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ADHD in Children Health Center

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Does Your Preschooler Have ADHD?

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WebMD Feature
Reviewed by Patricia Quinn, MD

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

ADHD can be diagnosed in children as young as 4, according to the American Academy of Pediatrics (AAP).

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But at that age, many kids are active and impulsive. So what are the signs of ADHD? And if your young child is diagnosed with ADHD, what is the treatment?

Standing Out From Other Tots

At such a young age, it can be hard to tell normal toddler behavior from ADHD. But there are some things that may stand out.

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 and chairman of Lehigh University's education department. "These kids are literally plowing through activities and people at a high pace."

Diagnosing and Treating ADHD in Preschoolers

ADHD is diagnosed based on symptoms related to inattention, hyperactivity, and impulsivity. But inattention may be less apparent in preschoolers.

To make an accurate diagnosis, your child's health care provider will rely on detailed descriptions of your child's behavior from parents, day care providers, preschool teachers, and other adults who regularly interact with your child.

Just because your child has some hyperactivity and impulsivity, that doesn't mean they have ADHD. For example, a child who is frustrated because he has a vision problem, language issue, or hearing issue may act out in the same way. It is important to discuss all symptoms with your doctor to make sure your child is accurately diagnosed.

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

Behavioral Therapy Comes First

For preschoolers and toddlers diagnosed with ADHD, behavioral therapy is the first line of treatment.

"Based on the research, more than half of young kids will respond positively to behavioral interventions," DuPaul says.

This type of treatment involves behavior modification by parents and teachers. Techniques include praising and rewarding good behavior, ignoring negative behavior, and using time-outs. Structure and routine are also important for young kids with ADHD.

The Medication Question

What if behavioral therapy doesn't seem to be enough? It's still going to be part of the plan.

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