This document discusses the importance of considering trauma and post-traumatic stress disorder (PTSD) as potential differential diagnoses when a child presents with symptoms of attention deficit hyperactivity disorder (ADHD). It notes that trauma, especially prolonged or interpersonal trauma at a young age, can produce effects that overlap with ADHD symptoms. Assessing for a history of trauma is crucial to properly diagnose and treat the child's symptoms. Misdiagnosing trauma as ADHD could result in ongoing trauma if the root cause is not addressed, as well as unnecessary medication without treating the underlying trauma.

1. When ADHD presents in traumatized children: A differential diagnoses. Sophia Deborah Erez California State University, Northridge December 2006

7. Note. From “Attention deficit hyperactivity disorder and posttraumatic stress disorder: Differential diagnosis in childhood sexual abuse ” by D. Weinstein, D. Staffelbach, and M. Biaggio, 2000, Clinical Psychology Review, 20 , p. 368.

10. Overlapping Comorbidity Note. From “ Findings from the NIMH multimodal treatment study of ADHD (MTA): Implications and applications for primary care providers” by Jensen et al., 2001, Developmental and Behavioral Pediatrics, 22 , 64. The symptoms resulting in the diagnoses of ADHD and ODD may have been caused by maltreatment and may actually be part of the anxiety associated with PTSD” (Famularo, Kinscherff & Fenton, 1992, p.866). “ A primary clinical implication is that children in treatment for disruptive behavior disorders may benefit from screening for maltreatment, accidental trauma, and PTSD symptoms” (Ford et al, 2000, p. 214).

15. Arousal Zones Hyper arousal Hypo arousal Optimal Arousal Zone 1. Ventral Vagal “Social Engagement” 2. Sympathetic NS – Fight or Flight 3. Dorsal Vagal “Immobilization” Note. From Empowering the body in the treatment of trauma: The role of Sensorimotor Processing in trauma, by P. Ogden, 2006. Paper presented at the conference: The Embodied Mind: Integration of the Body, Brain, and Mind in Clinical Practice, Los Angeles, CA.

19. How does trauma present? Note. From Complex trauma in children and adolescents (p. 32), by National Child Traumatic Stress Network, 2003. Retrieved April 9, 2006, from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All.pdf

20. Child Trauma History: Most Frequent Exposure Types Note. From Complex trauma in children and adolescents (p. 32), by National Child Traumatic Stress Network, 2003. Retrieved April 9, 2006, from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All.pdf

21. Child Trauma History: Less Frequent Exposure Types Note. From Complex trauma in children and adolescents (p. 32), by National Child Traumatic Stress Network, 2003. Retrieved April 9, 2006, from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All.pdf

22. Complex Posttraumatic Sequelae: Most Frequent Difficulties Note. From Complex trauma in children and adolescents (p. 33), by National Child Traumatic Stress Network, 2003. Retrieved April 9, 2006, from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All.pdf

23. Complex Posttraumatic Sequelae: Less Frequent Difficulties Note. From Complex trauma in children and adolescents (p. 33), by National Child Traumatic Stress Network, 2003. Retrieved April 9, 2006, from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All.pdf

24. Relationship of Victims to Perpetrators in Substantiated Cases Note. From Complex trauma in children and adolescents, by National Child Traumatic Stress Network, 2003. Retrieved April 9, 2006, from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All.pdf

30. Improving Diagnosis, Improves Prognoses