Curious about ADHD?

When a child with CHD struggles with attention, focus, or behavior, parents often wonder: Is this ADHD… or something else?

You might notice things like:

• Trouble staying focused unless your child is very interested

• Difficulty following directions or completing tasks

• Daydreaming, zoning out, or seeming “not to listen”

• Disorganization, forgetfulness, or losing things

• High energy, restlessness, or impulsive behavior

At first glance, this can look like ADHD. And sometimes—it is. But in children with CHD, the answer is often more complex.

Why ADHD is More Common in CHD

Children with CHD are at higher risk for attention and executive functioning challenges. This is not random.

The heart and brain develop together early in pregnancy, and differences in brain development, blood flow, or medical complications can impact how the brain organizes and how the child learns to self-regulate themselves over time. This means:

• ADHD is more common in children with CHD

• But attention problems may also reflect broader neurodevelopmental differences

• And symptoms may change across development (sometimes not showing up until later)

Common Misunderstandings (especially in CHD)

“My child can focus on video games, so it can’t be ADHD.”

Not quite. Attention is easier when something is highly rewarding. ADHD reflects difficulty regulating attention when it’s required—not when it’s fun.

“My child is smart and doing okay in school.”

Children with CHD often have scattered strengths and weaknesses. A child can be bright but still struggle with attention, organization, or processing.

“They’ll grow out of it.”

Some children mature into better self-regulation—but in CHD, challenges may actually emerge later, especially as academic and life demands increase.

Here’s the Critical Question: Is it ADHD… or Something Else?

Attention problems are a symptom, not a diagnosis.

In children with CHD, attention difficulties can be caused (or worsened) by many factors:

• Learning differences (e.g., reading comprehension, math)

• Language delays

• Anxiety or emotional overwhelm

• Social challenges

• Sleep problems (which are more common in some CHD populations)

• Medical history impacting brain development

• Current medical status

As one example, a child who struggles with reading may look “inattentive”—but is actually avoiding something that feels too hard.

Another child may appear distracted, but is actually anxious, exhausted, or overwhelmed.

Or a child may avoid difficult tasks and need constant redirection when they are physically exhausted or uncomfortable.

Whereas some children…. They truly have ADHD—but alongside other neurodevelopmental disorders (e.g., autism, dyslexia, language disorder, etc), not in isolation.

Why This Matters: Diagnosis Drives the Right Support

Research shows that attention problems rarely occur alone. Children with ADHD often also have:

• Anxiety

• Learning differences

• Executive functioning problems

• Language or social challenges

And in CHD, this overlap is even more common—and sometimes harder to untangle.

A quick screening (like rating scales from parents and teachers) can identify symptoms—but it cannot explain why they are happening. A screening can also miss a lot, especially when symptoms are subtle.

Without that understanding, interventions may miss the mark.

What Parents of Children with CHD Should Do

If you notice attention or self-regulation concerns:

1. Don’t wait and see. Monitor and act. Children with CHD are a higher-risk group. Early awareness matters—and so does follow-up over time.

2. Think beyond ADHD alone. Ask:

• What else could be contributing?

• Are there learning, emotional, or medical factors involved?

3. Follow neurodevelopmental care guidelines. The American Heart Association recommends ongoing monitoring across development—not just one evaluation early in life.

4. Advocate for a comprehensive evaluation when needed. A full neurodevelopmental evaluation can:

• Clarify strengths and weaknesses

• Identify underlying causes

• Guide targeted supports at home, school, and medically

A Final Thought for CHD Parents

Children with CHD don’t always follow a predictable developmental path.

Some challenges are visible early. Others emerge when life gets more complex—academically, socially, or emotionally.

That’s why your role matters so much.

You are the one who notices patterns.

You are the one who connects the dots over time.

And you are the one who helps ensure your child gets what they need—not just to get by, but to thrive.