Does My Toddler Have ADHD?
It is very difficult to know whether or not a toddler has ADHD, or Attention Deficit/Hyperactivity Disorder (previously called ADD). There are a number of reasons for this. The diagnosis of ADHD has to be made by a doctor or other professional using criteria from the most current Diagnostic and Statistical Manual (DSM-IV-TR, soon to be DSM-V), which is written by the American Psychiatric Association.
The DSM-IV states, “Some impairment from the symptoms is present in 2 or more settings (eg, at school [or work] or at home.” Most toddlers, ages 12 to 35 months of age are not even in preschool. There is no way to observe impairment in their functioning outside of the home.
Another reason is it hard to diagnose ADHD in a toddler is that behavior considered abnormal in a school age child can be completely normal in a toddler. It is very difficult for a parent to know if their toddler is simply doing normal toddler things, or if the behavior is not normal for the child’s age.
The types of behavior listed for diagnosis of ADHD clearly include actions a normal toddler might take. There are two basic types of ADHD, although some children have a mixture of both types. They are called “inattention” and “hyperactivity/impulsivity.” A child must have six or more of the following types of behavior to have the inattention type of ADHD. He or she:
- Makes careless mistakes
- Does not sustain attention
- Does not seem to listen
- Fails to finish tasks
- Dislikes organizing tasks (like schoolwork)
- Dislikes task requiring sustained mental effort
- Loses things
- Is easily distracted
- Is forgetful
For the hyperactivity/impulsivity type of ADHD, a child must show at least six of the following types of behavior, again adapted from the DSM-IV. He or she:
- Fidgets and squirms
- Does not stay seated
- Runs and climbs when not appropriate
- Does not play quietly
- Is “on the go” or “driven by a motor”
- Talks too much
- Blurts out answers before questions finished
- Has difficulty waiting for his or her turn
- Often interrupts or butts in
Parents will recognize some of this as normal behavior for a toddler. In the case of ADHD, as noted above, there has to be an impairment of function along with the behavior, it has to be causing problems for the child, and not be consistent with the developmental stage of the child.
You should not really be very concerned about some of this behavior in a two, or even three, year old. As your child gets a little older, you should try and see if he or she is really disruptive, hyperactive, or inattentive as compared with other children. Once your child is old enough to go to preschool, this may allow you to see how he or she acts in a school situation, watched by teachers who have experience with children this age.
While it may be possible to use the criteria in younger children, the American Academy of Pediatrics has promoted the use of the DSM-IV criteria so that doctors can diagnose children ages 6 through 12 years correctly.
In the meantime, if your toddler’s behavior is really disrupting family life, you may need some help dealing with it. It may be extremely frustrating to not to know whether or not your toddler has ADHD, but remember that he or she may in fact not have this disorder and grow in to normal behavior. Your child does not need a label that may not fit. If his or her behavior is challenging for you, get help wherever you can, including from your family and other parents. Parenting classes and education have been shown to help parents deal with difficult behaviors, including those caused by ADHD. You should talk to your child’s doctor and find out about parenting classes or other sources of assistance.