How is hyperactive-impulsive ADHD misdiagnosed or overdiagnosed?

PostedSeptember 16, 2025

UpdatedSeptember 17, 2025

ByMy Patient Advice

Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

The fast pace of modern classrooms and the increasing awareness of attention challenges have led to more frequent diagnoses of hyperactive-impulsive ADHD , especially among young students. However, this rise has also raised concerns about both misdiagnosis and overdiagnosis. In some cases, children are labelled prematurely without a full evaluation, while others may have similar behaviours due to different causes such as trauma, anxiety, or sensory processing issues.

Misdiagnosis can happen when educators or clinicians rely solely on observable behaviour without using comprehensive diagnostic tools. For children who are naturally energetic or experiencing short-term stress, there’s a real risk of confusing normal development with ADHD in children.

Why careful assessment matters

Understanding how diagnosis can go wrong helps highlight the importance of thorough, collaborative evaluations:

Behaviour overlaps with other conditions
Impulsivity, restlessness or inattention may also appear in anxiety, learning disorders or gifted children. Without detailed assessments, these can be mistaken for impulsive ADHD.

Pressure from classroom dynamics
Overwhelmed teachers and large class sizes may lead to quick referrals. While well-intentioned, this can increase the chance of mislabelling students who need classroom support but not a clinical diagnosis.

Inconsistent use of school accommodations
When academic struggles aren’t supported with appropriate school accommodations, the default may become a referral for diagnosis rather than improving the learning environment.

Lack of holistic tools
True diagnosis should involve feedback from parents, teachers and clinicians using structured interviews, observations and validated checklists, not just surface impressions.

Raising awareness and making accurate diagnoses are key to supporting ADHD in children, so those who need help get it and others aren’t wrongly labelled. Visit providers like ADHD Certify for expert guidance and access to reliable diagnostic tools that lead to clearer answers and better outcomes.

For a deeper dive into the science, diagnosis and full treatment landscape, read our complete guide to Hyperactive‑Impulsive ADHD .

Lucia Alvarez, MSc

Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.