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Things That Cause ADHD-Like Symptoms
by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.
In diagnosing ADHD, a doctor has to check carefully for other conditions that can imitate ADHD but require very different treatment. As the parent of a child who may have ADHD, you should know about these other possibilities so that you can be alert to signs of them.
The following list isn't complete, but it covers the most common problems that can look like ADHD:
- Medications: The most common medical cause of ADHD symptoms is probably medications taken to treat other conditions. Allergy medicines and medicines to treat seizures are well known for causing hyperactive behavior, but many others do, too. You may or may not find this side effect listed on the bottle; when in doubt, check with your child's doctor or the pharmacist.
- Seizures: A particular kind of seizure, called absence seizures or petit mal, causes a child to stare with a blank look for several seconds or even minutes at a time. It looks like the child is daydreaming, when in actuality he is unconscious. He may or may not fall down. These seizures can cause a child to lose track of what's going on in the classroom and appear inattentive. An EEG test is good at picking up this treatable condition.
- Sleep problems: A child who is overtired much of the time may appear to have ADHD. A common cause of overtiredness is obstructive sleep apnea (OSA), a condition that almost always involves snoring. Any child who may have ADHD and who snores needs to be evaluated for OSA.
- Vision and hearing deficits: Obviously, a child who can't see the board or hear the teacher will have trouble paying attention in class. Even partial hearing loss can interfere with the child's ability to make sense of what he hears, and therefore to pay attention to it. The best way to rule out such possibilities is through formal hearing and vision testing.
- Learning disabilities: Children with various types of learning disabilities (LD) often have difficulty staying focused in class. They tend to do much better at home and with friends. LD can mimic ADHD, or the two conditions can coexist. The treatment for LD is not medication, but rather special education.
- Too little, or too much, structure: Classrooms and homes that are disorganized, with lots of distractions (such as other children yelling or the TV playing all the time), can make some children act as though they have ADHD. On the other hand, classrooms or homes that are overly structured--requiring a child to sit still for long periods of time without talking, for example--can make a child who simply has an active and spontaneous personality appear to have ADHD.
- Anxiety: Children who are anxious all the time--perhaps because there is fighting at home or at school, or because of some other source of stress--often have difficulty paying attention. A family history of anxiety disorders should raise this possibility in any child suspected of having ADHD. Closely related problems include obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Children who have been abused--either physically, sexually, or emotionally--can have a tough time focusing on particular tasks and controlling their impulses. The medications often used to treat ADHD can make anxiety disorders worse, so the distinction between these conditions is very important.
- Depression: Although many adults with depression move less than normal, children who are depressed may be overactive, impulsive, and inattentive--just like children with ADHD. There are also other symptoms that a skilled doctor can find that point toward depression. Because the treatment of this condition is very different from the treatment of ADHD, it's important for the child's doctor to consider depression.
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Created November 28, 2001
Reviewed August 15, 2004
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