A typical 3-, 4-, or 5-year-old is always on the run, easily distracted, and prone to temper tantrums. But if yours seems to break down every time you try to leave the house, often runs into trouble playing with other kids, and is disruptive in preschool, you may wonder if these could be early signs of attention deficit hyperactivity disorder (ADHD).
"For most kids under six, it's very hard to diagnose," says James Perrin, M.D., the chair of the American Academy of Pediatrics's committee on ADHD. But, he adds, the good news is that a diagnosis isn't necessary to help your child. You can hone behavioral skills that are beneficial for all kids. Any preschooler needs structure, predictability, help in breaking down tasks into manageable steps, and rewards for small successes. But some need it more than others.
Visual cues can be very helpful. For instance, if one of your kids is always getting in the other's space while watching TV, put down two towels so it's clear where each one should sit. Or if your child has trouble staying focused when getting dressed in the morning, break it down into smaller steps ("First, take off your pajama top, now put on your undershirt") and illustrate it with a chart near his bed. Reward him when he gets a step right. And be patient; it may take weeks before you see an improvement. "But if at the end of that time he can get himself dressed, you have a plan that will work for your child," says Sharon Weiss, a behavioral consultant and author of From Chaos to Calm: Effective Parenting for Challenging Children With ADHD and Other Behavioral Problems.
If you've tried these approaches and your child is still having trouble functioning, talk to your pediatrician, who may refer you to a mental health professional, such as a child psychologist or psychiatrist, or a develop-mental behavioral pediatrician. These specialists will be able to diagnose the rare cases of ADHD that can be picked up in a child this young—or help uncover a developmental delay if there is one. "He may say that you have a very typical four-year-old," says Dr. Perrin. "But it's good to check."
As he grows
Even if your child does eventually get a diagnosis of ADHD, any behavioral parenting skills you learn now can only help him down the line. If he does eventually need medication, the dose can almost certainly be smaller than it might have been. And experts say that half the kids who get behavioral help never need medication at all.