Event + Child’s Subjective Response = Level of Trauma
Sufficient trauma or adversity can cause a child to look like they have ADHD. However, simply calling the problem ADHD can feel pretty insufficient. When a child has symptoms like ADHD, parents and clinicians alike are, these days, attuned to the need to rule out a learning disorder, depression, or a health condition. But a blind spot remains for considering the possibility of a reaction to emotional trauma or to severe adversity.
Emotional traumas are partly subjective—a physical or sexual attack or a serious auto accident in which someone is injured may be emotionally traumatic for 90% of children, while verbal teasing or threats may be emotionally traumatic for 10% of children (I am using these pretend numbers to illustrate the point that an event plus the child’s subjective response combine to cause the trauma, though to varying degrees).
What Counts is the Level of Survival Fear Activated.
The survival fear reaction causes a “toxic stress reaction” in the body that can, if too extensive or sustained, interfere with a child’s emotional development. Alternatively, a child may not have had an acute traumatic event, but rather a history of sustained, adverse events that also take a toll on the development of self-regulation over time. These traumatic events continually place a child in a state of emotional arousal and “fight or flight” feelings. Some examples of sustained adverse events might include:
- Living with an emotionally abusive individual
- Addiction in the household
- Physical conflict in the household
- Sustained physical hardship (such as when families are homeless or living in a home that is inadequate for healthy sustenance)
- Witnessing or experiencing serious violence in the neighborhood
- Extended and scary or permanent separation from a parent due to overseas deployment to a war zone, incarceration, or death
- Suffering racism and discrimination as a minority individual
- The emotional aftermath of a volatile parental divorce
Such sustained adversities can continually overwhelm a child’s developing emotional capacities so that they can’t quite achieve the level of self-regulation they otherwise might. The result: a child who seems like they might have ADHD, but is in actuality living with an overwhelmed emotional world. I continue this conversation in an upcoming article in ADDITUDE Magazine and in Chapter 7 of my book, “Getting Ahead of ADHD”, I delve in detail into the triple whammy of emotional trauma and adversity for ADHD (and what to do about it).
Always Look For The Science
You can find it in Getting Ahead of ADHD and with every Dr. Nigg blog post: