How can parents differentiate between ADHD & PTSD in children? ABA therapist Ruth Stieff explains how she's learned to determine which is which.

Did you know that post-traumatic stress disorder (PTSD) is often misdiagnosed in kids as attention deficit hyperactivity disorder (ADHD)? Guest blogger and ABA therapist, Ruth Stieff, explains how’s she’s learned to determine the difference between ADHD and PTSD in children in this post.

“You mean it’s not ADHD?” This is a comment that is heard around the disability and social service community everyday. If you have a child that has been diagnosed with ADHD and nothing is working, maybe, you need to look a little further. You may ask, “How do I know if it will take longer with the current treatment plan or is it the wrong diagnosis?” Great question and there are a few red flags to look for when little or no progress is seen.

  • Is the work the therapist is doing with your child making any difference? This assumes that you are pursuing treatment and following through with the therapist’s counsel at home. If you have not sought out therapy for ADHD, that is where to start.
  • The quantity of pharmaceuticals your child takes is rising. A prescription will not solve all the issues. Individual and family therapy is needed. The strategies that aid a person with ADHD or other diagnosis must be learned and practiced.
  • A therapist adds more diagnoses for your child. When I see a child diagnosed with ADHD with autism tendencies, Oppositional Defiant Disorder, General Anxiety Disorder or other similar disorders, I begin asking questions. I remember a conversation with parents who had a child who had a long list of diagnosis and was taking large doses of medications, “Do you feel this is really the issue?” Their answer was “No.”


With that child, I began asking questions related to life experiences. I was looking for clues of trauma. PTSD in children is a complex issue.What questions need to be asked?

  1.  Pre birth trauma. This could be physical or emotional. If the child is adopted, you may have little knowledge of this. Was the child exposed to substance abuse in-vitro?
  2.  Birth trauma. Once again, it could be physical or emotional. This would include a life-threatening circumstance in the first hours/days after birth. This includes being away from the mother for tests or in intensive care. Pain associated with this can cause trauma. If the child was taken from the mother and placed in the hands of an orphanage, a foster care home or  the adopting family, there are many traumatic and attachment issues associated with this.
  3.  Trauma in the early years. This could come in many forms. Neglect, abuse, medical procedures, multiple placements with family or in foster care, divorce, death of a significant person in the child’s life.
  4.  Trauma in elementary or later can include any of the above that happen during this time or things unresolved from earlier times.


If your child does not respond to cognitive behavior therapy or anything based on applied behavioral analysis, look at possible trauma or attachment issues. Many attachment and trauma difficulties mirror symptoms of ADHD or high functioning autism. The difference is that the strategies used in these neurological diagnoses don’t usually work if trauma is the underlying problem. Most schools use an approach that rewards good behavior and looks for motivators to do it. This may have a small amount of success but normally is short lived. Once you have a trauma diagnosis and begin to use more helpful strategies, you will play a new role advocating for trauma based approaches at school.

In this scenario you might say, of course it’s not ADHD. Hopefully, it doesn’t take a long time down this road to figure out that your child has issues different than ADHD! It is a complicated journey but parents know this child better than anyone else so they can often know when the diagnosis is not quite a fit. That’s why there is no advocate like a loving and determined parent!

Your Questions about ADHD and PTSD in Children?

Has this post stirred up questions about your child’s special needs diagnosis? Feel free to leave them, so Ruth can answer them. Then stop by Connecting One Piece at a Time to learn more about Ruth and her work.

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How can parents differentiate between ADHD & PTSD in children? ABA therapist Ruth Stieff explains how she's learned to determine which is which.