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Early Signs of ADHD

Early Signs of ADHD


My child never stops moving and rarely runs out of energy.

My daughter is always getting hurt.  She jumped from the top of the jungle gym the other day without a moment’s hesitation.

My preschooler is always daydreaming instead of doing what I asked.

My young son flies off the handle over the smallest things.   


Most parents and caregivers have likely observed these or similar behaviors in their young children at one time or another.  These same behaviors can also be early indicators of attention-deficit/hyperactivity disorder (ADHD). How can one differentiate between typical, age-appropriate behavior and the early signs of ADHD?  In this article, we will examine attention-deficit/hyperactivity disorder in young children and discuss what caregivers can do if they suspect their child may have this disorder.

Attention-deficit/hyperactivity disorder is one of the most common neurodevelopmental disorders in children. ADHD is most often diagnosed in school-age children and adolescents; however, children as young as four years old can be diagnosed with this condition.  There are three main types of ADHD.  

  • Inattentive Type—Individuals with the inattentive type of ADHD have trouble focusing their attention. They are easily distracted, lose things often, and struggle with following directions.
  • Hyperactive and Impulsive Type—Individuals with the hyperactive and impulsive type of ADHD exhibit a need to be in constant motion.  They may talk nonstop and have trouble controlling their behavior or emotions.  
  • Combined Type—Individuals with the combined type of ADHD exhibit inattentive, hyperactive, and impulsive tendencies.  


One of the challenges of diagnosing ADHD among preschool-aged children is distinguishing between age-appropriate behaviors and those related to an ADHD diagnosis. High energy levels, short attention spans, and emotional outbursts are common among young children.  However, young children with ADHD exhibit these behaviors with greater frequency and intensity when compared to other children.  Unlike their peers who may outgrow these behaviors, young children with ADHD continue to display challenging behaviors over extended periods of time.  The problematic behaviors associated with ADHD also tend to occur across different settings.  Preschoolers with suspected ADHD frequently experience delays in learning academic skills, which sometimes results in early referrals for special education.  In addition, young children with ADHD experience higher rates of suspension from preschool or childcare settings due to their disruptive behavior.  

ADHD is a lifelong condition that can impact all areas of an individual’s life.  The earlier a child receives interventions to address the impact of ADHD, the more likely the child will experience successful school outcomes.  If parents or caregivers suspect that their preschooler may have ADHD, they may begin by sharing their concerns with their child’s teacher or childcare provider.  These early childhood professionals are familiar with child development and can compare the child’s behavior to typical age-level norms.  Parents and caregivers should discuss their concerns with their child’s primary care physician as well.  The child’s pediatrician may conduct an ADHD evaluation, which will include parent interviews and an examination of the child.  Physicians may attempt to rule out other health conditions that can cause symptoms similar to ADHD, so they may check for vision and hearing problems, sleep disturbances, or other conditions such as anxiety, autism spectrum disorders, or mood disorders.  Parents, teachers, and childcare providers may be asked to complete ADHD rating scales to confirm the diagnosis. 

            There are many ways to help preschool-aged children diagnosed with ADHD.  According to recommendations from the American Academy of Pediatrics, the first line of intervention should include parent training in behavior management.  A behavioral therapist will work with parents to develop ways to manage a child’s challenging behaviors through a system of rewards and consequences.  Physicians may consider prescribing ADHD medication for preschool-aged children if behavior therapy is unsuccessful.  When prescribing ADHD medications for young children, health care providers typically begin with the lowest possible dose to minimize potential side effects.

Exhausted parents and caregivers know that young children sometimes have a seemingly endless supply of energy.  Preschoolers barely finish dragging out one toy before abandoning it in favor of the next. Young children occasionallly act impulsively as they run out into traffic to retrieve a ball or precariously scale the kitchen cupboards to reach a desired snack.  Indeed, most toddlers and preschoolers engage in inattentive, hyperactive, and impulsive behaviors from time to time.  In young children with ADHD, the frequency and severity of these challenging behaviors can disrupt family life and impede the child’s developmental progress. Recognizing the early signs of ADHD can help parents and caregivers obtain the necessary interventions to minimize the lifelong impact of this disorder. 



References and Resources

American Academy of Pediatrics Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder.  (2019).  Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents.

Centers for Disease Control and Prevention.  (2021).  Attention-deficit/hyperactivity disorder.

Children and Adults with Attention-deficit/hyperactivity disorder [CHADD].  (2015). Preschoolers and ADHD.

Understood.  (n.d.).  ADHD and behavior therapy.

Dr. Krislyn Carlson is a K-5 special education teacher with the Beresford Public School District. She has twenty-three years of experience teaching special education at the elementary and middle school levels. Krislyn obtained her doctorate degree with an emphasis on special education and administration from the University of South Dakota. Current interests include adapting literacy and language instruction for students with significant cognitive disabilities and complex communication needs.