Your child runs on an unstoppable motor, zipping through life in turbocharged style. He's constantly running and talking and jumping and climbing, and if you had a dime for every time somebody asked if he had attention deficit hyperactivity disorder (ADHD), you'd be able to pay for a nice long vacation. But does your child really have ADHD, or is sensory integration disorder somehow responsible for all that activity?

Making an ADHD Diagnosis

To make a diagnosis of ADHD, a pediatrician will review information provided by parents and teachers and use DSM guidelines to identify certain patterns of behavior. ADHD is indicated when a child frequently has trouble with the following:

• Keeping his hands and feet to himself

• Staying in his seat

• Controlling behavior like running or climbing in places where that's not allowed

• Playing quietly

• Settling down

• Being quiet

• Letting an adult finish a question before answering it

• Taking turns

• Entering a conversation without interrupting

• Joining other children without intruding

As with ADD, the doctor would expect to see problems in a majority of these areas; problems lasting more than six months; problems that impact behavior in a variety of settings, including home and school; problems that began before the age of seven; and problems that can't be explained by developmental delays, neurological problems, or another mental disorder.

The Sensory Integration Difference

If your child is hyposensitive to proprioceptive and vestibular input — that is, she doesn't have a good sense of balance or gravity or how her limbs are arranged — the movements she makes to feel more comfortable may look like ADHD. Lack of sensitivity to differences in sound can cause problems as well.

Looking at the criteria for an ADHD diagnosis, your child with sensory integration problems may have trouble with the following:

• Keeping her hands and feet to herself if she needs to move those body parts to register where they are

• Staying in her seat if sitting still makes her feel sleepy

• Controlling behavior like running or climbing in places where that's not allowed if it's hard to sustain movements without momentum

• Playing quietly if she can't sense the difference between soft and loud

• Settling down if her body feels unsettled and off-kilter

• Being quiet if she needs a lot of self-talk for planning and sequencing movements

• Letting an adult finish a question before answering it if she misses differences in tone that indicate the end of a question is still to come

• Taking turns if she strongly needs the input from a swing or a slide in order to feel comfortable and in control

• Entering a conversation without interrupting if her auditory system isn't sensitive to the flow of speech among other noises in the room

• Joining other children without intruding if she can't control her movements or judge how much force she needs to use

Ironically, although your child appears to be overstimulated, he may in fact be understimulated and engaging in frantic movement in order to stay awake, pay attention, and make his body comfortable. Think of how you feel when your foot is asleep. You need to move it hard and fast to clear the prickly feeling, and if you don't, you won't be able to concentrate on anything else. Your child may be experiencing the same problem when he runs, jumps, climbs, and crashes into things.

One question to ask when trying to tell the difference between ADHD and sensory integration disorder is this: What happens when my child actually does sit still? Children with sensory integration problems who need to move to stay alert may fall asleep if they stop, or seem to fall into a trance. They truly can pay better attention when they're wiggly.