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When It Looks Like ADHD But Isn’t

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Attention deficit disorders are running rampant among today’s youth (at least according to the media). Children who can’t seem to sit still, have trouble focusing and concentrating, and who are easily distracted are being labeled and given medication left and right. Yet, for as many as 50% the prescribed ADHD medication doesn’t work, symptoms don’t get better, and kids continue to struggle1. There isn’t any definitive test for diagnosing ADHD, and mental health practitioners often must rely on a combination of observed and reported behavior as well as family history, and connections with other conditions. ADHD can look different in different kids, in boys and girls, and even in the same kid in different kinds of environments. And, to add to the complication, ADHD isn’t a deficit, it is often coupled with desirable characteristics of highly successful people, such as intuition, creativity, thinking outside-the-box, and the ability to hyperfocus when interested in the topic. But, what looks like ADHD may not always be ADHD. Parents should be aware of other conditions that can cause similar symptoms. One such condition is Irlen Syndrome.

At Irlen, we see lots of individuals who have been diagnosed with ADHD (as kids or adults), who struggle with attention, concentration, focus, and memory, but whose attention issues are actually caused by lighting. These individuals may look like they have ADHD, but in reality they don’t. The medications don’t seem to help, they tend to have most of their attention issues when under fluorescent lighting (when at school or at work), and can often perform without difficulty in other environments. Irlen Syndrome can result in ADHD-like symptoms in some individuals, but unlike individuals with true ADHD, the environment and lighting conditions are what create over-activity in the brain that leads to difficulties in focus and concentration and even physical symptoms like feeling jittery or anxious. In fact, researchers in Australia determined that symptomology didn’t differ significantly between individuals with Irlen Syndrome who had not been diagnosed with ADHD and those who had been diagnosed with ADHD by a qualified health professional, suggesting that there is a large amount of overlap in symptoms between ADHD and Irlen Syndrome2. Other sources suggest as many as 50% of children with ADHD also have a reading disorder3, and we suspect that at least some of that 50% may actually suffer from Irlen Syndrome instead of ADHD. Of course, it’s also possible that a child has both Irlen Syndrome and ADHD, as research shows that in nearly 70% of kids with ADHD there are also other co-existing conditions4. In either case, it can make a lot of sense to screen for and address Irlen Syndrome first, then re-asses for ADHD to determine if attention issues are still present.

At the Irlen International Conference in 2015, researchers from Israel shared their work on distinguishing Irlen Syndrome from ADHD. Preliminary results from their ongoing study suggest that it may be possible to determine whether someone’s attention issues are caused by ADHD or Irlen Syndrome simply by looking at their scores on standardized ADHD diagnostic tools such as the T.O.V.A. or CPT-d test (MOXO). In their study, individuals diagnosed with both ADHD and Irlen Syndrome had different profiles on the test than individuals who were only diagnosed with ADHD (and did not have Irlen Syndrome). Furthermore, when the individuals with Irlen Syndrome put on their Irlen Spectral Filters, their results profile no longer looked like someone with ADHD5.

 

References

  1. Riddle, M. A., Yershova, K., Lazzaretto, D., Paykina, N., Yenokyan, G., Greenhill, L., … Posner, K. (2013). The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-Year Follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 52(3), 264–278.e2. https://doi.org/10.1016/j.jaac.2012.12.007
  2. Loew, S. J., & Watson, K. (2013). The prevalence of symptoms of scotopic sensitivity/Meares-Irlen syndrome in subjects diagnosed with ADHD: Does misdiagnosis play a significant role?. Hrvatska revija za rehabilitacijska istraživanja, 49(Supplement), 64-72.
  3. Yoshimasu, K., Barbaresi, W. J., Colligan, R. C., Killian, J. M., Voigt, R. G., Weaver, A. L., & Katusic, S. K. (2010). Gender, ADHD, and Reading Disability in a Population-Based Birth Cohort. Pediatrics, 126(4), e788–e795. https://doi.org/10.1542/peds.2010-1187
  4. Patel, N., Patel, H., & Patel, M. (2012). ADHD and comorbid conditions. INTECH Open Access Publisher.
  5. Elad, S. (2015). Spectral filters or medication? Can spectral filters replace Ritalin? Presentation at the 12th Irlen International Conference, July 8-12, 2015, Houston, TX, USA.