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ADHD vs PTSD in Children

Attention Deficit Hyperactivity Disorder (ADHD) vs. Post-Traumatic Stress Disorder (PTSD) in Children
By: Nate Pearlman, MA, LCPC

“Is my child ADHD/ADD?” “Could my child have PTSD?” “Can a child be diagnosed with ADHD/ADD and PTSD?”
These are just a few commonly asked questions that, as a Mental Health Counselor, I am asked almost daily by parents that bring their child to the clinic for a mental health assessment and counseling services. My first task in answering their questions is to educate them about the “Pros” and “Cons” related to giving a child a “formal” clinical diagnosis. My biggest priority is to help them understand why diagnoses are necessary as a clinical “shorthand” that allows other clinical members of their Child’s Treatment Team to communicate about the cluster of symptoms or presenting problems or issues that the child is struggling with and in need of counseling services. I stress that the letters ADHD/ADD and PTSD allow clinicians to know what the cluster of symptoms or presenting problems are that need to be addressed and work on with the child in their counseling treatment.

So, with that being said, let me address the questions that were posed at the top of this blog before diving into the symptom comparison between Attention Deficit Hyperactivity Disorder vs Post Traumatic Stress Disorder in Children.

“Is my child ADHD/ADD?”: The answer is “No”. Your child struggles with a cluster of symptoms that make it difficult for your child to pay attention, focus on tasks, not get distracted, not make impulsive choices, or act out impulsively without thinking about the potential consequences of his/her actions and not daydreaming or “drifting” or “racing” from one thought process to another. Your child is NOT a diagnosis! Your child is your child and he or she is struggling to control symptoms that, much of the time, they are very much aware of, don’t like and wish very much that they could control or manage those symptoms, choices or behaviors because they don’t like the negative consequences that accompany said symptoms, choices or behaviors!

“Could my child have PTSD”: The answer is “Possibly”. The best way to determine a more definite answer only comes when a trained and qualified mental health professional does a thorough Comprehensive Diagnostic Assessment (CDA) with parents, child and possibly any other person involved in the child’s life that would be deemed part of the family support system. Extensive focus needs to be on significant life stressors, losses/deaths, possible abuse, witness to violence, medical problems/conditions for self or others, etc. The most important thing for parents and caregivers to keep in mind is keeping perspective on what is or could be stressful to a child might be overlooked or disregarded as stressful to a grown adult. I educate parents or caregivers, when asked the assessment questions about life stressors, losses/deaths, possible abuse, witness to violence, medical problems/conditions for self or others, etc. to think about answering those questions through the mind or eyes of their child. Is it stressful or potentially traumatic to a child when their best friend moves away? Is it stressful or traumatic to a child who has lost his beloved stuffed animal that his now deceased grandmother gave him/her as an infant? Is it stressful or traumatic to a child who repeatedly hears his/her parents yelling and screaming at one another? Is it stressful or traumatic to a child when he/she is 7 years old, and they have already moved 10 times in their young life? If you answered “Yes” to any or all these proposed scenarios than you would be correct in your thinking and you would be thinking and answering from the mind or the eyes of your child!!

“Can a child be diagnosed with ADHD/ADD and PTSD?” The answer is “Yes”. However, the key to making a definitive diagnosis when deciding between the two diagnoses lies in the thorough Comprehensive Diagnostic Assessment! I can still distinctly recall, during my Advanced Child and Adolescent Trauma course in Graduate School, my distinguished professors repeatedly emphasizing that a Child/Adolescent Assessment needed to be focused on inquiring closely the significant life stressors, as seen through the mind and eye of the child being assessed, to determine the nature of the symptoms and presenting problems being reported. When a clinician looks at the diagnostic criteria for ADHD/ADD vs PTSD, that clinician must also assess the potential underlying life stressors that could potentially be the cause of the symptoms or presenting problems. Many of the “symptoms” or “presenting problems” that are listed in the diagnostic criteria for an ADHD/ADD diagnosis can also be found in the diagnostic criteria for a PTSD in Childhood diagnosis!! Hypervigilance (Hyperactivity), difficulty focusing on tasks, easily distracted, daydreaming, “drifting” and/or “racing”. If these symptoms or presenting problems can be linked to or attributed to a or several significant life stressors or losses then perhaps the more accurate diagnosis could or would be PTSD in childhood, given the child meets all other diagnostic criteria a PTSD in Childhood diagnosis.   

For more information about the Mental Health Counseling program at Children’s Therapy Place, visit www.childrenstherapyplace.com or call us at 208-323-8888.

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