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ADHD in Children Health Center

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ADHD in Preschool Kids

WebMD Feature
Reviewed by Smitha Bhandari, MD

How early is too early to tell if your toddler or preschooler might have ADHD?

Most children aren’t checked for ADHD until they’re school age, but kids as young as 4 can be diagnosed, according to guidelines set by the American Academy of Pediatrics (AAP).

At that age, many kids are active and impulsive. So what’s different about kids with ADHD? And if your young child has ADHD, how is it treated?

Stand Out From Other Tots

Compared to other kids their age, children with ADHD often have a harder time sitting still, even for a few minutes. They are unable to wait their turn -- blurting out answers or cutting to the front of the line, for example -- and they may talk excessively.

"Young kids with ADHD are incredibly active all the time," says James Perrin, MD, a pediatrics professor at Harvard Medical School. "Most 4-year-olds are very active in general, but they settle down -- take naps, sit for meals. A child with ADHD is on the go all the time."

"What sets these kids apart is the degree and frequency with which they are hyper and impulsive," says George DuPaul, PhD, professor of school psychology at Lehigh University. "These kids are literally plowing through activities and people at a high pace."

The Diagnosis

ADHD is diagnosed based on symptoms of inattention, hyperactivity, and impulsivity. But inattention often isn’t as apparent in preschoolers.

Sometimes, well-meaning parents, caregivers, or teachers may suspect ADHD. That's not enough. A doctor's full evaluation is needed for diagnosis.

To diagnose a preschooler, a doctor will rely on a detailed descriptions of your child's behavior from parents, day care providers, preschool teachers, and other adults who regularly see your child, along with his own observation. It’s important to talk about all symptoms with your doctor.

Just because your child has some hyperactivity and impulsivity doesn't mean he has ADHD. For example, a child who is frustrated because he has a problem with seeing, hearing, or talking may act out in the same way as a child with ADHD. Your child may need testing to rule out other possibilities.

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