On the last track, we talked about the eight common ADD symptoms. These
eight symptoms are inattention, impulsivity, difficulty delaying gratification,
emotional overarousal, hyperactivity, noncompliance, social problems,
On this track... we will be discussing five Idiosyncratic, Unique Patterns
of children with ADD. These patterns may cause the diagnosis to be missed
in a genuine ADD child. These factors include good social skills, a high
IQ, shyness, no siblings or one-on-one preschool situation with parents,
and ADD without hyperactivity. In the second part of this track, we will
also talk about the misdiagnosis of ADD for Learning Disabled.
Five Idiosyncratic, Unique Patterns
Pattern #1 - Good Social Skills
The first pattern causing an ADD child to be misdiagnosed is good social
skills. ADD children with good social skills get along well with their
peers. As you are aware, the ADD symptoms are moderated just enough for
the children to become social assets. For example, a child with ADD may
be seen as having leadership abilities instead of bossiness tendencies.
Pattern #2 - High IQ
The second pattern that may cause an ADD child to be misdiagnosed is
a high IQ. For children with ADD and a high IQ, school is an arena where
they can not only succeed but may actually enjoy life. Because the ADD
child with a high IQ receives positive reinforcement from his or her
parents and teachers, he or she can often control inappropriate behavior
in the academic environment. However, as you can probably guess, once
the ADD child with a high IQ gets home from school, he or she often displays
a number of hyperactive symptoms.
Pattern #3 - Shyness
Like the first two patterns of good social skills and a high IQ, the
third pattern of shyness can cause a child with ADD to be missed. While
most ADD children seem uncaring about others and socially boorish, the
shy ADD child will be extremely concerned about others’ opinions.
For this reason, like the ADD child with a high IQ, the shy ADD child
will inhibit their hyperactive behavior in public but show the ADD symptoms
Pattern #4 - No Siblings or One-on-One Preschool Situations
The fourth pattern that causes an ADD child to be missed is a lack of
siblings or having a one-on-one preschool situation with parents. For
these ADD children, the symptoms of ADD do not appear until they begin
school. The lack of ADD symptoms is often tied to the lack of competition
with siblings. Having reasonably competent and attentive parents can
also produce fairly normal behavior for a while. It is not until these
ADD children start school and are introduced to competition that they
begin to display ADD symptoms.
Pattern #5 - ADD without Hyperactivity
Finally, the fifth pattern that can cause an ADD child to be missed
is ADD without hyperactivity. Without hyperactivity, many other symptoms
of ADD, like emotional overarousal, are moderated better. However, the
child with ADD but no hyperactivity will still exhibit some symptoms
of ADD. In these cases, as you know, diagnosis must focus on the existence
of a major concentrational difficulty. As you know, concentrational difficulty
is often displayed through persistent passive noncompliance and disorganization.
Misdiagnosed as Learned Disabled
In addition to the five Idiosyncratic, Unique Patterns that cause ADD
children to be misdiagnosed, there is also the possibility that the child
with ADD will be misdiagnosed as Learning Disabled. While ADD and LD
often overlap, there are children who have one handicap but not the other.
I have found that there are four ways to discriminate ADD from LD.
4 Ways to Discriminate ADD from LD
first way to determine if the child has ADD or LD is to look at his or
her developmental history. By age two or three, most LD-only children
will not show many ADD symptoms, such as hyperactivity, impulsivity,
or emotional overarousal.
--2. Second, check the child’s IQ. If the
IQ and achievement are compatible and the tests are considered valid,
LD can often be ruled out. For example, If the IQ is below average and
the achievement is below average, the child may simply have LD. However,
if the IQ is above average and the achievement is below average, the
child may be ADD.
--3. Third, consider past comments by teachers. If during
the early school years the comments were consistently about distractibility
and short attention span, the child is likely ADD-only.
--4. Fourth, a medication
trial can often eliminate many ADD symptoms. If the child with ADD is
medicated and then shows no academic handicaps or underachievement, he
or she is likely ADD-only.
So if they have no handicaps or underachievement,
the child is only ADD as opposed to ADD with LD. Medication cannot remedy
a true learning disability. Do you have any clients who may have been
On this track... we talked about the five Idiosyncratic, Unique Patterns
of good social skills: a high IQ, shyness, no siblings or one-on-one
preschool situation with parents, and ADD without hyperactivity. We also
discussed the misdiagnosis of ADD for Learning Disabled.
On the next track, we will talk about how education about
ADD and counseling for children with ADD and their parents can work together.
We will talk about three examples of combined education with counseling.
The three examples of combined education with counseling are 1. the “no-fault” notion
about cause, 2. the Symptom Rating Scale, and 3. self-esteem reevaluation.
What are the five idiosyncratic, unique patterns of children with
ADD? To select and enter your
answer go to