Does my lively son have ADHD?
JOHN SHARRYanswers readers' questions
Q
My son, who is 2½ years old, has no sense of danger and can be a nightmare when we are out as a family. He runs away at the slightest chance. When we go anywhere new, the first thing he will do is climb on things and I fear he will fall. If I tell him not to do something, he doesn’t listen and will immediately go and do it. He is very hard to manage on the road, etc. He is very different to his two older sisters (six and four) who were always well behaved and contained. Until he became a toddler we used to be able to go out as a family and even visit restaurants and so on, but now this has all stopped. We even shorten our visits to family and friends because if we take him, he will be into everything and we spend the whole time tracking and managing him. We hoped he would settle as he got closer to three but if anything he is getting worse. I also wondered if he might have ADHD, though I’m not sure about this.
A
Lots of young children have an impulsive active temperament that is hard to manage during the early years.
Such a temperament is more common for boys who can mature more slowly especially in the area of self-regulating activity and impulsiveness. Though your son is two and a half years old, it sounds like he is displaying the impulsive unboundaried behaviour of a younger child. You ask whether this is a sign of attention deficit hyperactivity disorder (ADHD).
The truth is it is very hard to tell at such a young age and depends a lot on how he is progressing in a range of developmental areas such as understanding, speech, hearing and so on. If you are concerned, you should consider seeking an assessment. Your public health nurse might be the first port of call. However, there is a good chance that he will settle in his own time as he gets older and matures and there are a number of things listed below to help him. By gauging how he responds to these strategies, you will also get a sense of his level of need and whether he might need further assessment or support.
Accept he will need extra vigilance for a period
It is helpful if you accept that, unlike his older sisters, at his age he will need extra vigilance and attention. This means he will need special care and attention when in dangerous situations, such as walking on the road, and this can include simple solutions such as keeping him in the buggy at these times. Some couples find it useful to allocate one parent “on duty” when out or in a new situation.
Prepare him in advance for situations
It can help if you explain to him step by step what is going to happen in new situations. To make it easier for him you can back up your explanation by making a picture story of what will happen and what is expected of him. For example, on a visit to his cousins, you might show pictures: (1) Ring the door bell; (2) play with Granny’s toys; (3) eat lunch/tell news; (4) go for a walk with Granny; (5) draw with sisters (6) drive home.