ADHD Vs. Trauma; Which One Is It?

The word trauma has become a buzzword, not just in the psychological community, but in trainings, doctors’ offices, schools, and agencies. According to the American Psychological Association (2019), trauma is defined as, “an emotional response to an event like an accident, rape, or natural disaster.” However, trauma is not limited. It can also include automobile accidents, injuries, abuse, neglect, death of a loved one, and more. When these experiences happen in childhood, it takes on the title of childhood traumatic stress. This can manifest through fears of helplessness, hyperactivity, increased arousal, dissociation, irritability and anger, being on alert, anxiety, and depression.

The Center for Disease Control and Prevention worked with Kaiser Permanente from 1995-1997 to research childhood trauma and stress through the Adverse Childhood Experiences (ACE) study (Center for Disease Control Prevention, 2019). The ACE questionnaire, which includes 10 questions, looks at the first 18 years of life. This was completed by thousands of participants and lead the CDC and Kaiser Permanente to identify that ACE’S can predict future risky behaviors, health conditions, and other problems later on in life such as mental health, substance abuse, and also educational concerns. It concluded the higher the score, the higher the risk.

In schools, children who demonstrate some reactions of trauma responses, or high ACE scores, are often misunderstood. They may be labeled as “rude” “disrespectful,” “out of control.” Other times, teachers, doctors, parents are often saying, “This child has Attention Deficit Hyperactivity Disorder.” But is this an accurate diagnosis, or is it a response to their experiences?

ADHD is a childhood onset neurobiological disorder with the primary characteristics to include developmentally inappropriate inattention, impulsivity or hyperactivity. In the classroom, it can manifest as struggles with following directions, organization, talking excessively, and more. While there is a genetic link, it may also be linked to genetic interactions, exposure to pesticides in early childhood, premature birth, brain injury, maternal stress in pregnancy, smoking during pregnancy, or prenatal exposure to substances such as drugs or alcohol (The National Child Traumatic Stress Network, 2016). Even though a child may demonstrate less symptoms later on in life, ADHD may still remain to be a struggle through adulthood.

So, is it ADHD or is it childhood traumatic stress? Both demonstrate similarities. Children may struggle with concentration in school, be easily distracted, not listen to authority or peers, appear disorganized, restless, or have difficulty sleeping. While research has not concluded if ADHD leads to a higher risk for childhood traumatic stress, it is important to note that having a mental health disorder or diagnosis often times is a predictor of past trauma.

How can a parent, teacher, or loved one help? There is a high percentage of misdiagnosis of ADHD and at times, children are not properly assessed. While medication can help many children, it may not be the answer for all, especially if it is a misdiagnosis. Linkage to counseling with a licensed social worker, psychologist, or mental health counselor may assist in identifying if it is ADHD, childhood traumatic stress, or both. These professionals can use techniques, such as social emotional skill building, trauma modalities (Eye Movement Desensitization and Reprocessing or Progressive Counting, for example), parent training, relaxation and stress management techniques, and psycho-education. Parents can assist by helping to promote safety, creating routines, and reminding children of the skills they have learned along with correcting distorted ideas of what may have happened in the past. Schools can assist through educational modifications that can address ADHD and also anxiety that may present from childhood traumatic stress.

Overall there is no one size fits all treatment for ADHD, and there is no one size fits all treatment for childhood traumatic stress. But, if one or both are left untreated, it may lead to developmental concerns, school failure, depression, conduct problems, relationship struggles, substance use, and may lead to legal involvement. The earlier the intervention for one, or both, may make a big impact in a child’s life.

If you would like to seek mental health counseling, Family Service of the Chautauqua Region has licensed therapist available to help. Contact us at (716) 488-1971 to set up and appointment.