October is ADHD Awareness Month.
Throughout the month of October, Time Timer is sharing resources and information specific to supporting children and students with ADHD, including amazing guest blog posts by parents and experts.
Today, we’re sharing an article by The Childhood Collective, a team of two child psychologists and a speech language pathologist.
Read on to learn about the process for getting a diagnosis of ADHD for your child.
By The Childhood Collective
Is it ADHD or Something More? 5 Common Co-Occurring Diagnoses
The process of getting a diagnosis of ADHD for your child can be exhausting! We know, because we walk this path with families on a daily basis. For so many families, the process of deciding to evaluate, finding a provider, scheduling, waiting, testing, waiting, getting feedback, and ultimately getting a diagnosis can feel like the rollercoaster of a lifetime.
In many cases, families get a diagnosis of ADHD but still have unanswered questions. Maybe you have gotten the diagnosis, but you are seeing some things that don’t fit within the diagnosis of ADHD. Or perhaps things were going well for a little while, but your child’s needs are changing again – leaving you feeling confused and overwhelmed, wondering if you have missed something.
First of all, hugs to you. Secondly, you may be right!
According to the CDC, up to 80% of children with ADHD have a co-occurring condition. So, if you feel like there might be more going on, trust your intuition – you may be correct.
Why are other diagnoses often missed?
The vast majority of children with ADHD receive a diagnosis from their pediatrician. However, these evaluations are often brief (parent interviews and behavior checklists) and are ONLY looking at whether symptoms of inattention or hyperactivity are present.
Because ADHD occurs so frequently with other conditions, we usually recommend that parents seek out a comprehensive evaluation to rule-out other explanations for symptoms they might be seeing in their child.
5 common diagnoses that often co-occur with ADHD (or might be mistaken for ADHD!)
1. Specific Learning Disorders. According to the CDC, around 50% of children with ADHD will also have a specific learning disorder diagnosis. Specific learning disorder diagnoses include dyslexia (i.e., a learning disorder affecting a child’s ability to read and sound out words), dysgraphia (i.e., a learning disorder that affects written expression), and dyscalculia (i.e., a learning disorder that affects math).
Why would a learning disorder look like ADHD? If your child is struggling to understand homework and classwork, this can look like problems with work completion, inattention, distractibility, frustration, and defiance.
2. Anxiety. Research has shown that around 33% of children with ADHD will also have an anxiety diagnosis. So how can you tell your child has anxiety? Children with anxiety will have great difficulty controlling their worries or fears. You might notice your child asking lots of questions before entering new activities or situations. When a child experiences anxiety, they will typically try to escape the situations to avoid their anxious feelings.
For many children, anxiety can look like ADHD because children spend so much time worrying that it is hard for them to focus on the present. In fact, difficulty concentrating is a symptom of anxiety.
3. Depression. In addition, around 10-33% of children with ADHD will have a separate mood disorder like depression. Depression often looks different in children than in adults. For instance, children may feel sad, may make negative comments about themselves, or may feel hopeless. They can also just as easily become irritable and angry. Children may experience changes in eating, sleeping, and withdrawal from activities they used to find enjoyable.
Why does depression look like ADHD? One of the symptoms of depression is difficulty concentrating. Additionally, children may lose motivation to complete schoolwork, homework, and grades may drop. Sleeping challenges that often occur with depression can also result in focusing challenges.
4. Autism Spectrum Disorder. Around 15% of children with ADHD will also have an autism spectrum disorder diagnosis. Children with an autism spectrum disorder may desire friendships, but struggle to make and keep new friends. They may also struggle with non-verbal communication, which may include difficulty making eye contact, using gestures, or making facial expressions. They may show repetitive body movements (e.g., finger movements, hand flapping, body rocking), difficulty making transitions or changes to their routine, deep/specific interests, and/or sensory sensitivities/interests (e.g., sound, smell, taste, feel).
Why would an autism spectrum disorder look like ADHD? Children with autism may prefer to spend time thinking intensely about something of interest, and this can look like inattention. A child’s repetitive behavior may also be misinterpreted as overactivity or fidgeting. Both children with ADHD and autism will sometimes have deep interests on specific topics.
5. Speech and Language Disorders. Research indicates that approximately 2/3 of children with ADHD also have a speech or language disorder (with some studies indicating as high as 90%!) What areas of speech and language are most often affected in children with ADHD?
- Language: Children with ADHD often score lower on tasks that measure language comprehension, but this may be partly due to their lack of attention, which causes them to perform poorly on a standardized assessment. They sometimes struggle to find the precise words they are looking for, even though they know the words. In the moment, they may be speaking too quickly and they use nonspecific language like “thing” or “stuff” to describe their ideas. They often have difficulty telling stories in the order they happened, and including the right amount of detail.
- Speech: Children with ADHD often have difficulty with the self-monitoring, so it can be difficult for them to learn a new, correct speech sound pattern. When children are very young, they develop a phonological system (the “rules” of speech sounds). Children with ADHD, who often also have dyslexia, can have significant issues with phonology. This can result in learning sounds later and/or having trouble hearing the speech sound errors.
Why would a language disorder be mistaken for ADHD? Children with a language disorder may appear to be inattentive, because they aren’t comprehending or connecting to what is being said. They may need directions repeated or said in a different way.
What should my next steps be?
If you are concerned that there may be more going on with your child, a comprehensive evaluation by a developmental pediatrician, psychologist, or neuropsychologist is recommended. From there, they may refer you for a speech/language or occupational therapy evaluation. Ultimately, you know your child best! If something feels “off” to you, your gut is probably right.
About the Authors
We would love to connect with you. Here at The Childhood Collective, we are a team of two child psychologists and a speech language pathologist… and we are also moms! We have lots of free resources available for parents who are raising neurodiverse children. One of our most popular free resources is our ADHD Treatment Guide which breaks down the research about ADHD treatment… saving you time so you don’t have to sift through hours of scholarly articles and confusing google searches.
Our online community is growing daily, so please hop on over to social media and give us a follow. We post daily tips and inspiration for parents just like you!
Have a beautiful day,
The Childhood Collective