Does my child have ADHD or not?
It’s no secret that kids are being diagnosed with ADHD in the US more and more frequently. Depending on which study you read, somewhere between 5-11% of children across the US are diagnosed with ADHD. And there’s been an increase of over 3% in just 8 years!
BUT- it’s entirely possible that many kids who are told they have ADHD are actually being misdiagnosed.
This is because the symptoms of ADHD are well known (hyperactivity, impulsiveness, lack of focus, disorganization), so it may be one of the first diagnoses doctors have in mind. And doctors and clinicians can observe these behaviors in a relatively short amount of time, which makes it easy to use for a diagnosis.
But there are many other reasons kids may be exhibiting these behaviors most often seen with ADHD.
Does My Child Have ADHD? Maybe Not…
ADHD is not always the answer. If you’ve been told your child has ADHD, but it doesn’t seem like the best explanation for your child’s behavior, there are other explanations.
Reasons to Question Whether or Not Your Child Has ADHD:
–There is no family history of ADHD. The hereditability rate of ADHD is around 76%. This means that if there’s someone in your (biological) family with ADHD, it’s very likely that another person will have ADHD, too. However, this also works in reverse. It’s unlikely, although possible, that one person in the gene pool will just pop up with ADHD.
–You don’t see any symptoms at home. If you’re only seeing symptoms like hyperactivity or impulsivity at school, and not at home, ADHD may not be an accurate diagnosis. For a true ADHD diagnosis, symptoms need to occur across different settings. (There’s a difference between seeing a symptom and it being a problem. It’s possible that you’re able to manage the high-energy level better at home than it can be at school. So the symptoms are still occurring across settings, but they may not be as problematic in different places.)
-If your child is receiving medication, but you don’t feel like it’s working well/correctly. It could be a sign that the brain chemistry is showing that the ADHD diagnosis is wrong. (It could also just be the wrong medication for your child; make sure to speak with your prescriber before stopping any medication as some medications can have adverse effects is suddenly stopped.)
What Else Could It Be? Other Explanations for ADHD-Like Behaviors
1. Anxiety
Anxiety makes it hard to focus, pay attention, and follow directions. Additional input is hard to process if your mind is already whirling with worries.
You may want to look into this if your child doesn’t have the typical hyperactive behaviors, but was diagnosed because of the attention-deficit part of ADHD.
2. Sensory Processing Disorder (Specifically Sensory-Seeking)
It can be tricky to tell the difference between ADHD and Sensory Processing Disorder. When a kid has a Sensory Processing Disorder, particularly if they’re a sensory-seeking child, they are lacking enough input on their body to tell it that they’re grounded in place. This can make them (literally) look like they’re bouncing off the wall, and they can look pretty hyperactive.
You may want to rule this diagnosis out if you have a child who can focus, but is high-energy. At this moment in time, I would recommend seeking an opinion from an OT (Occupational Therapist) since they tend to be more familiar with sensory issues than many mental health clinicians.
3. Giftedness
When kids understand the concept in 5 minutes, but the teacher spends an hour teaching, you have a recipe for boredom and lack of focus. Which can make these kids look like they have ADHD. Additionally, gifted children tend to have high (although not quite hyper) levels of energy.
These kids absolutely get misdiagnosed with ADHD. And instead of being given the education they need, they get medicated.
Black and Hispanic children are severely underrepresented in gifted programs in schools. And yet Black children are diagnosed with ADHD more often than white children, which should be a red flag.
I believe this study from the American Educational Research Association hits the nail on the head with the explanation, “What a teacher may attribute to precocity for one student may be considered disruptive behavior for another.” Of course, there are also many other variables, like access to quality education, socio-economic status, and adverse childhood events (more on that later) but don’t think the perceptions of those in charge should be discounted. For more, here’s a great article about nurturing gifted children of color.
4. Poor Diet/Lack of Exercise or Free Time Outside
Let me start by saying, in no way do I mean to sound blaming with this one. But kids have small bodies, and they can have bigger responses to smaller doses of sugar, etc. Before you put a kid on medication, it might be worth looking at how much excess sugar, pop and caffeine they’re consuming.
Free time, especially non-structured time outside, is also critical. Kids need a chance to move their bodies. If you’re noticing an increase in hyperactive behavior during the months you stay the most indoors, this is an explanation worth exploring.
5. Learning Disorders
Non-verbal learning disorders (like dyslexia/dysgraphia/dyscalculia/slow-processing disorder) can create challenges when asked to focus at school. If you’re struggling to read the words or numbers in front of you, or you just can’t make the words come out of your pencil, chances are you’re going to lose focus and not want to pay much attention.
This could be the case if you didn’t see any signs of ADHD at home, and school was the first place it was noticed. If you think your child might have a learning disability, here are some additional steps you can take.
5. Auditory Processing Disorder
Kids with Auditory Processing Disorder have a difficult time taking in verbal instructions. They may also have a delay in responding to questions, which can make it seem like they’re not paying attention. This leads to the appearance of being inattentive, or even actual inattentiveness because it’s a challenge to pay attention.
You may want to talk to the school psychologist about this if ADHD is being suggested as a diagnosis, but you’re not seeing much impulsivity (because all kids are a little impulsive) or hyperactivity.
6. PTSD/Stress Disorders
As much as we’d all like to think of childhood as this really idyllic, safe, wonderful time, it’s an unfortunate truth that many kids experience stressful- and even violent- events during their childhood.
If you’re constantly stressed and in fight-or-flight (or freeze) mode, it’s hard to focus. You may also have additional energy to burn off from all the adrenaline. You may have also developed coping skills that would distract others before conflict could arise (which may appear as some ‘class clown’ type of behavior).
Additionally, kids who live in poverty have higher incidents of adverse childhood events– most of which could be considered trigger events for PTSD. This mimics the impact of poverty on the rate of ADHD diagnosis.
My Child Has An ADHD Diagnosis. Why Should I Mess With It?
First, let me assume you’ve read this far because you’re truly wondering if your child has ADHD. We both know that pursuing a new/additional diagnosis can be time-consuming, expensive, exhausting and even heart-breaking.
But you know your child better than anyone. Trust yourself, and follow your parenting instincts. The worst case scenario is that you don’t find any other explanation, but you get to know that you are a great advocate for your child and you tried your best. At best, you find a more correct diagnosis for your kid.
The right diagnosis can open the door to the right treatment. Seeking the most complete information about your child is a form of advocacy. And it shows your kid that you won’t stop fighting for them.
It’s important to note that ADHD can occur in addition to many of the previously discussed disorders/explanations. It is possible that you could come away from investigating this more closely with two diagnoses; the ADHD + something else. But if you have the flu and a broken leg, you’re going to want treatment for both. Not just one, and hope the other resolves on it’s own.
Does My Child Have ADHD? Getting Second Opinions
You know your child better than anyone. After educating yourself about the symptoms and what it may look like in your kid, if you still don’t think ADHD is the answer, you may want to consider a second opinion.
If you have a therapist, doctor or counselor who balks at the idea that it’s anything but ADHD, try getting another assessment from someone else. At the very minimum, they should be willing to explore and rule other diagnoses out. A good clinician will always be open to exploring and improving their diagnosis to find the answer to whether or not your child has ADHD.
So if your child has an ADHD diagnosis that isn’t sitting right with you, do some self-reflection and figure out why.