Is this Child's Behavior ADHD or Trauma Related?

Many of you appreciated that I shared this article with you, yesterday: ADHD versus Trauma.

I'm glad to connect to the sensitivity in you that can see the importance of this distinction.

In my previous practice as a psychiatric nurse at an inpatient facility in Austin, Texas, this distinction between ADHD and Post Traumatic Stress Disorder was as clear as a bell. The former can benefit from medications ("Start low, go slow" is the prescriptive maxim, however). The later, especially severe post traumatic stress disorder, can look EXACTLY like ADHD - poor attention span, distractibility, labile emotions, disassociation from whomever is speaking to them at times, little resilience, and poor goal-directed behavior skills.

All of these symptoms make sense if the world is as dangerous as you know it to be.

If you have been physically, emotionally, mentally, and/or spiritually abused - by a loved one especially - your mind map of the world is so fraught with danger that you do one of two things: Shut Down, or Turn Up.

Shutting down is disassociation, falling into the well of one's mind to avoid reality. Turning Up is becoming more hyper vigilant, more easily stressed by small triggers or sounds that remind you of a lack of safety. Rage is your best friend if you are Turned Up - in many ways, anger can keep someone safe (at least in the short term).

Connecting with traumatized children is my passion. Rey, my RN mentor during my RN Residency in Austin, mirrors the kind of calm demeanor - and infinite listening capacity - I have for these children, too. His phenomenal skill set with abused and neglected children have made him into one of the most profound mentors to hundreds of nursing students.

No matter how egregious a child's abuse story, their voice is important to listen to - even if they did just spit at me.

Children and teenagers have often been misdiagnosed with the label of "ADHD" without proper testing (The Vanderbilt Survey tool need to be completed by THREE sources - not one) -- or a proper trauma assessment being performed.

How to do a Sensitive Trauma Assessment:

Children sense when an adult is uncomfortable - and if you never want a child to tell you the truth, be uncomfortable. Discomfort with a possible trauma story - even in subtle body language cues - tells a child that their Secret is so large that even an adult can't handle it. They will keep hold of their Secret - perhaps to protect you, but also to protect themselves from certain disaster if they happen to upset another adult.

Children's incredibly perceptive nature demand that we, as adults, show up as solid, present, capable listeners.

How to Help a Child Tell You They Have Been Traumatized:

  • Witness.
  • Normalize the idea of trauma existing (especially since 1 in 3 of us experience severe trauma in our lives - so it a regular occurrence!).
  • Speak to the fact that EVERYONE has a chance of healing - no matter how deep the wound.
  • Emphasize that you are with them, and that they will not get in trouble.
  • Disregard arbitrary, non-vital job functions until you are truly able to make this child feel as worthy, safe, and deserving of help as they truly are.
  • Reassure them that they will live through this - and even become more amazing because of how they decide to heal. Talk about celebrities, authors, friends that have pulled through hard times and still lead wonderful lives.

Note: Whatever you tell a traumatized child at the point of their disclosure will color the rest of their life. If you act as though they will become triumphant after their trauma, they have a better shot at doing so. If you look down at them as poor, "sad little victims" of a crime that must be ever so debilitating...they will take on this belief pattern. Be careful.

My nonprofit, Journal To Save Your Life, is trauma-informed. All of our 52 weeks of mental health curriculum assists people to come to terms with their trauma in an empowering fashion, no matter how deep the wound.

Please donate to Journal To Save Your Life, here, so that we can continue to grow and do the work that we do:

Looking forward to your support - and please leave comments!

Thank you,

~Holly Claire Werstein, MBA, RN, FMHPNP
Founder & CEO, Journal To Save Your Life 501(c)3


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