The first attention deficit hyperactivity disorder (ADHD) symptoms often appear between the ages of 3 and 6. However, the earliest symptoms can be hard to recognize and are often overlooked. For example, silly or erratic behavior can be dismissed as adorable toddler antics—kids will be kids, after all. In addition, ADHD symptoms vary from person to person, so there is no one-size-fits-all diagnosis.

Recognizing Symptoms

Often, ADHD is first recognized when a child starts school and is suddenly required to participate in organized activities, follow distinct rules, and play with other children in a more structured environment. Teachers may be the first to detect symptoms such as a child having trouble following class rules, sitting still, waiting turns, following instructions, or if the child frequently "spaces out" in the classroom or on the playground. In other cases, parents may be the first to sense that their child is not succeeding in school or interacting socially with others.

Other Causes of ADHD Symptoms

If you or your child’s teacher suspects your child may have ADHD, you should meet with a pediatrician. The pediatrician will assess your child and may refer you to a mental health specialist with experience in diagnosing and treating ADHD. Before diagnosing ADHD, it is essential to rule out other possibilities for the symptoms the child is experiencing. For example, certain situations, events, or health conditions may cause temporary behaviors that are similar to symptoms of ADHD. These include:

  • Previously undetected hearing or vision problems
  • Other medical problems that affect thinking and behavior
  • Learning disabilities
  • Undetected seizures
  • Anemia (low red blood cell count that can cause low energy and poor concentration)
  • Anxiety, depression, or other mental health problems that elicit ADHD-like symptoms
  • Sudden life changes such as the death of a family member, a divorce, or recent move

Investigation by a Specialist

If the specialist is able to rule out these other possible causes for your child’s symptoms, he or she will consult with people who know your child well. This will allow the doctor to gain more information about the child’s symptoms and determine if the behavior is regular or temporary, if it occurs in all situations or just a few, and if there are any other environmental clues that could indicate a cause for the ADHD-like behaviors. The specialist may also observe your child in a variety of settings and situations to see if he or she reacts in ways that are typical of someone who suffers from ADHD. 

It’s also important to remember that “normal kid” behavior such as getting distracted easily, acting impulsively, and struggling to concentrate at times can be mistaken for ADHD. Children have personalities, temperaments, and energy levels that change as they mature. Only a medical professional can accurately diagnose a disorder such as ADHD.

Tests for ADHD

Unfortunately, there are no tests that can confirm with 100 percent accuracy a diagnosis of attention deficit hyperactivity disorder (ADHD). The tests that a specialist will perform when assessing a child for ADHD are primarily geared toward first ruling out any other potential causes of ADHD-like symptoms and then gathering as much information about behavioral patterns as possible. These may include:

  • A complete medical exam to rule out conditions such as seizures and vision or hearing problems
  • Blood work to rule out anemia
  • Discussing your child’s behavior in many different settings
  • Filling out questionnaires/checklists about your child’s behavior
  • Interviewing people in your child’s life about his or her behavioral patterns
  • Observing your child playing with friends, working in the classroom, and interacting at home
  • Having your child complete tasks that require focus and concentration
  • Attending a family counseling session

Some ADHD symptoms such as getting distracted, acting impulsively, and losing concentration can be experienced from time to time in all children, so it’s key to determine whether these behaviors are temporary or ongoing. ADHD symptoms can be similar to other mental and medical disorders, so thorough testing by a doctor is essential.