Do preschoolers have ADHD?

According to the 2016 National Survey of Children’s Health (NSCH), 6.1 million U.S. children ages 2-17 (9.4%) had received a diagnosis of ADHD. 388,000 of those were ages 2-5, considered preschoolers. Preschooler with ADHD? How can you tell?

Though the cause of ADHD is still undetermined, the American Academy of Child & Adolescent Psychiatry (AACAP) states that most research points to ADHD running in families. Even with an undetermined cause, though, there are standards for diagnosis. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), the National Resource Center on ADHD, states that an ADHD diagnosis is based on The Diagnostic and Statistical Manual of Mental Disorders (DSM5), with three different presentations of ADHD: 1) Inattentive; 2) Hyperactive-Impulsive; and 3) Combined. Each has very specific symptoms and a defined period during which those symptoms must be displayed.

For preschoolers, it is important to differentiate between normal age-related behavior and the need for an ADHD evaluation. Three-year-olds who show symptoms are much more likely to meet the diagnostic criteria by age 13. Early diagnosis is critical in order to help minimize other problems. The CDC states that about two out of three of children (of all ages) with ADHD have other disorders, which may include other behavior disorder such as Conduct Disorder; learning disorders such as dyslexia; and anxiety disorders. About one in seven children with ADHD develops depression, and many experience social difficulties and a higher risk of physical injury.

Medications do not cure ADHD but can help a child control their symptoms. When medications are necessary, options include stimulants such as methylphenidate and amphetamine salts (70-80 percent of children have fewer symptoms when taking these); and non-stimulants such as atomoxetine, guanfacine, and clonidine (these don’t work as quickly as stimulants but last up to 24 hours). The AACAP Preschool Pharmacology Working Group also recommends that preschoolers have their medication stopped after six months to reassess.

While many families rely on medication alone, a recent study funded by the National Institute of Mental Health found that the best outcomes were a results of medication plus behavior therapy. The American Academy of Pediatrics (AAP) also calls for utilizing behavioral treatments first with preschoolers, and medication only when needed. Yet, the CDC reports that 1 in 2 preschoolers do not receive the recommended behavioral treatment. The rates of preschool-aged children taking medications for ADHD has doubled in the last four years, and 1 in 4 receive only medication treatment, which should be the last resort.

If you have concerns about your child—whether they have been diagnosed with ADHD or not—please feel free to reach out. We have several pediatric ADHD research studies enrolling now in Lakeland, Maitland and Bradenton, Florida. Call 888-777-8839 or visit our individual study pages for more information.