- December 2015
- Vol. 16, No. 9
Differential Diagnosis: Trauma and ADHD
Many children who exhibit clinical symptoms of attention deficit and hyperactivity disorder (ADHD) and have been diagnosed often exhibit symptoms that may resemble symptoms of children who have experienced or been exposed to trauma. Symptoms of trauma and ADHD manifest with conditions affecting the child's behavioral, mental, physical, and/or emotional health. As a consequence of the overlapping symptoms and lack of trauma-informed training, medical and educational professionals are sometimes unable to distinguish the cause of problematic behaviors, resulting in an unfitting diagnosis. To help separate the behavioral commonalities of ADHD and trauma, the National Child Traumatic Stress Network (NCTSN) published a podcast that features an interview with Dr. Heather Forkey, a pediatrician at the University of Massachusetts Memorial Medical Center.
During her interview, Dr. Forkey highlights similarities in how trauma and ADHD impact the brain at different stages of a child's cognitive development. She also explains how the cognitive impact from exposure to trauma impacts the same part of the brain as ADHD. Because the impact is identical, the resulting behaviors can be identical. Therefore, when medical and educational professionals witness behaviors such as the inability to control impulses, difficulty focusing, problematic behaviors at school or at home, aggression, or difficulty acquiring developmental milestones, they commonly assume the child has ADHD.
To support the progress of a trauma-informed child welfare system, Dr. Forkey suggests that parents and medical and educational professionals continuously communicate about any traumatic experience(s) encountered by the child. Furthermore, she suggests continuous reassessment of the child's behaviors to help identify any progress.
In addition to the podcast interview with Dr. Forkey, the NCTSN provides a family handout guide for foster and adoptive parents who are raising children exposed to trauma. Produced by the American Academy of Pediatrics in collaboration with the Dave Thomas Foundation for Adoption, the guide begins with an explanation of what trauma is, the effects, and triggers that compound the existing symptoms. It also mentions the importance of trust in relation to the healthy development of a child, particularly one who has been affected by trauma. In its conclusion, the guide provides suggestions for parents to help better understand their child's needs after trauma.
Listen to Dr. Heather Forkey's podcast interview, "Is it ADHD or Trauma Symptoms?" on the NCTSN website at http://learn.nctsn.org/mod/pcast/showepisode.php?eid=37.
Access Parenting After Trauma: Understanding Your Child's Needs: A Guide for Foster and Adoptive Parents on the American Academy of Pediatrics website at https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/healthy-foster-care-america/documents/familyhandout.pdf (2 MB).
Child Welfare Information Gateway recently published the issue brief Developing a Trauma-Informed Child Welfare System, available at https://www.childwelfare.gov/pubs/issue-briefs/trauma-informed/. Information Gateway also published a series of factsheets for families about parenting children who have been exposed to trauma, experienced sexual abuse, or experienced abuse or neglect. These publications are available at:
- Parenting a Child Who Has Experienced Trauma: https://www.childwelfare.gov/pubs/factsheets/child-trauma/
- Parenting a Child Who Has Experienced Abuse or Neglect: https://www.childwelfare.gov/pubs/parenting-CAN/
- Parenting a Child Who Has Been Sexually Abused: A Guide for Foster and Adoptive Parents: https://www.childwelfare.gov/pubs/f-abused/