In a time when Attention Deficit Hyperactivity Disorder (commonly referred to as ADHD) appears more prevalent than ever, it can prove difficult to distinguish between an energetic, hyperactive child and one truly warranting a formal diagnosis. Children younger and younger are being diagnosed with it, but how can you tell as a parent if your child is just “being a kid” or truly has ADHD?
The American Psychiatric Association’s Diagnostic and Statistical Manual (commonly referred to as the DSM-5) recognizes ADHD as a persistent pattern of inattention or hyperactivity beginning prior to age 12. The DSM-5 distinguishes three types of ADHD: inattentive type, hyperactive type, or combined type. Symptoms may include inattention to details, difficulty sustaining attention, low task completion, failure to complete directions, forgetful, fidgets or squirms, leaves seat often, runs around, overly talkative, difficult waiting or taking turns, and interruptive. With all of these being behaviors a typical youth may exhibit at one time or another, intensity is going to be crucial in distinguishing “child like” behavior from true pathology. To what extent does it interfere with daily life? ADHD symptoms must be present and disruptive to daily life for at least six months. Youth with ADHD will face difficulty as even the simplest of tasks can prove to be impossible without redirection.
Additionally, it is important to ascertain that patterns of hyperactive or inattentive behavior cannot be explained by external factors including major life change or exposure to stress and is not the result of an underlying medical origin, sleep deficiency, or other mental health condition. Notably, children exposed to prolonged trauma or abuse can mirror ADHD symptoms. Intentional defiance should also be ruled out as a cause for low task completion.
Prior to 2011, the American Pediatric Association only recognized diagnostic criteria for ADHD starting at age 6. However, the 2011 revisions were inclusive of ages 4-5. This age is not arbitrary as 4-5 year olds are starting to enroll into school programs and are expected to thrive in the learning environment. Expectations for prolonged periods of attention and control of impulses in children aged 4 to 5 are ever growing due to educational regulations. As a parent, you may recognize some of the symptoms at home prior to a school setting; however, ADHD tends to manifest more pronounced when students are faced with the quick pace of the classroom. Though, arguably, 4 year olds can be anticipated to be hyperactive and distracted, a true distinguishing diagnosis indicates severe deficiencies in concentrating, minimal to no control of energy and impulses, and distractability resulting in disengagement. Youth with ADHD often experience problems with their executive functioning, and they are incapable of slowing down enough to truly process the information provided. This is differential from a child who is hyperactive because they are excited or inattentive because they are bored.
So is it ADHD? Your child may be displaying some of the signs and symptoms of ADHD; however, if he/she is able to control their impulsivity, pay attention, and respond appropriately across settings, they are likely just energetic. That said, if you feel your child needs additional support, you should consult your child’s pediatrician. Treatment options include behavioral health services or medication management (though typically not considered without behavioral health treatment or until reaching age 6). •
Mesha E. Rebstock, Licensed Professional Counselor, received her Bachelor degree in Psychology and Masters Degree in Clinical Mental Health Counseling from Nicholls State University. She is a Clinical Manager at Magnolia Family Services, LLC supervising in-home behavioral health services and conducting psychiatric evaluations. She lives in Cut Off with her husband Jacob and their two children, Chord and Sawyer.