Does my toddler have high energy or ADHD?

Take a peek into any childcare setting and you’ll generally find a bunch of very active boys, full of beans, racing about, fighting and yelling. There’ll often be a few tomboy girls in the mix as well. Nothing unusual about that. So what’s the chance of any of these naturally boisterous kids actually having attention-deficit hyperactivity disorder?

Research indicates that if we applied the criteria for identifying ADHD to 3-year-old boys, 40 per cent could be diagnosed as having ADHD. However, by the time they are 6 years of age, applying the same criteria would result in less than 5 per cent of the same boys having ADHD. Even less will develop to have a more severe behaviour disorder.

The reason for this thinning out of numbers as children get older is that, developmentally, it’s normal for boys to be very active, wrestle, test limits and even be defiant, to an extent. Some girls are also full of beans, being over-exuberant and constantly chatty.

Toddlers learn by making mistakes and experimenting, both of which are an important part of growing up. Similarly, some forms of highly active play are helping toddlers develop their creative-thinking skills, imagination and problem-solving ability. A parent’s role is to guide appropriate play, set reasonable limits and then intervene when the play becomes dangerously over-exuberant or damaging.

A key concern for parents, then, is to know the difference between normal and excess exuberance.

What to look for or ignore
Toddlers who are only occasionally full of beans, or who only become too exuberant in a specific setting, rarely develop to have more severe problems. If your toddler is full of beans with other rowdy souls but settles elsewhere, you need not be too concerned.

Most toddlers who develop to have ADHD or hyper-arousal conditions are typically very constant and intense in their behaviour. They lack any inhibition, are consistently impulsive, constantly exhausting, and are almost never calm and attentive.

If your toddler is occasionally simply naughty but can accept some direction or discipline, it’s less of a worry. Similarly, if your toddler can accept they’ve done wrong and show some future self-control, it’s likely that consistent parenting, good boundary setting and positive recognition for good, calm behaviour will make a difference.

However, if your toddler can’t control impulses, is constantly hyperactive and deliberately wilful, or can’t exercise self-control, then early intervention and professional help is essential. If your toddler becomes so hyperactive that he is hurtful to others or abusive, he needs support and professional guidance rather than you hoping he will simply grow out of the hyperactive behaviour problems.

Not all consistently hyperactive toddlers will be diagnosed with ADHD, however, because their particular behaviour pattern might suggest a different kind of problem. Among the possibilities are hyper-arousal problems, sensory integration disorder or even dietary problems. There’s also something called oppositional defiance that might fit some very naughty, hyperactive toddlers.

If your toddler isn’t responding well to your efforts, ask your GP or even trusted childcare staff to refer you to someone for professional help, such as a paediatrician or child psychologist who can assess your child. Avoid using the internet to make a diagnosis, as the information there can be dangerously misleading, and don’t panic, as there are positive solutions for most toddler behaviour.

Meet Alex
He was very active right from birth. He barely settled, slept poorly and constantly demanded attention. As soon as he was mobile, he was into everything. When Alex’s mum went out for coffee she wondered how the other mums managed to control their toddlers. Alex did whatever he was told not to, repeatedly and always impulsively.

Alex hit preschool in a whirlwind. He raced from activity to activity, never paying attention long enough to finish anything. He was deliberately naughty, constantly into everything, not seeing any consequences. At home, he only seemed to need minimum sleep before being wide awake, constantly talking and on the move until he collapsed, exhausted.

The key was that Alex wasn’t just very busy occasionally, his activity was constant and intense. Alex was a delight, a real lovable rogue, yet he always seemed to be in mischief or seeking out danger, never learning from his mistakes. Alex’s parents tried their best, but became exhausted. Alex challenged every parenting skill they had. By age 5, Alex had been diagnosed as having ADHD and began a broad treatment plan. He began taking medication, which he remained on until he finished school.

However, we didn’t just rely on pills. Alex needed help to develop social skills and overcome the stigma of being ‘naughty Alex’. He needed to learn self-regulation of behaviour and required tutoring for a memory-based learning difficulty often associated with ADHD.

Alex was always creative, dynamic and engaging – strengths often associated with ADHD. He’s now a very successful property manager with a loving partner, and has learnt to manage his ADHD condition and use the strengths it offers.