Does my son have ADHD

[NOMA0512]

My son is 4 and 3 month. His attention does not seem to be a problem as he enjoys story time at home and at preschool.  However, he is always running around the house or doing some silly things such as climbing and running around the house.  I get frustrated in the mornings as I have to tell him more than 10 times to put on his clothes, if I do not stop everything and keep an eye on him he gets distracted. He gets bored easily and the only thing that gets him to sit still is reading a book and watching cartoons(whilst sucking his thumb). I have as a result limit the TV to 3 times a week.  He gets frustrated with this and moans and sometimes try to put on the TV behind my back.  He knows what he is doing is wrong though because he closes the door whilst doing this.

He is extremely impulsive and he bumps his head whilst doing his highly dangerous "stunts" he even has a patch in his hair where the hair is not growing.  He does not learn from his mistakes and I am afraid that his behaviour is starting to rub off on his sister(2 and a half who also thinks running around is cool).  My son is very strong wield and you have to repeat the sames things to him all the time.  He does not seem to know the difference between what is right and wrong sometimes.  I have raised this concern with his teacher and she told me that I should not worry as he can do puzzles(even though it is not his favourite) and complete them and likes to repeat the stories and ask questions at schools.  He will not do puzzles at home though and colouring is not his past time either. I guess he does these activities at school because he has to.  He has a good memory and can remember things from where he was 2 years old(without triggering).  He speaks well for his age but I am concerned with his impulsive behaviour and stubborness. We give hime time out and I my husband has stopped smacking him. After time-out he does come and hug and apologises but the next day he repeats the bad behaviour.

[Rebecca Resnik, PsyD]

Hello,
    the key to determining if a young child has ADHD is to determine to what degree his symptoms are occurring across settings, and how much his behavior differs from that of other boys his age. Much of what you describe is common unwanted behavior in a boy his age, though it is clear that he needs to learn new skills to follow rules and keep himself safe. To make a diagnosis of ADHD, the symptoms you describe have to happen everywhere he goes, including school, home, grandparents house etc. Children with the primarily hyperactive type of ADHD do present with the symptoms you describe--including hyperactivity, impulsivity, disruptive behavior, and difficulty sitting still long enough to eat, fall sleep, or do school work. Kids with ADHD often have problems making and keeping friends because of their impulsive behavior. The ability to sustain attention to video games or television do not mean that a child does not have ADHD. Video games and television shows are so stimulating that even children with ADHD can spend lots of time with them. You may notice, however, that he is more active than other boys even while doing passive activities like watching tv. You may see him doing things like leaping off the couch as he watches (although many little boys do this too, its all a matter of degree and how well they can suppress the urge).

There are some things you describe that are not consistent with ADHD. Core deficits of ADHD inclued working memory deficits and relatively weak problem solving skills. Its a good sign that he can sustain attention to individual work at school, though you were correct to bring your concerns to the teacher's attention. Teachers can be an excellent resource because they see your child as compared to the hundreds they have taught, and see him functioning outside of home. If the symptoms are not happening at school, then the more likely situation is that you can get the behaviors under control at home by using some new techniques.

To really find out if he meets diagnostic criteria for ADHD, consult a psychologist. A psychologist who specializes in young children will have the needed testing materials to assess your son (he is not too young to be tested). Your pediatrician may be able to give you some screening questionnaires for you and his teacher to fill out to get a rough idea of how unusual  your son is as compared to same aged boys. Just keep in mind that these checklists are just a crude tool, and no replacement for a careful assessment (lots of children come up as having significant levels of symptoms for conditions that are not ADHD). Your pediatrician should be able to make a referral to a psychologist.

Regardless of whether your son has ADHD or not, I am sure you want to get these behaviors under control. You did the right thing by switching away from smacking, though after stopping it you are probably asking yourself, "Well, what do we do now?" If you can, I would recommend you find a psychologist or licensed professional counselor who can help you. Having professional help will take the guess work out of changing your parenting style. It is also important to work with a professional because he can be objective, and see things that you will not because of your own involvement in the situation. Seek a therapist who will work closely with you and your husband to help you learn new techniques. The psychologist can teach you and your husband how to communicate effectively with your son, how to use positive behavior management, and how to teach him new skills to replace the disruptive behaviors. I do not recommend someone who wants to work only with your son, as that is not likely to have much of an impact on the immediate problem of disruptive behavior at home.

If getting professional help is not feasible, there are very useful books that will help you learn different ways of managing his behavior. These are all available in paperback and used for a few dollars on the internet.
The Kazdin Method for Parenting the Disruptive Child, by Alan Kazdin
Taking Charge of ADHD by Russell Barkley
How to Talk so Kids Will Listen and Listen So Kids Will Talk, by Adele Faber and Elaine Mazlish
Dr. Larry Silver's Advice to Parents on ADHD by Larry Silver

Best Wishes
Rebecca Resnik
Disclaimer: This post was written for informational purposes only. It is not intended to be a substitute for face-to-face psychological or medical care. This post is not intended to create a clinician-patient relationship, nor to give or rule-out a diagnosis.

[allmymarbles]

My husband and I both come from big families and ourselves have a several children and lots of grandchildren. So you might say we are very familiar with the common problems of childhood. What you describe is a very active child who is somewhat lacking in discipline. He does not sound abnormal.

He is probably very excitable so I would adopt a quiet demeanor with him. If he doesn't get his clothes on when you tell him, don't yell, but get his clothes and stand by while he gets into them. That way you let him know that he can't get out of putting his clothes on when you tell him. In the same way, if he is doing something he shouldn't, don't tell him not to. Stop him instead. It takes more work, but it pays off.  I would go easy on punishment. Think QUIET, PATIENT, FIRM.

[Lilak2002]

My son has ADHD, ODD and a mixed receptive speech delay.  In my opinion your son is normal.  My son does do a lot of the thing your son does but there is a lot more to ADHD then just naughty behavior.  He is a boy so that is part of his problem but I think your son will be just fine.  Honestly I wish my son was as well behaved as yours. I know that sounds strange but I have had to deal with a lot of difficult behavior.  Your kids will have their own personalities and this is just who your son is.  My youngest son also copy’s his big brother but he has a personality all his own, difference between night and day with those two. Your daughter will always look up to her brother whether she will admit it or not as she grows older and will mimic his behavior.  As long as your son is doing well in school and is well behaved you shouldn’t worry.  He is probably coming home and just letting out all the energy he is not allowed to let out at school. That’s why I bought a trampoline for my son.  I let him play on it for about an hour after school or when he drives me up the wall and all the energy comes right out!  Try sports also to keep him busy. He will be better for it.  I’m not trying to discourage you in anyway by saying his is normal, all children are different.  Comparing him to my son he sounds just fine.