When students have difficulties in school, lack of attention is often noticed. We often assume that he/she has ADHD (Attention Deficit/Hyperactivity Disorder). But ADHD is not the only cause of attentional issues. ADHD "imitators" include the following:

    • Hearing deficit
    • Vision deficit
    • Age-appropriate over-activity
    • Coordination
    • Poor nutrition / malnutrition
    • Vitamin deficiency
    • Caffeine
    • Self-esteem problems
  • Speech and receptive language
  • Developmental language impairment ~ speech or language delays
  • Insufficient sleep (sleep disorder or environmental causes)
  • Too much stuff in the bedroom (TV, video games, cell phones, etc.)
  • Functional disorders
  • Oppositional defiant disorder
  • Conduct disorder
  • Mood disorder
  • Depression
  • Dysthymia
  • Anxiety disorder
  • Realistic fears
  • Personality disorder
  • Obsessive-compulsive disorder
  • PTSD
  • Mania or bipolar disorder
  • Adjustment disorder with disturbance of behavior
  • Situation, environmental, or family problems
  • Improper learning environment (unsafe, disruptive)
  • Inappropriate school placement (e.g. gifted child, learning disabled, developmentally delayed child in regular classroom)
  • Personality conflicts with teachers or peers
  • Family psychosocial adversity
  • Social disruption (poverty, divorce, moves, deaths, illness in family)
  • Unstable / chaotic home setting
  • Conflict
  • Adult domestic violence
  • Abuse, neglect, or both
  • Poor parenting (e.g. inappropriate, inconsistent, punitive)
  • Level of parental stress
  • Parental absence
  • Parental psychopathology
  • Fetal alcohol syndrome
    • Fragile x syndrome
    • Lead blood level
    • Thyroid deficiency
    • Phenylketonuria 
    • Petite mal epilepsy
    • Seizures
    • Sequelae of head trauma
    • Thyroid abnormality
    • Learning disability
    • Mental retardation
    • Borderline intellectual functioning
    • Frontal lobe abscess
    • Neoplasm
    • Lead toxicity
    • Medication-induced e.g. antihistamines, beta-agonists, Phenobarbital
    • Acute or chronic medical illness esp. asthma, allergic rhinitis, eczema, enuresis/encopresis 
    • Substance abuse (alcohol, OTC medication, illicit substances)

 

  • Pervasive Developmental Disorder (Autism / Asperger's)
  • Tourette's syndrome
  • Multiple tic disorder