Although Carol Stevenson didn’t suspect attention deficit hyperactivity
disorder (ADHD) when her son, Jacob, was very young, she still knew at an early
age that there was something different about her child. As a toddler, Jacob was
slow to talk and often resorted to hitting out of frustration. By the time he
started kindergarten, he was speaking well, but his behavior was sometimes
troublesome and disruptive at school.
“He was always playing with things, dropping his pencil, or using one pencil
to flick another off the desk,” says Stevenson, who lives in Santa Clarita
Valley, Calif. “He didn’t pay attention in class and would get up and walk
around.” As a result, she says, he was always being redirected, reprimanded,
and sent to the principal’s office.
Shortly after Jacob started first grade, Stevenson received a call from his
teacher that ultimately led to a diagnosis of ADHD (previously known as
attention deficit disorder, or ADD). “She said in her 30 years of teaching, he
was only the second or third child she had so quickly recognized as having
ADHD,” recalls Stevenson. “Essentially, she was sending out the message that it
was something she doesn’t throw out frequently or lightly.”
Early Symptoms of ADHD in Children
Like Jacob, many children who are later diagnosed with ADHD show signs of
hyperactivity or other red flags from the time they are very young, experts
say. Parents may recall the symptoms of ADHD to be excessive for the
developmental age of their child.
Some mothers say they remember their hyperactive children kicking in the
womb more vigorously than their other children, says Walt Karniski, MD, a
developmental pediatrician and executive director at Tampa Day School, which
specializes in educational services for children with ADHD. Although the fetal
kicker and colicky baby theories have never been substantiated, it is clear
that children with ADHD often show signs early in life.
To be diagnosed with ADHD, a child must have displayed symptoms for at least
six months and those symptoms must have started prior to age five. “If a child
had ADHD at age five, he also had it at age four, and anyone who has ADHD at
four had it age three, though it may not have been manifested,” says Karniski.
Often the first suspicions of ADHD arise when children begin preschool and have
to be in a structured environment for the first time, he says. As they
progresses through school, other signs of the disorder may become evident. The
diagnosis also requires that the symptoms be present in several settings.
ADHD in the Toddler and Preschool Years
No one knows what causes ADHD but structural and functional imbalances in
the brain are believed to play a role. Children may show signs of this
imbalance early in life. They may be slow to walk and have poor balance because
their eyes don’t work well together, says Robert J. Melillo, author of
Disconnected Kids: The Groundbreaking Brain Balance Program for Children
with Autism, ADHD, Dyslexia, and Other Neurological Disorders (Perigee
Toddlers and preschoolers may be unable to sit still, follow even simple
directions, or control impulses. They may become angry for no reason and hit
their peers or siblings. They tend to be impatient, breaking in line on the
playground, or interrupting others when they are talking or playing. They may
move constantly, jump from one activity to another, and have a high level of
energy and a low sense of danger (and perhaps a high threshold for pain). When
shopping, they may refuse to sit in the shopping cart or stroller; they may
take items from the shelves and open them or throw tantrums if you don’t buy
something they want.