{"id":1291,"date":"2016-03-01T15:30:47","date_gmt":"2016-03-01T20:30:47","guid":{"rendered":"https:\/\/singlecare.com\/blog\/?p=1291"},"modified":"2024-04-24T11:42:02","modified_gmt":"2024-04-24T15:42:02","slug":"child-misdiagnosed-adhd","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/child-misdiagnosed-adhd\/","title":{"rendered":"Is your child being misdiagnosed with ADHD?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#what-is-ADHD\">What is ADHD?<\/a> | <a href=\"#symptoms\">Symptoms<\/a> | <a href=\"#similar-conditions\">Conditions with similar symptoms<\/a> | <a href=\"#statistics\">ADHD misdiagnosis statistics<\/a> | <a href=\"#misdiagnosis\">Why misdiagnosis happens<\/a> | <a href=\"#proper-diagnosis\">Proper diagnosis<\/a> | <a href=\"#treatment\">Treatment<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Does your daughter seem to have boundless energy, running circles around all of her peers? Or does your son seem to have a hard time concentrating in class, earning poorer than expected grades? It\u2019s hard for a parent to know whether behaviors like these are symptoms of ADHD\u2014or simply kids being kids. Getting an accurate ADHD diagnosis for your child from a mental-health professional could mean the difference between just getting by and growing up with confidence.\u00a0\u00a0<\/span><\/p>\n<h2 id=\"what-is-ADHD\">What is ADHD?<\/h2>\n<p><span style=\"font-weight: 400;\">Attention deficit hyperactivity disorder is a neurodevelopmental disorder \u201ccharacterized by a pattern of behavior, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings,\u201d according to the <\/span><a href=\"http:\/\/www.dsm5.org\/documents\/adhd%20fact%20sheet.pdf\" target=\"_blank\" rel=\"noopener\"><i><span style=\"font-weight: 400;\">Diagnostic and Statistical Manual of Mental Disorders<\/span><\/i><\/a><span style=\"font-weight: 400;\"> (<\/span><i><span style=\"font-weight: 400;\">DSM-5<\/span><\/i><span style=\"font-weight: 400;\">). These patterns of behavior are divided into either inattention or hyperactivity-impulsivity and include symptoms ranging from failure to listen or follow instructions to fidgeting or excessive talking.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The cause of ADHD is unknown, according to <\/span><a href=\"https:\/\/www.dianadeutschmd.com\/about\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Diana Deutsch, MD<\/span><\/a><span style=\"font-weight: 400;\">, a Brooklyn-based psychiatrist, though she says that there is a suspected hereditary component at play.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cYou&#8217;ll often see a child who has this, and the father will say, \u2018Oh, well, I had that when I was a kid,\u2019&#8221; she explains, adding that while you are likely born with ADHD, environmental factors can also have an effect on the condition. These environmental factors can include <a href=\"https:\/\/www.singlecare.com\/blog\/news\/cyberbullying-statistics\/\">bullying<\/a>, inconsistent routines, boredom, and possibly diet.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The fact that ADHD is associated with a <\/span><a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)61684-6\/fulltext\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">big increase in deaths<\/span><\/a><span style=\"font-weight: 400;\"> makes it even more important to establish a correct diagnosis. The increase in deaths is mostly from accidents, but suicides and drug overdoses are also more common in both kids and adults with ADHD.<\/span><\/p>\n<h2 id=\"symptoms\">ADHD symptoms<\/h2>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.cdc.gov\/ncbddd\/adhd\/diagnosis.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">symptoms of ADHD<\/span><\/a><span style=\"font-weight: 400;\"> fall into two categories: inattention and hyperactivity-impulsivity, with most kids having a combination of both, according to Dr. Deutsch.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Typical inattention symptoms include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficulty sustaining attention<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Getting distracted easily<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Not paying attention to details<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Making careless mistakes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Struggling to finish assignments or follow directions<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Losing or forgetting things<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Typical hyperactivity-impulsivity symptoms include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Acting before thinking<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Restlessness and fidgeting<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Talking a lot or interrupting people at inappropriate times.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These symptoms must present in a child before the age of 12 and cause disruption in their life, in order for an ADHD diagnosis to be reached.\u00a0 For children younger than 17, the diagnosis requires at least 6 symptoms for at least 6 months and for those ages 17 or older, the diagnosis requires at least 5 symptoms for at least 6 months.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To that end, if <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/adult-adhd-medication-treatment\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">as an adult<\/span><\/a><span style=\"font-weight: 400;\">, you suddenly find yourself having difficulty concentrating, there are a lot of other conditions (such as anxiety or depression) that your provider will likely rule out first. Though, it\u2019s common for an adult to have had ADHD as a child and have it persist into adulthood. In these cases, Dr. Deutsch says the symptoms may look much the same in adulthood, though the vocabulary used to describe them will likely be a little different.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThere isn&#8217;t a pediatric ADHD list of symptoms in the DSM versus an adult list,\u201d she says. \u201cHowever, it often presents differently. You could have a spouse saying, \u2018My husband goes from one thing to the next and it&#8217;s hard for him.\u2019 Or sometimes a young adult will come in and say, \u2018I know I&#8217;ve always had this difficulty, but no one ever took me [to the doctor], or I was smart enough that I managed.\u2019\u201d\u00a0<\/span><\/p>\n<h2 id=\"similar-conditions\">What can ADHD be mistaken for?<\/h2>\n<p><span style=\"font-weight: 400;\">There are several conditions that mimic ADHD symptoms in kids, such as the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anxiety disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Depression<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stress response<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sleep disorders or poor sleep hygiene<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Substance use<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Learning disabilities, such as dyslexia<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hearing problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Autism spectrum disorder<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Oppositional defiant disorder<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sensory processing disorder<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bipolar disorder<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These conditions often occur alongside ADHD. When diagnosing ADHD, providers should be careful not to conflate ADHD symptoms with other mental-health issues, such as anxiety disorders or mood disorders. \u201cAnyone who&#8217;s ever been anxious, which is everyone, knows it&#8217;s impossible to pay attention when you&#8217;re really anxious,\u201d Dr. Deutsch says. \u201cYou cannot focus.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Developmental disorders, such as learning disabilities and autism spectrum disorders, should also be ruled out. \u201cThe other thing is sometimes a kid is just academically mismatched,\u201d Dr. Deutsch says. \u201cThis is very important. Somebody&#8217;s kids will come home and they&#8217;ll say they&#8217;re bored, but actually maybe they have a learning disability.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is possible for a child to have both a developmental disorder and ADHD (or anxiety\/depression and ADHD), so there is a lot of nuance involved in accurately diagnosing the underlying issue(s). That\u2019s why it\u2019s important to have a specialist determine the cause of ADHD-like symptoms. For <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/adult-adhd-medication-treatment\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">school-aged children<\/span><\/a><span style=\"font-weight: 400;\">, adolescents and college students, it is important to seek an educational evaluation to achieve the proper diagnosis and important educational accommodations.<\/span><\/p>\n<h2 id=\"statistics\">How often is ADHD misdiagnosed?<\/h2>\n<p><span style=\"font-weight: 400;\">The estimated number of children to ever be diagnosed with ADHD, per a 2016 parenting survey cited by the <\/span><a href=\"https:\/\/www.cdc.gov\/ncbddd\/adhd\/data.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Centers for Disease Control and Prevention<\/span><\/a><span style=\"font-weight: 400;\"> (CDC), is 6.1 million. Yet, a 2017 study published in <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5240230\/#\" target=\"_blank\" rel=\"noopener\"><i><span style=\"font-weight: 400;\">Child and Adolescent Psychiatry and Mental Health<\/span><\/i><\/a><span style=\"font-weight: 400;\"> suggested that around 1.1 million children in the United States have \u201creceived an inappropriate diagnosis\u201d of ADHD.\u00a0<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/news\/adhd-statistics\/\"><b>ADHD statistics<\/b><\/a><\/p>\n<h2 id=\"misdiagnosis\">Why does ADHD misdiagnosis happen?<\/h2>\n<p><span style=\"font-weight: 400;\">The study listed a number of potential reasons for the misdiagnosis of ADHD in children including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Having a birthdate close to the kindergarten cut-off date. Often, these immature students\u2019 behaviors are compared to their relatively more mature classmates\u2019 behavior in order to reach a diagnosis. (Essentially, while all the students are in kindergarten, the 5-year-old\u2019s actions will likely be less savvy than the 6-year-olds\u2019 actions.)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Providers coming to their own conclusions and not properly utilizing the diagnostic methodologies outlined in the <\/span><a href=\"https:\/\/www.cdc.gov\/ncbddd\/adhd\/diagnosis.html\" target=\"_blank\" rel=\"noopener\"><i><span style=\"font-weight: 400;\">DSM-5<\/span><\/i><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Symptoms of ADHD mimicking those of other conditions, or a patient presenting with multiple conditions, making the diagnosis more complicated.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pressure from parents to make this diagnosis instead of exploring parenting or lifestyle issues<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">While overdiagnosing is an often-discussed problem with ADHD, less attention is paid to the phenomenon of underdiagnosing. Girls and adolescent young women are typically diagnosed less frequently, often because their symptoms aren\u2019t the more noticeable hyperactive kind and they are able to compensate well enough.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSmart girls are the most overlooked group, who I get to see when they are 27 years old,\u201d says Owen Muir, MD, a psychiatrist and co-founder of <\/span><a href=\"https:\/\/www.brooklynminds.com\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Brooklyn Minds<\/span><\/a><span style=\"font-weight: 400;\">. \u201cNobody cares if you\u2019re getting an A not an A+, or if you\u2019re a girl, and you\u2019re getting a B+, especially if you\u2019re quiet. And so quiet girls who have inattentive type ADHD and are very smart, there&#8217;s not enough difficulty range in grade school or high school to make it matter. They can do those things in their sleep. They can be tremendously impaired, but If they\u2019re smart enough, it doesn\u2019t matter\u2014until you get to the point where you hit the wall.\u201d And that point is when the demands outstrip their ability to deal with them, prompting a diagnosis much later in life.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Living with undiagnosed (and, therefore, untreated) ADHD can have major consequences, from low self esteem and difficulty at work to relationship problems\u2014even attempted suicide.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/adhd-medication-for-teens\/\"><b>The benefits of ADHD medication for teens<\/b><\/a><\/p>\n<h2 id=\"proper-diagnosis\">Properly diagnosing ADHD<\/h2>\n<p><span style=\"font-weight: 400;\">If your child or adolescent is exhibiting symptoms of ADHD, it\u2019s important to take them to a medical professional for testing. The first step, according to the <\/span><a href=\"https:\/\/www.cdc.gov\/ncbddd\/adhd\/facts.html#1\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">CDC<\/span><\/a><span style=\"font-weight: 400;\">, is typically a simple medical test to check their vision and hearing to rule out any physical conditions that could mimic the symptoms of ADHD. After that, a mental health professional will likely conduct a series of interviews, with parents, teachers, and the child, to really get a sense of what the issues are and how they are affecting the child\u2019s school and home life.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cIt really is a clinical diagnosis,\u201d says Dr. Deutsch. \u201cBut in order to make it, we have to put in a lot of pieces that aren&#8217;t clinical. But mostly it&#8217;s the list. It&#8217;s performance: Why is this child not doing what you would expect? Why is this person having so much difficulty in this academic setting? It\u2019s like being a detective.\u201d\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There is not one test to diagnose ADHD and the best approach is comprehensive neuropsychological or educational evaluation. The assessment may include observational forms for the parents and teachers to complete, known as the <\/span><a href=\"https:\/\/www.nichq.org\/sites\/default\/files\/resource-file\/NICHQ-Vanderbilt-Assessment-Scales.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Vanderbilt forms<\/span><\/a><span style=\"font-weight: 400;\">. The optimal testing age range, according to the <\/span><a href=\"https:\/\/publications.aap.org\/pediatrics\/article\/144\/4\/e20192528\/81590\/Clinical-Practice-Guideline-for-the-Diagnosis\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">American Academy of Pediatrics<\/span><\/a><span style=\"font-weight: 400;\">, is 4 to 18 years of age.\u00a0<\/span><\/p>\n<h2 id=\"treatment\">ADHD treatment<\/h2>\n<p><span style=\"font-weight: 400;\">Treatment for ADHD falls into two categories: behavioral and pharmacological. Depending on the child\u2019s age and needs, they will often be used in tandem to treat the disorder.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">How do you treat ADHD without medication?\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Behavioral treatment is usually the first step for very young children (ages 4 and 5) diagnosed with ADHD. This often takes the form of parent training. \u201cParents have to understand that they need to positively reinforce the good behavior they see,\u201d says Dr. Deutsch. Parents also learn how to break down large tasks into smaller steps. In order for their child to successfully follow along, each step should be accompanied by more positive reinforcement. For older kids, behavioral treatment may also include some form of therapy. Mental health professionals may also consult with a student\u2019s teachers to devise the right kind of learning plan for them. Other important considerations include: providing clear expectations, using a consistent routine, ensuring adequate sleep, setting age-appropriate goals, breaking tasks up into smaller chunks, giving lots of praise and rewards, and communicating frequently with school staff.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/adhd-drug-holiday\/\"><b>Should your children take a break from ADHD medication?<\/b><\/a><\/p>\n<h3><span style=\"font-weight: 400;\">What is the best medicine for ADHD?\u00a0<\/span><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/conditions\/adhd-treatment-and-medications\"><span style=\"font-weight: 400;\">ADHD medications<\/span><\/a><span style=\"font-weight: 400;\"> fall into two categories: stimulants and non-stimulants. \u201cFirst line is stimulants,\u201d says Dr. Deutsch. Stimulant medications (which are usually methylphenidate or amphetamine-based) include drugs like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/adderall\"><span style=\"font-weight: 400;\">Adderall<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ritalin\"><span style=\"font-weight: 400;\">Ritalin<\/span><\/a><span style=\"font-weight: 400;\">, <a href=\"https:\/\/www.singlecare.com\/prescription\/concerta\">Concerta<\/a>, and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/dexedrine\"><span style=\"font-weight: 400;\">Dexedrine<\/span><\/a><span style=\"font-weight: 400;\">. According to the <\/span><a href=\"https:\/\/www.fda.gov\/consumers\/consumer-updates\/dealing-adhd-what-you-need-know\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Food and Drug Administration (FDA)<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">\u201cthey are believed to increase brain levels of dopamine\u2014a neurotransmitter associated with motivation, attention, and movement,\u201d which has a calming effect. If children cannot take a stimulant (perhaps because of another underlying condition), they will then be prescribed a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/qelbree-viloxazine-fda-approval\/\"><span style=\"font-weight: 400;\">non-stimulant drug<\/span><\/a><span style=\"font-weight: 400;\"> such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/strattera\"><span style=\"font-weight: 400;\">Strattera (atomoxetine)<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/intuniv\"><span style=\"font-weight: 400;\">Intuniv (guanfacine)<\/span><\/a><span style=\"font-weight: 400;\">, or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/kapvay\"><span style=\"font-weight: 400;\">Kapvay (clonidine)<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These drugs can have side effects, and there is no one-size-fits-all treatment plan for ADHD, so it\u2019s important to work with your child\u2019s physician to tailor a treatment plan for them, which may need some tweaking along the way.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/when-medication-wears-off-adhd-rebound\/\"><b>When ADHD medication wears off: How to handle the after-school witching hour<\/b><\/a><\/p>\n<p><span style=\"font-weight: 400;\">While ADHD cannot be cured, it can be well-managed. Many people with the condition build such effective coping strategies that they no longer need medication as adults.\u00a0\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>What is ADHD? | Symptoms | Conditions with similar symptoms | ADHD misdiagnosis statistics | Why misdiagnosis happens | Proper diagnosis | Treatment Does your daughter seem to have boundless energy, running circles around all of her peers? Or does your son seem to have a hard time concentrating in class, earning poorer than expected [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":11382,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[15107,3564],"coauthors":[8215],"class_list":["post-1291","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-adhd","tag-children","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>ADHD misdiagnosis: What can ADHD be mistaken for?<\/title>\n<meta name=\"description\" content=\"There are various ADHD symptoms in kids, making it easy to overlook or confuse with other conditions. 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