Overactive Child or ADHD?

Q. My 15-month-old never stops moving. He won't sit for longer than a minute or two to play with a toy or read a book. He just wants to be on the go. I'm worried -- could he have ADHD?

A. It certainly sounds like you have a very busy, active toddler. And in this day and age, with parents hearing so much about attention deficit hyperactivity disorder (ADHD), I can understand why you might wonder about your own child. However, from your description, it sounds as if your son is healthy and thriving, and that his attention span is right in line with that of other 15-month-olds -- the average attention span for this age group is actually less than two minutes!

ADHD is generally not diagnosed in children younger than 5 or 6 because being highly active is well within the range of normal for toddlers and preschoolers. In fact, all the scientific literature on ADHD describes the disorder as "inattention and/or hyperactivity-impulsivity that's inappropriate for age." A child younger than 5 who might get diagnosed with ADHD usually exhibits severe impulsivity that puts him in danger, such as running into traffic or jumping off a high wall. In addition, any child diagnosed with ADHD must exhibit symptoms that interfere with his functioning (trouble with making friends and learning, not following the rules) in more than one setting, such as home and school.

What you want to watch for as your child becomes a preschooler (age 3 or 4) is whether his activity level gets in the way of his interacting and connecting with others, such as engaging in back-and-forth play and taking turns. You also want to make sure his activity level is not affecting his ability to learn: Is he moving so often and quickly that he doesn't have time to take in information or learn to problem-solve? If you're concerned at that time, talk with your child's pediatrician or another trusted child-development professional.

For now, while your son's behavior sounds quite typical, there are things you can do to help him learn to slow down:

• Establish routines, especially around transitions such as getting into the car to go somewhere. For example, give him a warning that it's almost time to go bye-bye, help him end his activity, and have him choose a book or toy to take in the car to divert his attention. Routines will help him to know what to expect and prepare for what's coming next.
• Make sure that your son is getting enough sleep since children tend to be more active and distracted when they are overtired. (Most toddlers his age need about 13 hours of sleep at night.)
• Offer lots of opportunities for safe, active play. Take trips to the playground; on cold or rainy days, create indoor obstacle courses with pillows that he can climb over.
• Make reading interactive. Encourage him to turn the pages. Ask him to point out the animals or objects in the pictures. As he grows, he can act out the story.
• Ask for your child's help with everyday activities, such as putting the spoons on the table or picking up leaves.
• Give your toddler time to wind down. Start limiting active play at least an hour before bedtime and 30 minutes before naptime. Engage in quiet, soothing activities.

And remember: Active children aren't wild or out of control -- they just need to move.

Claire Lerner, LCSW, is a child development specialist at Zero to Three, a national nonprofit promoting the healthy development of babies and toddlers (zerotothree.org).

Originally published in American Baby magazine, January 2005.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.