The first symptoms of attention deficit hyperactivity disorder (ADHD) often appear between the ages of three and six. The earliest symptoms can be hard to recognize and are often overlooked. For instance, silly or erratic behavior may be dismissed as typical toddler antics. Kids will be kids after all. ADHD symptoms also vary from person to person. There are no one-size-fits-all diagnostic signs or clues.
ADHD is often first recognized when a child starts school and is required to participate in organized activities. Teachers may observe that a child has difficulties following set rules and playing with other children in a structured environment. This can include:
- trouble following class rules
- sitting still
- waiting turns
- following instructions
It might also include frequent "spacing out" in the classroom or on the playground. Parents often may be the first to sense that their child is not succeeding in school or successfully interacting with others.
You should meet with a pediatrician if you or your child’s teacher suspects that your child may have ADHD. The pediatrician will assess your child and may refer you to a mental health specialist with experience in diagnosing and treating ADHD. It’s essential to rule out other possible explanations for the symptoms your child is experiencing.
Certain situations, events, and health conditions may cause temporary behaviors that are similar to symptoms of ADHD. These include:
- previously undetected hearing or vision problems
- other medical conditions that affect thinking and behavior, such as bipolar disorder
- learning disabilities
- undetected seizures
- low red blood cell count that can cause low energy and poor concentration (anemia)
- anxiety, depression, or other mental health problems that cause ADHD-like symptoms
- sudden life changes, such as the death of a family member, a divorce, or a recent relocation by the family
A mental health specialist may be able to rule out these other explanations for your child’s symptoms. In this case, they will consult people who know your child well. This will allow the doctor to get more history and gain a better idea of the time frame of the behavior.
It also will help determine if there are any other environmental factors causing the ADHD behaviors. The specialist may also observe your child in a variety of settings and situations. This is to see if they react in ways that are typical of someone who suffers from ADHD.
It’s also important to remember that “normal kid” behavior can be mistaken for ADHD. This can include getting distracted easily, acting impulsively, and struggling to concentrate. Children have personalities and energy levels that change as they mature. Only a doctor can accurately diagnose a disorder such as ADHD.
There are no tests that can confirm a diagnosis of ADHD with 100 percent accuracy. The tests a specialist will perform when assessing a child for ADHD are geared toward ruling out any other potential causes of ADHD-like behaviors. These tests then gather as much information as possible about the behavioral patterns. Possible tests may include:
- a complete medical examination to rule out conditions such as seizures and vision or hearing problems
- a blood test to rule out anemia
- questionnaires or 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
- having your child attend a family counseling session with you