Assessment of Attention Deficit Hyperactivity Disorder (ADHD) with children who have experienced early adversity and trauma

The assessment for ADHD is particularly challenging in the presence of known or suspected coexisting conditions or presentations, such as other neurodevelopmental conditions, mental health conditions or intellectual disability, but accurate identification of aetiology is vital to ensure appropriate and effective support or intervention is offered. This paper focuses on the assessment for ADHD in the context of possible or known developmental trauma, two presentations with significant overlap and co-occurrence. Using theoretical knowledge and clinical experience we attempt to offer a framework to guide assessment. An overview of each of these presentations is given; similarities and differences in key domains for each presentation are defined; and features in a child’s presentation that may have been attributed to possible ADHD but may in fact be related to developmental trauma are identified. Guidance regarding the approach to assessment of ADHD for a child who may also present with developmental trauma, is woven through the paper.