The Risks of ADHD Misdiagnosis

Reader’s Question

My son rocks from foot to foot and flaps his hands. He is very very smart and wants to know what everything is and how it works. He has a little trouble paying attention, and the teachers at school say that they think he may be ADD or ADHD. One thinks Autism. I have looked at all of these online and none seem to match. Is it something more?

Our Clinical Psychologist’s Reply

Many children have these repetitive, stereotyped, and purposeless movements such as rocking, hand-flapping, waving, twisting, hair-twisting, facial grimaces, etc. While pre-school children may pass through developmental phases and exhibits these behaviors, when they remain for many years, these repetitive behaviors can be a sign of a medical/developmental problem. We can find these repetitive and purposeless behaviors in several conditions such as:

• Attention-Deficit Hyperactivity Disorder (ADHD): Children with ADHD often have excessive motor energy and activity that looks like rocking and constant fidgeting when bored.
• Autism and Asperger’s Disorder: These two disorders in what we call the “autistic spectrum” commonly have repetitive motor mannerisms. In your description of your son, Asperger’s Disorder is most likely as these children often have intense curiosity and academic interests.
• Tourette’s Disorder: Children can have motor tics that are part of Tourette’s Disorder.
• Some purposeless, repetitive motor movements can be found in Epilepsy, but this seems unlikely in your child’s situation.

In your brief description, Asperger’s Disorder is a possibility. I would recommend seeking consultation with a clinical psychologist or psychiatrist. In these situations, it’s just as important to know what the condition isn’t as what it might be. As an example, if his symptoms are misidentified as ADHD and he is prescribed medications for that disorder, Asperger’s symptoms might be increased and Tourette’s motor tics will be severely exaggerated. I’d start the workup and evaluation procedure for your child. Importantly, it sounds like the teachers are very supportive.