ADD

My 4yr old is having problems at daycare/preschool.  She has been suspended twice, for hitting her peers. so far she has kicked a girl in the face, threw sand at a girl, threw the wooden blocks and today she poked a girl with and object and left a mark on her face, so they called me and told me to pick her up. I toke her to her doctor and talked with her, as we were talking she was also observing her and she came to the conclusion that she might have this ADD problem. Her father thinks that nothing is wrong. I need some advise. Please help?

[Kevin Kennedy, Ph.D.]

Dear Ms. Aguilar,

Aggressive behavior is not a feature of Attention-Deficit Hyperactivity Disorder. This is not to say that your daughter does not display ADHD, but only to point out that ADHD does not account for her aggressive posture.

Even if your daughter displays ADHD (and she is really too young to be concluding such a diagnosis), her aggression needs to be managed. Generally, a protocol calling for immediate time out in the wake of any aggressive gesture, followed by a gradual re-introduction, whereby she is first required to play by herself for a period of time, then with only one other child, is effective.

If the aggression does not stop in the face of sound behavior management, you should seek evaluation by a pediatric behavioral health cliniciian.