Can ADHD be diagnosed in a preschooler?
ADHD can be diagnosed in a child as young as 3 years of age. Signs of ADHD in preschoolers may include a noticeably high activity level, inability to persist with tasks, problems in following group instructions, poor behavior modulation, difficulties with social interactions, unending curiosity, excessive aggression or destructive play, silliness, bossiness, and impulsivity. Preschoolers
with ADHD may have sleep problems, such as restless
or decreased sleep. In addition, argumentative behavior
and temper tantrums may be more common in preschoolers
with ADHD. These children may also be quite
immature, frequently demonstrating off-task or inappropriate
behaviors. All of this can contribute to conflicts
within the family, ranging from battles with siblings and
parents to difficulties in keeping baby-sitters.
Do the symptoms of ADHD change as children mature?
Yes. Although some symptoms persist, many symptoms
of ADHD change with development. For example,
hyperactivity diminishes in some children after elementary
school. Many people think that the hormonal
changes of puberty are responsible for this, although we
do not understand the mechanism. Older children may
have either outgrown their hyperactivity or found ways
in which to channel it. A sense of inner restlessness may
replace the hyperactivity. In the preteen and adolescent
years, poor grades, inability to sustain attention, difficulties
in maintaining social relationships, disorganization,
and risk-taking behavior may surface as primary symptoms.
At school, ADHD may show up more as written
work becomes increasingly complex and a teenager is
required to plan ahead for long-term assignments. Socially,
the range of accepted behavior in many ways is narrowed
by the unwritten rules of a teenager’s peer group.
The difficulties with emotional self-control and interpersonal
communication common in ADHD makes
these teenagers appear more immature and clumsy
among their peers. Their impulsivity may cause them to
blurt out answers inappropriately or to interrupt conversations.
They can become disruptive in the classroom
or even be perceived as the “class clown.” This can result
in peer rejection and subsequent distress in ADHD children.
Are there other signs of ADHD besides the ones traditionally used
to establish the diagnosis?
ADHD can show up in children in many ways besides
those defined by established criteria in DSM-IV-TR.
Social-skill issues may be the presenting symptoms at
home and at school. Children may display isolated
aggressive behavior in preschool and early elementary
school, because of their impulsivity and poor attention
to verbal and visual cues. Because their disruptive
behavior often results in conflicts with peers, siblings,
and authority figures, such children stand out from their
classmates. Consequently, they tend to be rejected by
their peers. Children with ADHD may also be quite
messy and disorganized. Parents frequently describe
bedrooms in complete disarray, backpacks with papers
falling out, and poor eating habits. General academic
difficulties are also common. Children forget their assignments,
do not appear to be listening in class, and get
poor grades. In addition, they may have what are usually
called executive functioning problems: difficulties
with planning, starting tasks, shifting from one activity
to another, controlling responses, and staying interested
and motivated.
Do ADHD symptoms in late adolescence
put my child at risk for other kinds of problems?
The persistence of ADHD symptoms into adolescence
is associated with more academic, behavioral, and social
problems. Research indicates that adults with continuing
symptoms complete less formal schooling, are employed
at the usual rates but have lower-status jobs, and have
higher rates of personality disorders. The frequency of
substance abuse is higher among adolescents and young
adults with continuing ADHD. Coexisting conduct and
antisocial personality disorders further increase the risk
of substance abuse.
Recent research comparing children who outgrow
ADHD to those who remain symptomatic suggests that
those with persisting ADHD are more likely to develop
other associated illnesses (e.g., conduct and oppositional
disorders), which can become increasingly prominent
and problematic for these adolescents and young adults.
The risk-taking and rule-breaking behavior can also
significantly worsen parent–child conflicts.
Among children whose symptoms decrease during adolescence,
the outcome is similar to that of non-ADHD
individuals regarding occupational achievement, social
functioning, and drug and alcohol use, although not
academic achievement. Academic issues may remain an
affected area even if ADHD disappears.
Read More: What Are ADHD Symptoms?
