What is ADHD? ADHD (attention-deficit hyperactivity disorder) is not just “being hyper” or “not paying attention,” but a set of strict criteria. It can be a challenging diagnosis to make since there are many other things that can mimic ADHD. It’s important to distinguish them, since the approach and treatment is very different.
One of the most common diagnoses that can look like ADHD are learning disabilities. Academic problems or learning disabilities are common mimickers of ADHD. These children often seem like they are not paying attention, however, due to a learning disability they truly do not understand what is being taught. Learning disabilities are commonly isolated to one type of subject like reading or math, so look for significant grade and performance discrepancies in subjects. Psychoeducational testing through the Department of Education is a good place to start investigating if there is a concern.
Hearing and vision problems can mimic ADHD as well. When kids can’t see or hear well they likely are not paying attention. These are easily picked up by some simple screenings at the pediatrician’s office and can be done at a young age.
Anxiety in children can happen at the same time as ADHD or can mimic ADHD, and it’s important to distinguish the two. Kids who are anxious are very busy being worried. When this happens they probably are not paying attention to what’s going on around them. As a result of this inattention, they may have poor grades. Anxious kids can be fidgety and irritable, which can all look like ADHD as well. The medication used to treat anxiety may worsen ADHD, so it’s important to have a medical professional make the diagnosis and monitor carefully for improvement.
Depression in children is rare but can mimic ADHD. While children who are sad can be depressed, it’s more common to see irritability as one of the first signs of depression. Children who are depressed can seem lazy, unmotivated and sloppy, which can interfere with their concentration. On the contrary, they feel like nothing matters, so their depression prevents them from focusing. This is a sudden, noticeable difference in behavior.
Behavioral challenges and oppositional defiant disorder (ODD) are common ADHD mimickers. Kids with ODD are constantly irritable, argumentative and don’t care about authority. This happens in more than one setting, for example in school and at home. Other important signs of ODD include inability to take blame, hurting or bothering others, quick to lose their temper, resentful and jealous. ODD and ADHD often go hand in hand and it is common for a child to have both of them.
Autism is a frequent mimicker of ADHD and often the two conditions overlap. Autistic children may lack social cues and as a result may seem impulsive and inattentive.
What next? If you or your child’s teacher is worried about inattention, the best place to start is by speaking to your pediatrician. There are screening tools, questionnaires and other resources available that can lead the family in the right direction. Once a diagnosis is made, it’s important to have good communication with the school so they can work together to support the child. Available tools may include a 504 plan, an IEP (individual education plan), tutoring, therapy and medication.
Jennie Berkovich, DO, pediatrician, is JOWMA director of health education. Sarah Becker, MD, child and adolescent psychiatry, is JOWMA director of mental health.
The Jewish Orthodox Women’s Medical Association (JOWMA) provides free health education to the entire Orthodox Jewish community and supports a network of current and future Jewish female physician leaders.