Conditions that mimic ADHD
As noted in 'What is ADHD?' ADHD is defined by its symptoms rather than its cause. The DSM-V, the guide that lays out the criteria to be used by doctors, mental health professionals, and other qualified clinicians when making a diagnosis of ADHD lists it in the category of 'Neurodevelopmental Disorders' and defines it as:
“a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with development, has symptoms presenting in two or more settings (e.g. at home, school, or work), and negatively impacts directly on social, academic or occupational functioning”.
If you look at 'How is ADHD diagnosed?' you will notice that there is a checklist of symptoms of which children must have at least six symptoms from either, or both categories, while older adolescents and adults (over age 17 years) must present with five.
Care must be taken to rule out other conditions that mimic ADHD. That is, symptoms of hyperactivity, distractibility, impulsivity, inattention and so on may be all too real but, before attributing them to ADHD and treating the ADHD accordingly, it would be wise to explore some conditions that may result in symptoms of ADHD.
This is a difficult task because many ADHD diagnoses are often accompanied by a co-morbid condition diagnosis such as anxiety for example.
Conditions may include:
- Vision problems
- Hearing problems - including Auditory Processing Disorder
- Learning disability
- Sleep disorders
- Sensory processing disorder
- Biochemical imbalances
- Food intolerances & sensitivities
- Medical conditions e.g. thyroid disorder, tumours, heavy metal toxicity etc
- Tourette's syndrome
- Asperger Syndrome (an Autism Spectrum Disorder)
- Obsessive Compulsive Disorder (OCD)
- Seizure disorders
- Mood disorders (e.g anxiety, depression, bi-polar)
- Fetal Alcohol Syndrome
- Fragile X Syndrome
- Substance abuse
- Emotional turmoil
If these conditions are diagnosed and treated it may be that the symptoms associated with ADHD may disappear as a result.
Receiving the correct treatment for the correct diagnosis as early as possible is vital as misdiagnosis can result in a delay or lack of appropriate treatment with significant impact on an individual.
Vision problems are usually extremely easy to correct once the problem is diagnosed but can often be overlooked. Vision-related problems are often hard to pick up in children, especially younger children, as the child may not recognise or wish to admit the problem. They may assume that everybody has the same view of the world as they do and so not think to mention it. However, if they are struggling to see this may well result in a child having attention problems.
There are various vision problems that can occur:
- Myopia - short-sightedness;
- Hyperopia - long-sightedness;
- Astigmatism - a misshapen cornea or lens causing blurring of vision;
- Presbyopia - problems focussing on nearby items;
- Binocular vision problems - where the eyes are working in tandem properly;
- Eye fatigue - fatigue of the eye muscles due to prolonged computer use
- Lazy eye - when the brain receives conflicting visual information from both eyes it may switch off the vision in one eye to obtain a clearer picture;
- Colour blindness - inability to see particular colours;
Most common vision problems can be easily diagnosed by a qualified ophthalmologist via a simple vision test. Some vision problem may require more specialised testing and treatment via a behavioural optometrist.
Hearing problems are another common problem in children which can cause symptoms of attention problems as if a child cannot hear their parent, teacher or other children they are going to appear inattentive and unfocussed or carry out tasks incorrectly. As with vision problems, hearing difficulties can often go undiagnosed as the child or indeed grown up may not realise they are not hearing at the same level as other people.
Hearing problems can be the result of many different causes some of which are listed below:
- Excessive ear-wax causing a blockage;
- Ear infections and sometimes resulting debris left blocking the ear;
- Tinnitus - high pitched ringing, buzzing or other sounds in the ear;
- Auditory Processing Difficulties;
- Injuries to the ear such as a ruptured ear drum;
- Side effect of some medications;
- Underdevelopment of the inner ear or auditory nerve;
- Congenital diseases e.g. Usher syndrome;
- Non-congenital diseases e.g. illnesses causing high fevers;
- Ear-based tumours;
Visit your GP in the first instance for them to check the ears. They may then refer you on to an Ear Nose & Throat specialist for further investigations. You can also make an appointment at an audiology clinic.
Auditory Processing is
Sensory processing disorder
Food intolerances & sensitivities
Medical conditions e.g. thyroid disorder, tumours, heavy metal toxicity etc
Asperger Syndrome (an Autism Spectrum Disorder)
Obsessive Compulsive Disorder (OCD)
Mood disorders (e.g anxiety, depression, bi-polar)