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ADHD In Preschool Age Children

Question of the Week

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Updated January 26, 2008

Q. I have a son who is turning 4 this Dec who is very active and playful. He is very intelligent, he speaks early before he turned two and he can easily memorize songs, alphabets, he knows the colors and he has good memory. But when he went to school (8 wks now) his teacher complained that he is always disruptive in the class, doesn't want to follow instructions (not at all times) and he is always playful and cannot sit still for 2 hours. He can only sit for at least 30 mins to 1 hour but when he gets distracted with play and toys, he doesn't want to go back to his sit and gets disruptive. He is also overwhelmed when there are lots of kids because at home he doesn't have playmates and his teacher cannot really control him. His teacher told me that he is very intelligent but the problem is his immaturity and behavior in school, he is always disruptive and doesn't recognize authority. I'm worried if he has ADHD. Joel, Canada

A. While those might all be symptoms of ADHD in an older child, they could also be a sign of an immature three or four year old boy. ADHD is difficult to diagnose in preschool age children.

Instead of jumping on an early diagnosis of ADHD for your son, you might consider that his teacher has unrealistic expectations for what he should be doing at this age. Many four year olds still have short attention spans, are hyperactive and like to play, and wouldn't be expected to sit still for 2 hours at a time. Such a structured environment with a lot of other children also may not be the best fit for him right now.

If ADHD runs in the family, if he is also overly aggressive and it is leading to problems with his relationships with other children, or if his behavior is extreme and very different from all of the other preschoolers at his age, then you might seek further evaluation by a child psychologist or your Pediatrician.

Early ADHD Diagnosis Dilemma

Considering a diagnosis of ADHD in a preschool age child poses some big dilemmas. While you don't usually want to start these young children on ADHD medications, you also don't want them to go several years with untreated symptoms that may lead to problems learning, making friends, and cause low self-esteem.

It is important to keep in mind that preschoolers can have ADHD, but as Dr. James A. Blackman said in his article on ADHD In Preschoolers - Does It Exist And Should We Treat It?, 'high activity level, impulsivity, and short attention span - to a degree - are age-appropriate characteristics of normal preschool-aged children.'

ADHD and Discipline Books

The following books may be helpful for you, your son, and his teacher:
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