Childhood trauma can produce behavior that is similar to Attention Deficit/Hyperactivity Disorder (ADHD) – characterized by impulsivity, hyperactivity, and an inability to focus. Caelan Kuban, a psychologist and director of the Michigan-based National Institute for Trauma and Loss in Children, explains, “Traumatized children often find it difficult to control their behavior and rapidly shift from one mood to the next. They might drift into a dissociative state while reliving a horrifying memory or lose focus while anticipating the next violation of their safety. To a well-meaning teacher or clinician, this distracted and sometimes disruptive behavior can look a lot like ADHD.”
Adverse Childhood Experiences (ACE), can have a profound effect on the way children see themselves and their world. They may experience important and long-lasting changes in their ability to trust others, their sense of personal safety, their effectiveness in navigating life challenges, and their belief that there is justice or fairness in life. These events can range from a one-time experience to a chronic situation. Traumatic events can include sexual and physical abuse, experiencing the divorce of parents, homelessness, having a depressed or alcoholic parent, the death of a loved one, witnessing domestic violence, or mental and/or emotional abuse.
Trauma can impact school performance, such as lower GPA, greater absenteeism, increased drop-out rate. It can also impair learning, such as affecting attention, memory, cognition, reduce ability to focus, organize, or process information, and interfere with problem solving. Traumatized children may experience physical and emotional distress, such as headaches and stomachaches, poor emotional control, impulsive behavior.
“Students who have experienced traumatic events may have behavioral or academic problems, or their suffering may not be apparent at all. Even a child who does not exhibit serious symptoms may experience some degree of emotional distress, and for some children this distress may continue or even deepen over a long period of time,” according to The National Child Traumatic Stress Network, Child Trauma Toolkit for Educators (October 2008).
Unfortunately, with increased pressure for short appointment times and the reliance on parental disclosure of trauma, it is sometimes even difficult for doctors or prescribers to recognize the difference. Furthermore, a misdiagnosis can lead to a prescription for stimulant medication that may help children with ADHD, but could trigger anxiety and hyper-vigilance in children experiencing the effects of trauma.
- Maintain usual routines. A return to “normalcy” will send the message that the child or teen is safe and life will go on.
- Give children choices. Often traumatic events involve loss of control and/or chaos, so you can help children and teens feel safe by providing them with some choices or control when appropriate.
- Increase the level of support. Designate an adult who can provide additional encouragement and support when needed.
- Set clear, firm limits for inappropriate behavior. Remember that even the most disruptive behaviors can be driven by trauma-related anxiety. Develop logical, rather than punitive, consequences.
- Provide a safe place. Set aside a designated time and place for sharing to help the child know it is okay to talk about what has happened.
- Clarify distortions and misconceptions. Give simple and realistic answers to the child’s questions about traumatic events.
- Preparing the child for the situation. If you are able to identify triggers, prepare a child or teen in advance of a potentially difficult situation. For instance, for a child who doesn’t like being alone, provide a partner to accompany him or her to the restroom.