Evaluating ADHD in Children and Adolescents
ADHD is a foundational disorder that frequently occurs with coexisting conditions. There are a number of sleep, neurodevelopmental, sensory processing, fetal substance exposure, psychological, trauma, substance use conditions which can frequently occur with and worsen ADHD, or cause ADHD-like symptoms when true ADHD does not exist. Between 67 to 80% of clinic-referred children and 80% or more of adults with ADHD have at least one additional disorder, up to 50% have two or more other conditions (Pliska, 2015), and 20% have three or more coexisting disorders. When other disorders exist along with ADHD, these combinations can magnify and sometimes even mask ADHD to create more complex diagnostic presentations that make successful evaluations and treatment even more challenging. Because ADHD can “hide” these conditions, they may not be recognized as separate disorders and these other symptoms and conditions may be incorrectly assumed to be part of the ADHD.
Additionally, while clinical practice guidelines recommend that ADHD evaluations include the exploration of potential coexisting or other conditions, clinicians may not adequately screen for and identify the numerous additional conditions as part of their diagnostic process because they do not know about the disorders, or have not been informed to do so. Sometimes true ADHD does not exist, but because many conditions can cause ADHD-like presentations, a misdiagnosis of ADHD may result. Further, when coexisting conditions are not identified, comprehensive and effective treatment typically does not occur and families and clinicians may experience confusion with only partial progress, while symptoms and frustrations can persist without hope or relief.
To support clinicians in their diagnostic work, Dr. Carroccia will present his 10-Step ADHD Evaluation Approach for Children and Adolescents. This comprehensive model includes exploring a number of other possible coexisting conditions, including trauma, neglect, medical, sleep, neurodevelopmental, sensory processing, fetal substance exposure, and psychological conditions. This approach will help clinicians more accurately conduct evidence-based ADHD evaluations, as well as identify and better understand the numerous other possible coexisting conditions that may present along with and worsen true ADHD, or cause ADHD-like presentations when ADHD does not exist.