Confabulation
 with Attention Deficit Disorder in Child and Adolescent           Home page

General description:
It happens that a child can tell stories partly or totality fictitious, without neither premeditation nor madness. The tendency to believe that "the truth comes from the mouth of children" is not always true in child psychology, especially in face of the difficult, immature, unpredictable child and moreover if suffering from a deficit attention disorder. This child does not always speak according to the objective reality, but rather his needs, desires or often the total opposite, his inner fears, without any concern of consequences, being so swallowed by his own magic thinking. The time needed to test reality is simply not there. Imagination is running to fast. The cognitive maturity, handicapped by ADD, does not allow distinguishing clearly what comes from the inside vs outside, the wish vs needs or the fear vs real threat. Thus, a story is told for the fun of it or as a self-defence, without any interest for its realism, a fantasy that can build itself from a physical sensation, an anecdote seen or heard, coming from the routines of the family, school or social life.

There is sometimes a lack of inhibition in the overflowing imaginary life, apart from the only fact of its creativity. It is necessary that the adult should add some judgement of reality to this situation.

Practical advice:

It would be necessary to eliminate any deficit attention disorder, supporting confabulation. First slowly bringing back some thinking on past events, as reviewing a movie that has been too fast and seeing each motion one by one, setting time in action. In the deficit attention disorder, the mind goes in high speed and is easily distracted or invaded by secondary stimuli. By reducing the speed of thoughts, the truth would appear under another light, as a voyager who walks slowly, step by step, sees a larger and more interesting landscape than anyone speeding in a car or flying high in an airplane.

The parent often says: "I knew my child lied because he said the truth as he was confronted". The word "lie" has a very moralistic side, without any psychological insight. The concept of time confusion makes it possible to understand that if the past, present and future do not have any bonds between them, the present moment is rather isolated from the other time sequences. Just this example of a child coming to his grand-mother, in afternoon, saying that he has not eaten once, during the day, because as he feels his appetite now, he is hungry and all past memories are completely forgotten or another boy calling 911, complaining of being beaten, because he was refused a permission. It is not even manipulation, as often interpreted. It is pure magic thinking, without relation to consequences. which are mostly negatives, not at all in his favors.

Sometimes, medication, such as methylphenidate, is needed to increase the concentration and suddenly reduces this morbid condition, quite capable of mixing up people or making severe damage to adult reputation

Claude Jolicoeur, child psychiatrist
Montreal, 2003