Are These Behaviours Signs of ADHD in Early Childhood?

We wanted to share this info because so many parents are concerned about ADHD in the early years.

It’s likely because the common symptoms of ADHD - impulsivity, short attention spans, high energy - are also normal behaviours in early childhood.

So how do you know if the behaviour you’re seeing is cause for concern?

Dr. Jennifer Cork, a doctor of social work (DSW) and licensed clinical social worker (LCSW), has answered some commonly asked questions about ADHD from parents and teachers.

Check out our Q & A below:

1. How can parents and teachers tell the difference between "typical behaviour" and behaviours that may need further assessment for ADHD? For example, impulsivity, short attention spans, etc.

It’s helpful to observe the child compared to their peers.

Is their energy level, impulsivity, or focus a lot different than other children their age?

For example, you might flag a child’s activity level that is so intense there’s often safety concerns. They constantly get into things they shouldn’t, climbing/jumping from heights, or you don’t feel comfortable leaving them unsupervised.

It can also be helpful to find your area’s developmental milestone checklist and review it with your child in mind, as neurodivergent children might meet milestones at different times.

The CDC's Milestone App has milestones for children as old as five years old and features images, videos, and specific examples of each milestone.

2. How does ADHD present itself in children at different ages?

The behaviours below are common in children with ADHD, though this is not an exhaustive list:

• They’re inattentive, often described as daydreaming
• They often lose or forget things
• They’re not paying attention to details. For example, if they’re doing math, they might mix up the addition and subtraction signs.
• They may be hyperactive. Children with ADHD are often described as "busy".
• They are novelty seeking, often getting into things they shouldn’t

It’s important to note that children with ADHD are typically 2-3 years behind their peers in executive functioning skills.

For example, a five year old will have the executive functioning skills of a three year old. Knowing this, it’s important to set reasonable expectations for your child. Meet them where they’re at and don’t set expectations entirely on age or peer capabilities.

3. How is ADHD diagnosed?

I typically recommend that concerned parents talk to their family doctor or pediatrician first.

It depends on where you live but MDs can typically diagnose or refer you to someone who can, like a psychologist.

There are a variety of assessments used, depending on where you’re located, so it’s best to talk to your local family or pediatrician to find out more.

4. What age can ADHD be diagnosed?

Most professionals don’t diagnose ADHD until at least age six because prior to that, you’re relying heavily on only parent and teacher reports.

By age six, children can also be a source of information about their experiences and struggles.

If they are diagnosed earlier than six, it’s often recommended that they are tested again, after age six.

5. What are some books you’d recommend for parents that want to learn more about ADHD?

My first recommendation is Taking charge of ADHD by Russell Barkley. This is one of the best books written about ADHD by one of the leading researchers in this field.

This book does a good job explaining the science behind ADHD:

• What’s going on the brain
• Common treatments and how they work
• The genetic component

In general, I think the book does a good job of explaining ADHD and the medications used to treat it. It helps families understand that children with ADHD have lower levels of dopamine and norepinephrine. When a toddler is constantly trying to jump off heights, it’s not because they’re ‘bad’ but rather because they're trying to boost those missing those brain chemicals.

The other book I’d recommend is Driven to Distraction by Edward Hallowell and John Ratey. They are both psychiatrists with ADHD. While this book is not as good as presenting the science behind ADHD, it does a better job presenting both the challenges and strengths that people with ADHD have.

6. What are some strategies you typically recommend to teachers to manage children with ADHD in the classroom?

These strategies are great for all children but specifically help those with ADHD:

1. Focus on routines - For example, use a visual schedule and keep daily routines consistent in the classroom.
   
   
2. Allow kids to wiggle and move as needed, use fidgets (shouldn’t distract the kids around them), and offer alternative seating (wobble cushions or wobble chairs).
   
   
3. Talk less - I once heard a presenter at a conference say that after 5-7 words, a child with ADHD is no longer listening to you. Make your words count!
   
   
4. Use visual timers to help support transitions and help children that have time blindness (a cognitive phenomenon where individuals struggle to accurately perceive the passage of time or estimate how long tasks will take).
   
   
5. Focus on positive feedback - ignore challenging behaviours when possible and focus on praising positive behaviours.
   
   
6. Give only 2-3 expectations at a time. For example, at circle time you can say that children need to sit and keep their hands to themselves. That’s two - there shouldn't be any other instructions given at that time.
   
   
7. Don’t assume children know the "rules" or expectations. You will sound like a broken record most of the year but you will need to consistently set clear expectations and rules over and over again.

7. How do you recommend teachers start the conversation with parents if they’re concerned about ADHD, knowing some parents are going to be resistant to that conversation?

This is always challenging. I would recommend that teachers simply share observations.

They can let the parents know, "This is just my opinion. I’d suggest checking in with a professional you trust."

As a teacher, know that you might just be planting a seed and it could take years for the parents to process this information BUT you are doing the right thing.

As a teacher, you’re one of the main caregivers to each of the children in your class. You also have the unique opportunity to see their behaviour compared to a group of their peers so reporting any concerns to parents is simply doing your due diligence.

8. How does ADHD typically impact learning?

Children with ADHD often have a harder time in school. Parents will report their children:

• Regularly get in trouble
• Struggle socially
• Get lower grades

Consequently, children with ADHD often end up as adults who are undereducated and underemployed compared to their abilities.

After treatment, many children report having an easier time in school and see an improvement in their grades. Their social lives also tend to improve. The right treatment and support really help children to reach their potential.


Hopefully this was helpful.

If you're interested in learning more about Dr. Cork, you can find her therapy book for neurodivergent children here: What's your Anxiety Level?

You can also find her at her website: https://www.drjennifercork.com/