Trauma Mimics ADHD: A Kinship Center Expert Commentary

A response to “Hyper One Day, Calm the Next: Changes in ADHD”, by Katherine Sharpe, published in Scientific American MIND, Feb 22, 2011

by Kinship Center Clinical Supervisor Grace Katzenstein, LCSW

Background: A recent article in Scientific American MIND cited research about ADHD (Attention Deficit Hyperactivity Disorder) that indicates the disorder may be less persistent that previously thought. The research found that the majority of children whose symptoms qualified for an initial diagnosis had lost their diagnosis by two years later, regardless of the seriousness of the disorder. Typically ADHD has been thought to be a long-lasting condition that can lead to lifelong learning and relationship difficulties, but the research suggests taking another look at this most commonly disgnosed behavior disorder of childhood.

Kinship Center Clinical Supervisor Grace Katzenstein submitted a response to the article that presents another perspective.

“I read with interest Katherine Sharpe’s brief article, “Hyper One Day, Calm the Next: Changes in ADHD,” regarding children who “lose” the diagnosis of attention deficit hyperactivity disorder (ADHD). I am a therapist who works with children with a history of severe childhood trauma. I have learned in my seven years with this population that indeed what looks or tests like ADHD or ADD may not be at all.

Children with early histories of neglect, abuse, abandonment or poor attachment often display behaviors that seem convincingly ADHD-like: distractibility, poor focus, impulsivity, short attention span, and an inability to delay gratification, control aggression, and so on. Traumatized children may also have many ADHD-like symptoms because of delayed cognitive development, hypervigilance regarding possible threats to their safety, and emotional dysregulation (stress hormones remain on alert status). And finally, children with sensory-processing disorders will have behaviors that closely mimic ADHD in their overreaction to hearing noises or being bumped by other kids.

The mental health community is only just beginning to research the impact of these issues—for reference, look up the work of physicians Daniel Siegel, Bessel van der Kolk and Bruce Perry. If a child is being treated, symptoms and behaviors may diminish in time. So it could look like an ADHD child “loses” their diagnosis.”
Grace Katzenstein
Clinical Supervisor, Kinship Center

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