Telling the Difference Between ADHD and Fetal Alcohol Spectrum Disorder

Ellen's (not her real name) adoptive parents weren't surprised when the school counselor suggested that she might have attention deficit hyperactivity disorder (ADHD). Several professionals had made this suggestion over the years. Given that homework led to one explosion after another, and that at school Ellen, who is eleven, spent her days jiggling up and down in her seat, unable to concentrate for more than ten minutes, it seemed a reasonable assumption. Yet her parents always felt that ADHD didn't quite capture the extent of Ellen's issues over the years. Fortunately the school counsellor was familiar with fetal alcohol spectrum disorder (FASD). When she learned that Ellen's birth mother had consumed alcohol during pregnancy, she raised the possibility that Ellen's problems could be attributable to FASD and referred her for further assessment.

It's a familiar story, and most of us reading about Ellen would assume that she did indeed suffer from ADHD.

But now researchers from McGill have suggested that there may be an overreporting of attention problems in children with FASD, simply because parents and teachers are using a misplaced basis for comparison. They are testing and comparing children with FASD with children of the same physical or chronological age, rather than with children of the same mental age, which is often quite a lot younger.