ADHD & Childhood Trauma - The Reynolds Clinic LLC

Closing Practice Letter

ADHD & Childhood Trauma

frustrated girl with adhdWhile ADHD is a real issue among many, children, adults and teens. Many doctors are quick to categorize misbehaving children as having ADHD, a disorder of the brain. However,  there may be many incorrect diagnoses out there, for issues that stem instead from childhood trauma. Dr. Nicole Brown, who was in the process of completing her residency at John Hopkins in Baltimore, Dr. Brown, found that many of her lower-income pediatric patients had been diagnosed with ADHD. Upon further study, she also discovered that they had many stresses and these children often saw violence first hand.


However, instead of taking these diagnoses and prescribing medications, Brown took a deeper look into their symptoms. These same children’s parents and teachers describe them as hard to manage, hyperactive, unable to pay attention, and other adjectives that accurately describe their diagnosed condition.


Dr. Brown found another correlation, however, that she feels may more accurately describe what these children are going through and that correlation is simply: trauma.  Family dysfunction could also be traced to ADHD in young children, who may be acting out in search of attention. She also points out that impulsivity is often a reaction to heavy amounts of stress.


ADHD Misdiagnosis?


Did you know that 1 in 9 children in the U.S. have been diagnosed with ADHD. However, Brown suggests the following: “Inattentive, hyperactive, and impulsive behavior may mirror the effects of adversity, and many doctors don’t know how—or don’t have time—to tell the difference.” She continues with the following observation, “Though ADHD has been aggressively studied, few researchers have explored the overlap between its symptoms and the effects of chronic stress or experiencing trauma like maltreatment, abuse and violence.”


So Brown took to doing the research herself. She conducted a survey of 65,000 children in the U.S..  Her sample included children from all walks of life, across the entire United States and she found that many children diagnosed with ADHD also had the following home conditions and life stresses.

They experienced markedly higher levels of poverty, divorce, violence, and family substance abuse. Those who endured four or more adverse childhood events were three times more likely to use ADHD medication.

Dr. Brown concluded that, while not all children are falsely diagnosed with ADHD, some may be and there needs to be a more conclusive treatment program, which can include behavior changing therapies for those who have some of these other contributing conditions in their lives.


According to recently collected statistics, however, the number of misdiagnosed children is approximately 1 million, each year. These statistics reference a study done in a number of kindergarten classrooms, in which 60% of the youngest/most immature students were diagnosed with ADHD, which is most likely not accurate.


It also points out that many doctors, clinicians, and nurses are under tremendous pressure to keep appointments, and make financial obligations and often are not thorough enough in their examinations of patients that may show ADHD tendencies, often leading to misdiagnosis in both children and adults.


Correct Treatment for Children Experiencing Trauma and Stress

Correct treatment is especially important for children who may not have any of the chemical markers in the brain that display with ADHD.  Actual ADHD patients can benefit from stimulants; however, if a child going through these other familial experiences is given the same treatment, it could exacerbate their symptoms and create additional problems for them.


Instead, coping methods, and therapy should be the prescribed treatments. Not only do children need to go through these treatments and therapies, but many specialists will suggest that families participate in these types of treatments together to create a better environment for the child overall.


Based on these conclusions and the number of misdiagnosis in the United States in recent years, The American Academy of Pediatrics has underway, a new guide on how to recognize, correctly diagnose, and treat ADHD as well as children with severe trauma or stress in their lives. The new guide will include a section on assessing trauma in patients and is set to be released in 2016.