You’ve faced the terrible twos and witnessed many surges of wild energy and sudden outbursts of emotion, but how do you know if this is typical toddler behavior? Could your little one who won’t sit still have early warning signs of attention deficit hyperactivity disorder (ADHD) or attention deficit disorder (ADD)?
If you’re concerned about ADHD in toddlers, take a deep breath, says Betsy Brown Braun, a child development and behavior specialist and author of “You’re Not the Boss of Me.” Before you schedule an ADHD evaluation for your little one, it’s important to keep in mind that these diagnoses often don’t happen when kids are toddlers, and it’s important not to label kids too early, she stresses.
“We live in a time when people are overly zealous and anxious and categorize children and diagnose children,” she maintains. “We all need to take a breath and look at what’s normal in children.”
What Is ADHD?
“Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior and hyperactivity (over-activity),” according to the National Institute of Mental Health.
There are three main subtypes:
- predominantly hyperactive-impulsive
- predominantly inattentive
- combined hyperactive-impulsive and inattentive
Warning Signs of ADHD
The problem with diagnosing ADHD in toddlers is that many behaviors that warrant concern are typical for toddlers. After all, who knows a toddler who can sit still for any period of time? “Parents should be concerned about a persistent pattern of multiple behaviors associated with ADHD, rather than one or two behaviors that toddlers often outgrow,” cautions Dr. Susan Perkins-Parks, director of the Behavior Management Clinic at the Kennedy Krieger Institute in Baltimore. With that in mind.
Here are some behaviors for you and your nanny to look out for:
- Climbing and Taking Unsafe Risks
“Excessive, persistent and possibly unsafe climbing even when instructed not to do so could be an early warning sign,” says Dr. Perkins-Parks.
- Continuous Movement
“Fidgeting, tapping hands or feet and an inability to sit without moving” could signal an early warning sign, says Dr. Perkins-Parks. But Braun stresses that in general, “two-year-olds don’t pay attention or sit still,” so the key is finding behavior that remains day after day, year after year and continues well after the toddler years.
- Being Excessively Loud Compared to Same-age Peers
Parents may need to be like sleuths to figure things out, Braun says. Start by comparing the worrying behavior with those of your toddler’s peers, but remember that toddlers can be excitable, loud and noisy.
- Showing No Caution or Fear in Situations That Warrant It
When kids aren’t afraid of strangers or show no signs of caution when there is a clear risk of physical danger or harm to themselves, this could be an early sign of ADHD, says Dr. Perkins-Parks. These kids, she notes, “will often sustain serious injuries, even stitches.”
- Can’t Focus on Activities That Should Grab a Toddler’s Attention.
When a child has trouble maintaining their attention for more than a minute or two, especially things that should grab their attention, this could be an early warning sign of ADHD, according to Dr. Perkins-Parks. They should be able to pay attention to their favorite television show or to bubbles with interest, but don’t expect a typical toddler to sit and listen to you reading an entire book.
Both experts advise parents to observe behaviors over time and not just focus on one or two specific times. “Children are supposed to act out,” Braun says. “They are supposed to be feisty, have tantrums, kick, pull hair — in doing those things they learn not to do those things. I worry more about a child who does not do any of these things than a child who does.”
It can take time to get a proper diagnosis, but if you are concerned about the possibility of ADHD in your toddler, bring it up to your pediatrician or primary care doctor.
Amy Aitman is a freelance writer and mommy blogger who likes writing about topics that parents discuss.
