Assessing Child Maladaptive Behaviors: Distinguishing between Attention-Deficit/Hyperactivity Disorder (ADHD) and Other Mental Illnesses
There are several conditions with overlapping diagnostic criteria that can look like ADHD. Let’s take a closer look at how to assess and distinguish between ADHD and some other mental illnesses.
Detecting ADHD
Refer to the ADHD clinical practice guidelines 
for guidance on diagnosing, evaluating and treating ADHD. When diagnosing and treating for ADHD with medications, complete an in-person or telehealth/remote follow-up within 30 days of the member starting medication.
Other Conditions Requiring Assessment of ADHD-Like Symptoms
ADHD has diagnostic criteria which can look similar in presentation to other mental illnesses besides depression, like:
- Oppositional defiant disorder (ODD)
- Conduct disorder (CD)
- Bipolar affective disorder (BD)
- Disruptive mood dysregulation disorder (DMDD)
Child traumatic stress may also overlap and look similar in presentation. Additional information on child traumatic stress and treatments is available here:
Compared to other conditions, ADHD might be unique in having the characteristics of 1) unproductive hyperactivity and 2) impulsivity that is internally and not externally driven.
Comparing Characteristics of Child Traumatic Stress and ADHD
|
Characteristic/Condition |
Child Traumatic Stress |
ADHD |
|---|---|---|
| Self–esteem | May feel guilt or shame | Variable |
| Pleasure | May struggle | Variable |
| Attention | Easily distracted | Easily distracted |
| Hyperactivity | Hyperactive | Unproductive |
| Sleep | May be disturbed | Chronic, poor, often late bedtimes |
| Speech | No pattern | Often rapid, may be pressured |
| Impulsivity | May react to sensing threats | Internally driven |
| Social | May be fearful, edgy, on alert for threats | Often poor |
| Academic | May have difficulty concentrating and learning | Often poor |
| Psychomotor activity | May be restless, agitated | Chronically agitated |
Need help?
Magellan Behavioral Healthcare manages services related to mental and behavioral health care. Medicaid providers can call 1-800-327-7390. You can also review the Behavioral Health Toolkit.
© 2020 American Academy of Pediatrics
The information in this document is being provided for educational purposes only and is not the provision of medical care or advice. Physicians and other health care providers are instructed to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. Regardless of any benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. Additional limitations and requirements may apply.
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