October is ADHD Awareness Month: Looking Beyond Behavior to the Root Causes
October is ADHD Awareness Month — a time to raise understanding, reduce stigma, and bring awareness to the many factors that can influence attention, focus, and behavior in children.
For many families, an ADHD diagnosis brings both relief and more questions. Parents often wonder, “Why does my child struggle so much to focus?” or “Could there be something more going on?”
As an occupational therapist specializing in orofacial myofunctional and craniosacral fascial therapy, I often see children who have been labeled with ADHD-like symptoms — yet, when we look deeper, we find underlying factors impacting the brain and body’s ability to function optimally.
Two areas that deserve more attention in the conversation around ADHD are airway function and retained primitive reflexes.
The Airway–Attention Connection
Breathing is our body’s most basic need, but for some children, it doesn’t come easily.
Mouth breathing, snoring, restless sleep, and enlarged tonsils or adenoids can all point to airway dysfunction — meaning your child isn’t getting enough oxygen during sleep.
When the brain doesn’t get adequate oxygen at night, the body remains in a “fight or flight” state. Children may wake frequently, move constantly in bed, or never reach deep, restorative sleep. By day, this can look like:
Difficulty focusing or sitting still
Impulsivity and emotional outbursts
Fatigue masked as hyperactivity
These symptoms overlap significantly with ADHD — but the root cause may be sleep-disordered breathing rather than a true attention deficit.
A simple airway screening can help identify whether your child’s structure or breathing patterns could be contributing to these challenges.
The Role of Retained Primitive Reflexes
Primitive reflexes are automatic movement patterns babies are born with to help them survive and develop. As the brain matures, these reflexes should naturally integrate — making way for higher-level skills like attention, self-regulation, and coordinated movement.
However, if these reflexes remain active (or “retained”), the body stays in a more primitive state of readiness and movement. This can lead to:
Fidgeting or constant movement
Poor posture and handwriting
Trouble sitting still or maintaining focus
Emotional regulation difficulties
For example, a retained Moro reflex keeps the nervous system in a constant state of alert, which can mimic anxiety or hyperactivity. A retained ATNR (Asymmetrical Tonic Neck Reflex) can make tasks like reading or writing more challenging.
When we assess for retained reflexes and support their integration, we often see improvements in attention, motor coordination, and self-regulation.
A Whole-Child Approach to ADHD
True understanding of ADHD requires looking at the whole child — their sleep, nutrition, sensory processing, motor development, and environment.
By screening for airway concerns and retained primitive reflexes, we can uncover hidden pieces of the puzzle that may be contributing to ADHD-like behaviors. Addressing these underlying factors helps the brain and body work together, allowing children to reach their fullest potential — not just manage symptoms.
How Occupational Therapy Can Help
Occupational therapy rooted in neurodevelopment and whole-body integration can support children by:
Screening for retained primitive reflexes
Addressing postural, sensory, and motor foundations
Supporting optimal breathing patterns
Collaborating with other professionals (such as ENTs, sleep dentists, or myofunctional therapists)
In Closing
ADHD is complex — and every child’s story is unique. This month, as we raise awareness, let’s also raise curiosity. If your child has difficulty focusing, sleeping, or regulating emotions, consider looking beyond behavior to the body’s foundations for learning and attention.
Sometimes, the answers are found not just in the mind, but in how the body breathes, moves, and feels.