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ADHD and Your Preschooler by Jean T. Rothman, LMFT

If you or your child's teacher suspect that problems at preschool or kindergarten are being caused by ADHD (Attention Deficit Hyperactivity Disorder), be sure not to jump to conclusions!  ADHD is a multi-faceted disorder, and many of its symptoms may be mimicked by other problems. Being unable to pay attention may be a sign of something as simple as the child being emotionally immature, or may be an expression of stress — such as when a new baby joins the family, or parents are divorcing. Problems concentrating may even indicate a medical condition such as low blood sugar, allergies, or a thyroid imbalance. If your child doesn’t seem to listen and follow instructions, there may be a problem with hearing, or with processing information.


How can you tell if ADHD is the culprit?
ADHD is not a one-size fits all diagnosis. In fact, there are three types:
  • Hyperactive-impulsive type
  • Inattentive subtype
  • Combined type
Let’s take a look at these three types and their symptoms.


Symptoms of ADHD : Hyperactive-Impulsive Type
Children (and adults) with this type of ADHD have high amounts of energy and are highly active, but they can pay attention.  Children with this diagnosis are frequently younger. Symptoms include:



  • Being in constant motion
  • Unable to stay seated 
  • Always squirming and fidgeting
  • Often running, jumping and climbing when this is not permitted
  • Unable to play quietly


In addition, those with this type of ADHD are impulsive and may:
  • Speak or act without thinking
  • Have trouble taking turns
  • Be unable to wait for things
  • Call out answers in class before the question is completed
  • Frequently interrupt others


Symptoms of ADHD: Inattentive Type
This used to be called ADD, or Atention Deficit Disorder. Girls are more frequently diagnosed with the inattentive subtype of ADHD than boys, and they are often diagnosed later.  Its symptoms include:
  • Being easily distracted
  • Not paying attention to details
  • Seeming to be lost in daydreams
  • Doesn't seem to listen
  • Frequently losing or forgetting things
  • Not following the instructions
  • Starting one thing before another is done
  • Not being organized


Symptoms of ADHD : Combined Type
As its name implies, this type of ADHD involves a combination of the symptoms of the other two subtypes.


But these lists of symptoms don’t tell the whole story.  According to the American Academy of Pediatrics, a diagnosis of ADHD also requires that the symptoms:



  • Begin before age 7, and have lasted longer than 6 months.
  • Occur in more than one environment: at school, in the community, and at home, for example.
  • Impair performance in social situations as well as in school.
  • Happen more frequently than in other kids the same age.


A Comprehensive Evaluation is Key
Because so many problems can cause similar symptoms to ADHD, it is crucial your child get the right diagnosis. A comprehensive evaulation is key. Mental health professionals who can diagnose and treat ADHD include child psychiatrists, psychologists, social workers, and marriage and family therapists. The evaluation process should include input from parents, teachers, your pediatrician, and childcare providers. Medical and psychological testing may also be required.


Treating ADHD in Preschoolers 
Treating ADHD in preschoolers involves working closely with parents, not just the child, using a combination of behavioral therapy and parent training. I use the Incredible Years program, one of a handful of treatment programs that are research-based and proven effective in a younger population.


What about Medication?
According to the Centers for Disease Control and Prevention (CDC) 1 in 2 preschoolers do not receive recommended behavioral treatment for ADHD. In fact, in the past 4 years, the rate of preschool-aged children taking medication for ADHD has doubled. Sadly, 1 in 4 receive only medication treatment, which is should not be a stand-alone treatment, and should not be the first line of treatment tried.



If you suspect your child’s difficulties in preschool or kindergarten may be ADHD-related, a comprehensive evaluation and treatment with a trained professional are available at Good Therapy San Diego!
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