Disorders Similar to ADHD
There are several disorders that may mimic or accompany attention-deficit hyperactivity disorder. ADHD exists alone in only about one-third of children. Many of these other disorders require different methods of treatment and should be diagnosed separately, even if they accompany ADHD.
Attention Deficit Disorder Without Hyperactivity
Attention deficit disorder can appear without hyperactivity, in which case the child's primary symptoms are distractibility and an inability to persist in tasks.
Oppositional Defiant Disorder
About half the children diagnosed with ADHD also have oppositional defiant disorder (ODD). The most common symptom for this disorder is a pattern of negative, defiant, and hostile behavior toward authority figures that lasts more than six months. In addition to displaying inattentive and impulsive behavior, these children demonstrate aggression, have frequent temper tantrums, and display antisocial behavior. Up to 25% of children with ODD have phobias and other anxiety disorders, which should be treated separately.
Pervasive Developmental Disorder
Pervasive developmental disorder (PDD) is rare and usually marked by autistic-type behavior, hand-flapping, repetitive statements, slow social development, and speech and motor problems. If a child who has been diagnosed with ADHD does not respond to treatment, the parents might inquire about PDD, which often responds to antidepressants.
Primary Disorder of Vigilance
Primary disorder of vigilance is a term for a syndrome that includes poor attention and concentration as well as difficulties staying awake. People with vigilance disorder tend to fidget, yawn and stretch, and appear to be hyperactive in order to remain alert; they typically have kind and affectionate temperaments. The condition is inherited and gets worse with age, but is treatable with stimulants.
Central Auditory Processing Disorder and Hearing Problems
Children with ADHD often have difficulties with tasks that involve listening or hearing. Research is indicating that symptoms of the two disorders often overlap but may actually be two distinct disorders. Hearing problems themselves may cause ADHD symptoms.
Bipolar Disorder (Manic Depression)
One study found that as many as 25% of children diagnosed with attention deficit disorder may also have bipolar disorder, commonly called manic depression. Indications of this problem include episodes of depression and mania (with symptoms of irritability, rapid speech, and disconnected thoughts), sometimes occurring at the same time. Children with mania and ADHD may have more aggression, behavioral problems, and emotional disorders than those with ADHD alone.
Anxiety disorders commonly accompany attention deficit hyperactivity disorder. Obsessive compulsive disorder is a specific anxiety disorder that shares many characteristics with ADHD and may share a genetic component. Young children who have experienced traumatic events, including sexual or physical abuse or neglect, exhibit characteristics of ADHD, including impulsivity, emotional outbursts, and oppositional behavior.
Lead - Children who ingest even low amounts of lead exhibit many symptoms similar to ADHD; they are easily distractible, disorganized, and have trouble thinking logically. The major cause of lead toxicity is exposure to leaded paint, particularly in homes that are old and in poor repair.
Genetic Abnormalities - A number of genetic disorders cause symptoms resembling ADHD, including fragile X and Tourette's syndrome. About 50% of those with Tourette's syndrome also have ADHD and some of the treatments are similar.
Medical Conditions - A number of medical problems can produce ADHD-like symptoms, including hyperthyroidism and hearing or vision problems.
Post-traumatic Stress Disorder - Young children who have experienced traumatic events, including sexual or physical abuse or neglect, exhibit characteristics of ADHD, including impulsivity, emotional outbursts, and oppositional behavior.
Restless Legs Syndrome (RLS) - RLS and periodic limb movement disorder are thought by some experts to be strongly associated with attention-deficit hyperactivity disorder in some children. The disorders have much in common, including poor sleep habits, twitching, and the need to get up suddenly and walk about frequently.
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