperactivity or impulsivity. ADHD can cause you to be disorganized in your everyday life and prevent you from performing your best at work or school.

If you recognize the signs of ADHD in yourself and have significant problems with your job or career, day-to-day tasks, relationships, or emotions, consider scheduling an appointment with a mental health professional with experience in treating ADHD to get an assessment. With the right treatment and support, you’ll be able to manage your symptoms and live a happy and productive life.

Iryna Horkovska
Special education teacher
Europe

Iryna is a passionate content writer and life-long learner with an ongoing curiosity to learn new things. She has a Bachelor’s degree in Health Sciences and Special Education and is studying for a Master’s degree in Psychology. Iryna uses her knowledge and writing skills to create well-researched articles that educate readers and empower them to take charge of their mental health and practice self-care.

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