ADHD Diagnosis in Kids

ADHD in Toddlers: Signs, Symptoms, and Treatment

Is your toddler more active than his or her friends? Does he or she have a hard time sleeping? Are transitions painful? If so, your young child might be showing signs of ADD. ADHD in toddlers is real. Read more to understand the first signs and symptoms of attention deficit in young children.

What Are the First Signs of ADHD?

ADHD symptoms in toddlers and young children typically include the following:

  • Hyperactivity, or higher levels of activity than a typical child
  • Problems sleeping and napping
  • Difficulty transitioning from one activity to another

These symptoms of attention deficit hyperactivity disorder (ADHD or ADD) may be detected in toddlers as early as 1 or 2 years of age. Signs of inattention — or inattentive ADHD — are rarely detectable until the child enters school.

Most doctors won’t treat children with ADHD medication until they are at least 5 — except in cases where they present a danger to themselves or others. My son was so hyperactive and impulsive that the physician recommended he start taking ADHD medication when he was 2. He had been asked to leave every day care center in our area, and we were forced to hire two full-time babysitters working together to keep him safe.

Like many parents of a hyperactive and disruptive preschooler, we were hesitant to pursue stimulant medication with such a young child and did not start him on medication until he was 5. I know now that research shows that a trial of medication would have been reasonable with a child such as mine who meets the criteria for the hyperactive-impulsive type of ADHD.

The use of stimulants in extremely disruptive preschoolers was studied extensively in the large Preschool ADHD Treatment Study (PATS) published in 2006. The PATS study found that methylphenidate therapy is effective and safe in preschoolers and, when combined with behavior management, is more effective than either stimulants or behavior therapy alone. The amphetamine class of medication is FDA approved for children as young as 3 years of age; methylphenidates are often prescribed off-label.

[Self-Test: Could Your Child Have ADHD?]

If your child is younger than 5, these alternative ADHD treatments may be helpful:

1. Find activities that soothe and settle your child. Busy environments like a shopping mall or a crowded park, as well as listening to music, can calm a hyperactive child. Some may find classical music soothing, while others settle down with country or even hip-hop. Test it out and see what your toddler responds best to.

2. Engage in physical activities to help her burn off energy before sitting down at a restaurant or at someone’s house. Before leaving the house, play tag or a physically intensive game on Wii or engage in a favorite activity your toddler likes to do with you. Brain Gym movements, which engage the body to activate and calm your brain, may also be helpful.

3. Use a leash or harness to keep your child safe in public places, if a cart or stroller isn’t available. I used a leash with my hyperactive son, and it helped a lot.

[ADHD in Children: Symptoms, Evaluations & Treatments]

4. Change your schedule to limit activities that require your child to stay quiet and still. Perhaps your partner can stay home with your child while you shop or attend a local concert. When going out to dinner, select a place that is kid friendly — Friendly’s is better than a fine-dining restaurant. Another alternative: Call and order ahead to minimize waits at a restaurant. Many restaurants will accommodate the requests of parents with special-needs kids.

5. Some parents calm their hyperactive children by giving them a little caffeine — like a glass of Mountain Dew — or Benadryl. Check with your doctor before trying this.

A final note: It’s vital for parents of hyperactive toddlers to take care of themselves and to get support from other parents who know what it is like to live with a disruptive child 24/7. Look for emotional support and understanding from your clinician, family and friends, online Facebook groups, and the local CHADD Chapter. Raising a special-needs child is a marathon, not a sprint!

[Is Preschool Too Early to Diagnose?]

Michele Novotni, Ph.D., is a member of the ADDitude ADHD Medical Review Panel.

Updated on October 4, 2019

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