Q&A: Does my son have ADD or ADHD?
What is the best way to tell if a very active, almost 5-year-old has ADD or ADHD, or if he is just being a typical little boy? My son has trouble focusing on certain things, (other things he can focus on for as long as he wants), and he exhibits problems with self-control. How much of this is normal for his age?
About 5 percent of children under 12 carry the diagnosis of ADHD, but it isn’t usually made until they are 5 or 6 years old. The hallmark behaviors are difficulty sustaining attention to what would usually interest a child of the same age, near constant motion, impulsiveness, distractability, difficulty following directions, and sudden emotional outbursts. Not all of these factors are always present, but the majority of them are. Since all 2-year-olds exhibit “hyper” behavior, and since children outgrow it at different rates (with boys usually later than girls) it is hard to say what is normal in any 5-year-old, and what is starting to fall out of the normal range.
Ask yourself two questions:
- After watching your son alongside other 5-year-olds, is he significantly more active, impulsive, and distractable than the others? Would someone who doesn’t know him likely agree?
- Is he like this every day and in every situation? This is key. Children with ADHD act like they do across time and places. They are not wild at home and perfect at school, or vice versa, though of course they can have better and worse days.
If your son does exhibit many of the above behaviors and you feel they are more extreme than those of his peers, and if the behaviors cross time and places, than you should bring this to your pediatrician’s attention. He or she will exclude other medical causes and may refer him for more formal testing.