Inattention and distractibility are caused by many medical conditions and life situations. You child may not have ADHD or ADD if they didn’t show signs when they were young.
Children don’t just catch ADHD or ADD
If your child has a behavioral change you haven’t seen before, there may be an underlying medical or co-occurring mental disorder that’s causing ADHD symptoms… especially if they’re on ADHD-ADD medications which are not working well.
“It is vital not to mistake another medical or psychiatric condition as ADHD.”
— Richa Bhatia, MD, Fellow of the American Psychiatric Association
The medical conditions listed below produce ADHD and/or ADD symptoms such as slow processing speed, impulsive behavior, and limited attention and focus.
Epileptic seizures: some types cause a brief freeze in thinking–the child’s brain goes blank for a few moments (“absence seizures”)
Diseases of the brain: Lyme disease, HIV infection, parasitic and viral infections, brain tumors
Brain damage from head injury or toxins (e.g. narcotics)
Chemotherapy side-effects, “stupor”
Hypothyroidism. Too little thyroid hormone results in memory, attention, and concentration problems. It decreases blood flow in brain regions that mediate attention and executive functioning (the hippocampus and cerebral cortexes).
Hyperthyroidism. At the other extreme, too much thyroid hormone causes anxiety and tension, irritability and impatience, and hyperactivity and distraction.
Sleep apnea. A condition where a child stops breathing during sleep, for a few seconds to a few minutes several times per night. The following day, the child can’t pay attention, remember, or follow a sequence of steps. It also causes hyperactivity and belligerence.
Mental health disorders with ADHD-like symptoms:
Anxiety disorders are common to most other mental health conditions, and create problems with concentration. The chronic stress from anxiety affects the brain regions responsible for memory and cognitive functions. If a child does not have a history of ADHD symptoms, than significant and pervasive anxiety may be the cause of inattention and distraction.
Abuse or trauma. Difficulty concentrating is one of the core symptoms of post-traumatic stress disorder (PTSD), and recent abuse or trauma can cause agitation, restlessness, and behavioral disturbance—symptoms that mimic ADHD.
Depression – Difficulty concentrating also is a criterion for major depressive disorder.
Bipolar disorder – ADHD symptoms are apparent in children with suspected bipolar disorder. Both disorders can cause distractibility, increased energy, and instant mood swings. (Some children are eventually diagnosed with both disorders.)
Drug abuse using marijuana, cocaine, ecstasy, produce similar symptoms of ADHD because they affect the same brain regions affected by anxiety. MRI scans of the brain were taken of young children who were exposed to cocaine in the womb. The scans revealed frontal lobe malformations which predicted long-term problems with attention and impulse control.
Common stimulant foods and beverages with excess caffeine or sugar
Insomnia from medical conditions. Sleep plays a huge role in memory and attention. Sleep disorders (e.g., sleep apnea, restless legs syndrome) can produce chronic tiredness and significantly reduce attention, concentration, and cognitive functioning in children, adolescents, and adults.
Plain old lack of sleep in healthy children can cause inattention and reduce academic achievement. There are many causes of sleep loss: early school hours; screen time at least an hour before bed (because the blue light suppresses sleepiness); or allowing the use of technology in the bedroom at nighttime. What helps getting to sleep and staying asleep:
A cool, dark room
Thirty minutes of reading or drawing on paper before lights out.
Removing phones, laptops, or desktops from the bedroom at night.
Learning disorders: Children with an undiagnosed learning disorder often present with ADHD symptoms. An undiagnosed reading or mathematics disorder (dyslexia), or an autism spectrum disorder that’s not yet diagnosed, can have a significant impact on classroom behavior. The child might not be paying attention because of his (her) restricted ability to grasp the subject matter, or because they are frustrated and irritated with the struggle to keep up.
Caution: Teachers often report a student’s inattention and confused thinking to parents, and suggest a diagnosis of ADHD when the real problem may be lack of sleep or something else. It’s useful to hear classroom observations of your child, but teachers are not trained in mental health diagnosis—get a second opinion from a professional!
This article contributed by the Diamond Ranch Academy.
Life with a child with ADD or ADHD can be trying and overwhelming. However, as a parent there are practical measures you can take to effectively control and minimize your child’s symptoms without controlling and monitoring their every move.
You help your child overcome daily challenges by redirecting his or her energy into positive activities. You start by having a dialogue with your child and family that honestly communicates the situation in a way that does not accuse them of being “bad”. Their behavior needs improvement, but speak as if it’s a ‘normal’ problem that must be addressed.
Children with ADD or ADHD typically have shortcomings in executive function: the ability to think and plan ahead, organize, control impulses, and complete tasks. This means that you need to take over as the executive, providing extra direction while your child progressively obtains executive skills of his or her own. With tolerance, kindness, and plenty of family teamwork, you can help your child manage childhood ADD or ADHD and maintain a steady, happy home
You must to be able to master a combination of support and predictability.
Living in a home that provides love and lots of structure is the best thing for a child or teenager who is learning to manage ADD/ADHD. There are effective and simple changes you can make that are easy to implement; we offer four practical tips to help you understand and support your child with ADD or ADHD:
1. Be honest with your child about ADD or ADHD It is important not to avoid or ignore your child’s condition. ADD or ADHD is not your child’s fault, it is a brain disorder that causes young people to have trouble focusing, completing tasks, or planning the future. Most parents can reframe things, but don’t look at the negative. Your child should understand it is something they can and should manage. The rest of your family should do this too.
2. Stay Positive When calm and focused, you are more likely to get your child’s attention and help him or her to be peaceful and attentive. And keep things in perspective. Your child’s behavior is related to a disorder, so most of the time it is not deliberate. Don’t sweat the small stuff; be willing to negotiate certain matters. For example, if one chore is left undone but your child has already completed two chores and their homework for the day, let it go and appreciate what they were able to complete. Staying positive also means believing and trusting your child. Trust that your child will learn, change, mature, and succeed. Trust that your child wants to!
Taking care of yourself will allow you to take better care of your child.
It is vital to live a full, healthy life because you are the child’s role model and source of strength. Eat right, exercise, and find ways to reduce stress. Getting involved with organizations related to ADD or ADHD will also provide you with safe places to vent your frustrations and share experiences.
3. Establish structure, enforce rules and consequences calmly
Help your child with ADD or ADHD to stay attentive and prepared by setting a strict routine. Set a time and place for everything to help your child with ADD or ADHD comprehend and meet expectations. Allow extra time for what your child needs to do, such as homework, chores, and getting ready in the morning. Keep them busy but not too busy—a child with ADD or ADHD will become more distracted and act up if there are too many after-school activities going on.
Create structure in your home so your child knows what to expect and when.
Children with ADHD are more likely to succeed if they can complete tasks when the tasks occur in probable patterns and in foreseeable places. Children with ADHD need rules because it helps them track time and progress. Make the behavior rules simple and clear. Write down the rules and hang them up in a place where your child can read them. Children with ADD or ADHD respond exceptionally well to prearranged systems of rewards and consequences. It’s important to explain what will happen when the rules are obeyed and when they are broken. Finally, stick to your system by following through each and every time with a reward or a consequence.
4. Encourage movement and sleep
Children with ADD or ADHD often have a lot of energy to burn. Organized sports and other physical activities can help them get their energy out in healthy ways, and refine their focus while enjoying the development of new skills and abilities. Exercise leads to better sleep with children with ADD or ADHD, which also reduces symptoms of ADD or ADHD. Children with ADD or ADHD often find “white noise” to be calming when sleeping. You can create white noise by putting a radio on static or running an electric fan, for example.
Guest Post by: Diamond Ranch Academy Diamond Ranch Academy is one of the premier youth residential treatment centers for struggling teens. Since 1999, the highly trained staff at this facility has provided guidance and support for teens with varying emotional and behavioral issues including; substance abuse, depression, ADHD, impulse control, peer pressure, anger management, oppositional defiance, self-esteem, grief/loss issues, family relationships, communication, and academic struggles.
Note from blog owner, I am not personally familiar with Diamond Ranch Academy and this post is not an endorsement, but this post offers good information for any parent of a child with ADD or ADHD. For ideas on what to look for in a good residential program, see the post Residential treatment checklist
I confess I used to think attention deficit disorders were not as serious as other disorders. I was so wrong.
Sure, teens with attention deficits had problems, but they didn’t compare with the disabling and dangerous problems resulting from bipolar or schizophrenia. ADHD kids seemed more ‘functional’ to me and treatments seemed to work better. They were also friendly and funny. While other families with mentally ill children talked about psychotic breaks, suicide, and panic attacks, I heard parents of ADHD kids talk about frustration and daily calls from school. Heck, kids with ADHD could attend school!
“Genius by birth; slacker by choice.” –seen on a T-shirt
I confess, I thought ADHD symptoms made a person interesting, and fun and creative (true), but my perception changed radically when I found research on children with ADHD who were tracked from childhood to adulthood. These studies revealed deeply unsettling news—the consequences of ADHD can be quite serious.
Adults with ADHD have a higher risk of developing other psychiatric problems, being victimized and incarcerated, and facing lifetime struggles with education, employment, and relationships. Summaries from 10 research studies on the long-term prognosis of ADHD are found at the end of this post.
People with ADD and ADHD have so many gifts!
When I attended a children’s mental health conference, a workshop was lead by a panel of young people with with ADHD. They were articulate about their experiences and needs, answered questions, and interacted appropriately with audiences. So many strengths! Young people with other disorders can be challenged by the cognitive and emotional demands of these tasks. I learned a lot.
Parents need the support to address the basics: behavior at school and home, school attendance and educational attainment, self-esteem, and self-actualization. In addition to medical/medication treatment as recommended, parents need to know how to teach self-calming skills so their child can effectively control impulses.
Little things start adding up – Without skills (and/or medication), a person with ADHD slips up on life’s daily little challenges–losing, forgetting, neglecting, overreacting, disappointing others, and undermining themselves in a thousand different ways.
Dependence and resentment – I’ve noticed that those with ADHD seem to find or attract others they can depend on to help them function, but their “caretakers” (spouse, friend, co-worker) and family pay a price. A person with ADHD can resent their dependence on others, or become so dependent that others resent them.
Unfinished business – Those with ADHD drag unfinished projects with them indefinitely, keeping them in an actual or metaphorical garage full of costly unfinished projects. Little repairs become big expensive repairs through lack of maintenance. Bills don’t get paid, licenses don’t get renewed, debtors get away with never paying them back.
Guide your child to his or her gifts
From personal experience with ADHD children and adults, I know they can love, be affectionate, funny, generous, highly creative, and show empathy for others.
Think of careers your child or teen might pursue that require creativity, energy, and enthusiasm. Introduce them to experiences that challenge them, and ignore the myth that they can’t focus or that they mess things up, not true. ADHD kids readily focus on projects they enjoy, demonstrate mental nimbleness with complexities, multitask with accuracy, and shine in emergencies, whether debugging software, making music, or even doing surgery.
Q: “How many kids with ADHD does it take to change a lightbulb?” A: “What was the question again? I saw something shiny.”
A personal rant: I’ve read articles that question the existence of ADHD or criticize parents who get medication for their son or daughter. Prejudice against this disorder and parents is sadly common. Public misinformation and controversy over ADHD and medication negatively influences parents’ decisions.
Some think ADHD is an excuse for bad parenting, or treatable with natural substances or meditation, etc. Parents don’t cause ADD, ADHD. And while non-drug options help, results can be marginal and short-lived. I know parents who cling to pseudo-treatments that fit a personal philosophy, but can’t admit when they’re child’s symptoms aren’t improving. If a non-drug remedy is effective, this will be the proof: the child keeps up with their peers at school, exhibits behaviors typical for their age, and is able to learn some self-control.
At another extreme, some parents want a “quick fix” with pills. Or, if parents are happy with the results of the right medication, they overlook their child’s discomfort with side effects, or worse, they overlook how their home environment aggravates distraction and chaos. A pill will partially compensate for bad parenting and a crazy-making household, but that child does not deserve the burden.
High School Students With ADHD: The Group Most Likely to…Fizzle
Breslau J, Miller E, Joanie Chung WJ, Schweitzer JB.Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time. Journal of Psychiatric Research. Jul 15 2010
Adolescents with attention deficit/hyperactivity disorder (ADHD), conduct disorder, or who smoke cigarettes are least likely to finish high school (HS) on time or most likely to drop out altogether, researchers at the University of California, Davis, School of Medicine (UC Davis) have found.
Lead investigator Joshua Breslau, PhD, ScD, medical anthropologist and psychiatric epidemiologist reported that of a total of 29,662 respondents, about one-third (32.3%) of students with combined-type ADHD were more likely to drop out of high school than students with other psychiatric disorders. This figure was twice that of teens with no reported mental health problems (15%) who did not graduate. Students with conduct disorder were the second at-risk group (31%) to drop out or not finish on time. Cigarette smokers were third in line, with a staggering 29% who did not finish high school in a timely manner.
Educational achievement squelched in children with ADHD Newsletter – NYU Child Study Center, New York, NY, February 2009
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common disorders in childhood and adolescence, with prevalence estimates ranging from five to ten percent. Children with untreated ADHD drop out of high school 10 times more often than other children.
Adult psychiatric outcomes of girls with attention deficit hyperactivity disorder American Journal of Psychiatry, January 2010 Researchers studied age 6 to 18-year-old girls with diagnosed ADHD and followed up after 11 years. Conclusions: By young adulthood, girls with ADHD were at high risk for antisocial, addictive, mood, anxiety, and eating disorders. However, ADHD medications appear to reduce the prevalence of multiple disorders at least in the short-term. These findings, also documented in boys with ADHD, provide further evidence for negative long-term impacts ADHD across the life cycle.
Brain abnormality found in boys with attention deficit hyperactivity disorder Journal of Abnormal Psychology, March 2009 Researchers trying to uncover the mechanisms that cause ADHD and conduct disorder found an abnormality in the brains of adolescent boys suffering from the conditions. The research focused on two brain areas, the “mid brain” striatal, and cerebral cortex. The mid brain motivates people to engage in pleasurable or rewarding behavior. The cortex notices if an expected reward stops and considers options. However, this doesn’t occur as quickly in boys with ADHD or conduct disorders. Instead, the mid brain region keeps trying for rewards, which is a quality of addictive behavior.
Kids with ADHD more likely to bully, and those pushed around tend to exhibit attention problems Developmental Medicine & Child Neurology, February 2008 Children with attention deficit hyperactivity disorder are almost four times as likely as others to be bullies. And, in an intriguing corollary, the children with ADHD symptoms were almost 10 times as likely as others to have been regular targets of bullies prior to the onset of those symptoms. Bullies were the kids in class who couldn’t sit still and listen, didn’t do their homework and were almost constantly in motion. Children with ADHD symptoms make life miserable for their fellow students, and they too can develop attention problems related to the stress of being bullied.
Girls’ hyperactivity and physical aggression during childhood and adjustment problems in early adulthood: A 15-year longitudinal study. Archives of General Psychiatry, March 2008 Girls with hyperactive behavior such as restlessness, jumping up and down, and difficulty keeping still or fidgety, and girls exhibiting physical aggression such as fighting, bullying, kicking, biting or hitting, all signs of ADHD, were found to have a high risk of developing adjustment problems in adulthood.
Teen’s inattentive symptoms may determine how long they stay in school Forum for Health Economic & Policy, November 2009 Poor mental health of children and teenagers has a large impact on the length of time they will stay in school, based on the fact that at conception there are differences in genetic inheritance among siblings. This study provides strong evidence that inattentive symptoms of ADHD in childhood and depression in adolescents are linked to the number of years of completed schooling.
Children with ADHD more likely to participate in crimes Yale School of Public Health and University of Wisconsin at Madison, October 2009 Children with ADHD are more likely to participate in crimes such as burglary, theft and drug dealing as adults. Those who had attention deficit hyperactivity disorder as children were at increased risk of developing criminal behaviors. Researchers said one reason is that children with ADHD tend to have lower amounts of schooling.
ADHD may affect adults’ occupational and educational attainments Journal of Clinical Psychiatry September 2008 Adults who have ADHD generally have lower occupational and educational attainments as adults than they might have reached if they didn’t have the disorder, at least compared to what attainments would have been expected given their intellect. “Educational and occupational deficits… are a consequence of ADHD and not IQ,” lead researchers Dr. Joseph Biederman said. The finding strongly underscores the need for “diagnosing and treating ADHD to avert these serious consequences,” he said.
Attention-deficit/hyperactivity disorder (ADHD) in the course of life. European Archives of Psychiatry and Clinical Neuroscience, September 2006. ADHD is a pervasive disorder that extensively impairs quality of life and that can lead to serious secondary problems. Long-term studies have demonstrated that the disorder is not limited to childhood and adolescence. The clinical experience indicates substantial difficulties for adults whose ADHD is not diagnosed and treated, and they often create extensive costs for the welfare system. The evidence-based psychiatric treatment available is highly effective and inexpensive.
70% of crystal meth (methamphetamine) inpatients had ADHD Journal of Addiction Disorders. 2005, and the blog:Adult ADHD Strengths.
Methamphetamine-dependent inpatients were screened for childhood attention deficit hyperactivity disorder (ADHD), and of the participants, 70.6% screened positive for ADHD and reported significantly more frequent methamphetamine use prior to baseline. ADHD participants exhibited significantly worse psychiatric symptomatology. At a three-week follow-up, all who didn’t complete treatment screened positive for ADHD.