Every 5-year-old wiggles. Every 8-year-old loses a shoe. So how do you know when it is more than normal kid behavior? ADHD is a common condition that affects focus, activity level, and self-control. It is also very treatable once someone looks into it.
The three kinds of signs
Inattention
- Loses things often
- Has trouble finishing tasks or homework
- Seems not to listen when spoken to
- Gets distracted easily
- Forgets daily routines, like brushing teeth
Hyperactivity
- Can't stay seated when expected to
- Is always moving, climbing, or on the go
- Talks nonstop
Impulsivity
- Interrupts and blurts out answers
- Has a hard time waiting a turn
- Acts before thinking
Some children show mostly inattention. They are quiet, they daydream, and they do not disrupt the class, so they are easy to miss.
Normal behavior or ADHD?
Preschoolers are naturally busy and short on attention. Pediatricians look for a pattern, not a single bad day. For ADHD, the signs usually:
- Start before age 12
- Last at least 6 months
- Show up in more than one place, such as home and school
- Get in the way of schoolwork, friendships, or family life
A child who is wild at home but fine at school may be dealing with something else.
How pediatricians check for ADHD
There is no single test. The American Academy of Pediatrics (AAP) says a child between 4 and 18 with school or behavior problems and signs of inattention, hyperactivity, or impulsivity should be evaluated. Expect the doctor to:
- Ask about your child's health, sleep, and behavior
- Give you and the teacher a rating scale to fill out
- Check hearing and vision
- Look for other causes or partners, such as anxiety, learning differences, or trouble sleeping
Other conditions often show up alongside ADHD, so a good evaluation looks at the whole child.
How it is treated
Treatment depends on age.
- Ages 4 to 5. The first step is usually parent training in behavior management. Medicine may be considered if that is not enough.
- Ages 6 and older. Treatment often combines medicine with behavior therapy and school support.
Schools can add help through a 504 plan or an IEP, such as extra time on tests or a seat near the teacher. Your pediatrician will check in regularly to see if the plan is working and make changes as your child grows.
What helps at home
- Keep a steady routine for mornings, homework, and bedtime.
- Give one short instruction at a time.
- Praise the exact thing your child did well, right away.
- Use calm, consistent consequences.
- Make sure your child gets enough sleep and time to run around.
- Stay in touch with the teacher so home and school use the same approach.
When to call your pediatrician
- Teachers raise concerns, or grades are slipping
- Your child struggles to make or keep friends
- Your child is often in unsafe situations, like running into the street
- Your child seems sad, angry, or says they feel stupid or bad about themselves
If your child talks about hurting themselves, call or text 988, or go to the nearest ER.
If you are worried, you do not need to wait for report cards. Book an appointment with Mill Brook Pediatrics in Sudbury, and bring any notes from school.
About the author: Mill Brook Pediatrics is a pediatric practice at 490C Boston Post Road in Sudbury, Massachusetts. The team cares for newborns, children, and teens.
