ADHD in Preschool Age Children

June 10, 2024

What is ADHD?

Attention Deficit Hyperactivity Disorder, or ADHD, is one of the most common brain-related disorders in children, with more than 9% of all children in the United States receiving a diagnosis. ADHD is defined by a persistent pattern of inattention, impulsivity, and hyperactivity, which causes significant impairment in the child’s functioning both in school and at home. Common behaviors of ADHD include being easily distracted during tasks, losing necessary objects, fidgeting, and running and climbing in situations where it is inappropriate. However, not all children have all of the symptoms. ADHD can present with primarily inattentive symptoms, primarily hyperactive or impulsive symptoms, or with a combination of the two.

The Importance of Diagnosing ADHD in Preschoolers

While parents, teachers, and physicians may be on the lookout for signs of ADHD in older children, it’s often the little ones – children below the age of 6 – that get missed. That doesn’t mean that ADHD in this age group doesn’t exist, however. In fact, a 2016 national survey found that 2.4% of children aged 2-5 years had been diagnosed with ADHD.

One reason that it can be difficult to diagnose ADHD in preschoolers is that many of the symptoms appear similar to normal toddler behavior. Young children, still learning the ways of the world, often talk out of turn, have trouble finishing complex tasks, and appear forgetful. However, children with ADHD may not meet the same milestones as their peers, who begin to grow out of these behaviors. For example, while many five-year-olds understand that they must sit quietly at the library, a five-year-old with ADHD might be running around the room and unable to sit. These children may be aggressive because of impulsivity–for example, they may hit another child who will not give them a toy. They may become easily frustrated and have tantrums that would be expected of a much younger child.

Dr. Ann Childress is a Las Vegas-based child and adolescent psychiatrist who specializes in ADHD. Often, she sees kids after their parents and pediatricians have noticed hyperactive, inattentive, or impulsive behaviors. “By the time many parents come to me, their child is usually having significant difficulties in school,” she emphasizes. “Teachers have reported their child being disruptive in class, not following instructions, or not getting along with other children in the classroom.”

Many times, parents are already dealing with the effects of their child’s behaviors by the time they seek treatment. Dr. Randi Lampert, a Las Vegas pediatrician who works alongside Dr. Childress, notes that she was on the frontline response for kids with ADHD as a primary care pediatrician. “Oftentimes, parents would come in because their child had been suspended or expelled from multiple daycares, and their kids were labeled as ‘problem kids’ in the classroom. The reality was that they had a disorder that was going untreated.”

More than 40% of preschool children with ADHD had been suspended from school or daycare, compared to only 0.5% of children without ADHD. This can have widespread impacts on family life. Dr. Childress reports that many parents miss work due to their child’s suspensions, have more trouble finding childcare, and may experience financial stress due to these issues.

The AAP currently recommends that all pediatricians evaluate for ADHD in any child greater than 4 years who presents with behavioral problems or signs of inattention, impulsivity, or hyperactivity.

Treating ADHD in Preschoolers

While there are many different therapies available for the treatment of ADHD, special considerations are taken in treating this age group. The AAP recommends that children under six with ADHD first receive behavioral parent training. Behavioral parent training is a form of treatment for ADHD that helps parents understand and respond appropriately to their child’s behaviors by providing structure and positive reinforcement. The second-line treatment is a low-dose stimulant medication. Stimulant medications work by increasing the presence of certain brain chemicals, specifically dopamine and norepinephrine, to help children increase their attention and decrease their impulsivity. Dr. Childress highlights that the most effective treatment model for children, however, is one that combines effective behavioral management techniques with medication therapy.

When considering ADHD in a preschool-aged child, it’s essential to keep in mind some special considerations. While the diagnosis requires impairments in behavior in school and home, many younger children don’t attend school. In this case, Dr. Childress recommends thinking about behaviors during other structured activities, including play groups, religious gatherings, sports, and daycare.

Another important note is that ADHD in preschoolers often presents with other conditions, including oppositional defiant disorder, phonological disorder, and expressive language disorder. In fact, more than 70% of children with ADHD also have another psychiatric disorder. Thus, in young kids already diagnosed with other often co-occurring disorders, screening for ADHD is an important consideration.

For parents, the most important thing is to understand that their child is not a bad kid. Kids with ADHD might appear to be misbehaving, but these behaviors are often symptoms of the disorder that can be treated with both therapy and medication. Speaking with daycare and preschool teachers and considering an individualized education plan (IEP) or a 504 plan can help kids with ADHD get the reasonable accommodations they deserve. With treatment, parental support, and the involvement of teachers and school staff, children with ADHD can thrive.

To learn more information about ADHD in preschool children, call us at 702-838-0742.

References

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Danielson ML , Bitsko RH , Ghandour RM , Holbrook JR , Kogan MD , Blumberg SJ . Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016. J Clin Child Adolesc Psychol. 2018;47(2):199–212

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Egger, H. L., Kondo, D., & Angold, A. (2006). The epidemiology and diagnostic issues in preschool attention-deficit/ hyperactivity disorder: A review. Infants & Young Children, 19(2), 109–122.

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About Us

Dr. Childress is a world renowned psychiatrist specializing in ADHD and Autism. She has been in clinical research for over 20 years with more than 80 published articles.  Dr. Lampert is a pediatrician with 25 years of experience. She has always had a special interest in behavioral and developmental problems. If you believe your child suffers from ADHD, contact us today!

 

The Center for Psychiatry and Behavioral Medicine Inc is made up of 4 clinical research coordinators, 1 clinical research recruiter, and 1 medical receptionist. Our tiny but mighty team are all eager to help ensure you and your child get the best treatment you deserve!

Contact Information

Center for Psychiatry and Behavioral Medicine Inc. 702-838-0742