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Handout On Trauma and ADHD

There is significant overlap between the symptoms of trauma and ADHD in children. Traumatic experiences can cause hypervigilance, dissociation, and intrusive thoughts that mimic the core symptoms of ADHD such as inattention, hyperactivity, and impulsivity. Brain imaging studies also show similarities in the areas affected by trauma and ADHD. It is therefore possible for a child to have both complex trauma and ADHD. However, complex trauma is often misdiagnosed as ADHD alone due to the overlapping presentations. The earlier these difficulties are identified, the better the outcomes for the child. Treatment may involve educational and behavioral therapies for ADHD as well as trauma-focused cognitive behavioral therapy and medication where needed.

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Vicki B Vee
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355 views3 pages

Handout On Trauma and ADHD

There is significant overlap between the symptoms of trauma and ADHD in children. Traumatic experiences can cause hypervigilance, dissociation, and intrusive thoughts that mimic the core symptoms of ADHD such as inattention, hyperactivity, and impulsivity. Brain imaging studies also show similarities in the areas affected by trauma and ADHD. It is therefore possible for a child to have both complex trauma and ADHD. However, complex trauma is often misdiagnosed as ADHD alone due to the overlapping presentations. The earlier these difficulties are identified, the better the outcomes for the child. Treatment may involve educational and behavioral therapies for ADHD as well as trauma-focused cognitive behavioral therapy and medication where needed.

Uploaded by

Vicki B Vee
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Confusions around Trauma and ADHD 

Below highlights the overlap between symptoms:

Ref: The National Child Traumatic Stress Network, 2016

Why is there so much overlap?


 In response to trauma, a child’s developing brain can become programmed to “look out” for
behaviour, activities or events that they perceive as threatening.  This “hyper-vigilance” can
often mimic hyperactivity and distractibility associated with ADHD.
 What may appear as inattention and “daydreaming” behaviour often seen in ADHD may
actually be symptoms of dissociation or subconscious avoidance of trauma triggers.
 Intrusive thoughts, memories or other reminders of trauma may make children feel confused,
agitated and nervous which may mimic impulsivity and aggression often seen in ADHD.
 Brain development studies for ADHD and child maltreatment show significant similarities
in the areas of the brain that are affected (areas responsible for emotional regulation,
decision making, memory, social processing and concentration). 
Could my child have both Complex Trauma and
ADHD?
Absolutely - if there has been significant trauma exposure. However, Complex Trauma is frequently
a “missed” diagnosis because:

 Parents often under-report trauma in their children due to fear of blame or guilt.
 Clinicians don’t always ask questions about possible childhood trauma
 Complex Trauma is simply misdiagnosed as ADHD due to significant the overlap between
presentations

Children who have a trauma history tend to have more severe ADHD symptoms than in either
diagnosis alone and have poorer overall functioning.  

So what can be done?


The earlier these difficulties are identified, the better the outcomes for your child. 

 If you suspect your child may have been exposed to significant trauma, seek help from a
professional as soon as possible. Your health professional is there to support you and your
child.
 Trust your instincts. If you feel like your child’s diagnosis of ADHD doesn’t quite “feel
right”, make sure you raise your concerns with your health professional and talk to your
child’s teachers and other carers to determine if they have been witness to any significant
traumatic events.
 Remember, children with ADHD and Complex Trauma backgrounds need:

 Consistency, predictability and routine within their lives - both at home and school
 Help to develop lasting, safe, and predictable relationships
 Key support people whom they feel comfortable going to, who understand them, and
can empathise with them  
 A sense of control through being provided limited choices  
 To learn to build on their strengths and resiliency! 

Treatment Options
ADHD :
 Educational adjustments for learning in school
 Parent Behaviour Management Strategies delivered in a group or individual setting
 Stimulant Medication if recommended by a Developmental Paediatrician

Trauma: 
 Therapy with a Psychologist who may utilise Trauma-Focussed Cognitive Behaviour
Therapy (TF-CBT) and anxiety management techniques
 Sensory Regulation Activities as recommended by an Occupational Therapist
 Anti-arousal or anti-anxiety medications where necessarily, recommended by a Child and
Adolescent Psychiatrist 

Sources
ADHD in Children: Health Direct: https://www.healthdirect.gov.au/adhd-in-children
Making Space for Learning: The Australian Childhood Foundation: https://professionals.childhood.org.au/making-space-for-learning/
Is it ADHD or Childhood Traumatic Stress: A Guide for Clinicians (August 2016):
https://www.nctsn.org/sites/default/files/resources/is_it_adhd_or_child_traumatic_stress.pdf
Trauma, Kids and ADDHD – Is there a Link? https://www.webmd.com/add-adhd/childhood-adhd/adhd-traumatic-childhood-stress
Costello, E.J., Erkanli, A., Fairburn, J.A., Angold, A. (2002). The Prevalence of Potentially Traumatic Events in Childhood and Adolescence.
Journal of Traumatic Stress, 15(2), 99-112.
Hanbury, L. (2017). ADHD, Trauma and Neglect. How Do We Prevent Children Who Are In The Child Protection System From Being
Misdiagnosed with ADHD? Improving Child Health Through Research Children’s Research Digest, 4(2).
Keeshan, B.R. & Strawn, J.R. (2014). Psychological and Pharmacological Treatment of Youth with Posttraumatic Stress Disorder: An
Evidence-Based Review. Child and Adolescent Psychiatric Clinics, 23(2), 399-411.
Littman, E.B. (2009). Toward an Understanding of the ADHD –Trauma Connection.  Drellenlittman.com
Perry (2006). Fear and Learning: Trauma related factors in the adult education process. New Directions for Adult and Continuing Education,
110, 21-27.
Van Der Kolk, B.A., Pynoos, R.S., Ciccheti,D.M., Cloitre, M., D’Andrea, W., Ford, J.D. et al. (2009). Proposal to include a Developmental
Trauma Disorder Diagnosis for Children and Adolescents in DSM-V. Unpublished Manuscript.  

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