Coexisting Conditions in Children

Let's clarify one thing before we begin: coexisting and co-morbid refer to the same thing. It is the medical term for two or more conditions that exist at the same time.

This is why we frequently mention the phrase “coexisting condition”,"co morbid condition", or “sensory sensitivity” when discussing children with neurobiological issues, most frequently Autistic Spectrum Disorder and ADHD.

Untangling a Ball of Yarn

The coexistence of ADHD with other disorders is between 60% and 80% (Margaret Austin, Ph.D., Natalie Staats Reiss, Ph.D., and Laura Burgdorf, Ph.D.)

At this time, scholars are debating the why's of this phenomenon. They don't know the answer. There are many theories, and undoubtedly this will become a focus of research.

Our reality as parents is that ADHD and Autistic Spectrum Disorders rarely travel alone. And we have to deal with each problem as it comes.

When co-morbid conditions are present, it can make diagnosing a child more difficult because of shared characteristics.

Think of it as trying to untangle a ball of yarn with lots of colors.

Common Travel Companions

Remember, ADHD and Autistic Spectrum Disorders like to travel with "friends." Conditions include, but are not limited to:

o Oppositional Defiant Disorder

o Depression

o Autism

o Anxiety

o Bipolar Disorder

o Conduct Disorder

o Obsessive-Compulsive Disorder


Sensory Integration Disorder/Sensory Processing Disorder

o Learning Disorder

o Early Speech/Communication problems

Possible Senarios

There are almost countless combinations and possible scenarios of coexisting conditions, which is why each child and situation is unique.

A classic combination to untangle could be ADHD and Sensory Integration Disorder. Is it that the child cannot pay attention due to ADHD, OR is it that they are over stimulated due to SID as both prohibit concentration?

Throw in a conduct disorder such as intermittent behavior disorder, which is at its roots, an impulse control problem. Are they explosive because of conduct? Or are they explosive because they lack impulse control, and anger is the first reaction to an unpleasant situation?

Autistic Spectrum kids frequently have a combination that includes Sensory Processing Disorder, Learning Disabilities, and Language problems.

Where Do I Begin?

You begin with your pediatrician. He or she will help you form a team of professionals who can sort out the tangle of yarn.

The process can sometimes be slow; however, it’s better to be slow and correct with the diagnosis.

Keep an accurate observation log for health care professionals. The log will help them pinpoint behavior patterns. Those patterns might help determine an accurate diagnosis.

Now What?

Once you have narrowed the range of possible coexisting conditions, then you can begin to address the issues.

Don’t address the diagnosis, address the behavior .

Depending on the doctor, our daughter had five possible coexisting problems! We couldn’t even begin to address them by name! We addressed the behavioral issues, and sometimes assigned them a category if there was an obvious correlation.

Here are two examples:

Our daughter has a horrible time going to sleep at night . It could be: anxiety issues (fear of going to sleep) that go way beyond the normal range. It could be SPD and she’s so over stimulated by bedtime she can’t sleep. Or, it could be ADHD; in which case she can’t slow down enough to sleep.

Regardless of the reason, she still needs to work on going to sleep. We continue to try different approaches, taking into account the possible reasons, but any way we can get her to sleep is a victory!

A second example: Our daughter has definite attention issues. Is it ADHD or Sensory Integration Disorder? Could it be both? Regardless of the category, she STILL has attention problems that need to be addressed.

Now, if you are considering medication, then it becomes very important to determine the root cause of lack of attention. A child with true ADHD will benefit from medication, but a child with SPD will not!

The more you know about ALL of the issues faced by your child, the more you can help them to integrate coping skills and appropriate accommodations into every aspect of his or her life.

You have a team that loves your child and wants what is best for him or her. Consult with them as much as you can before making huge decisions.