What Does ADHD Look Like in Preschoolers?

According to the Diagnostic and Statistical Manual of Mental Disorders-IV lists, ADHD symptoms include the following:

• Does not stay seated
• Does not follow instructions
• Avoids tasks that require sustained mental effort
• Fidgety and restless
• Cannot wait for their turn

ADHD may take on specific symptoms in preschoolers. A preschooler with ADHD may have the following behavioral issues:

• Paying attention
  • Dislikes or avoids activities that require paying attention for more than 1-2 minutes
  • Finds it nearly impossible to read or eat while sitting at a table
  • Has a hard time during story time or nap time
• Concentration
  • Has a hard time concentrating on tasks they don’t enjoy
  • Cannot maintain focus when the task at hand is boring or repetitive
• Making noise
  • Talks or makes noise excessively
  • Cannot stay quiet when the teacher is giving instructions
  • May ask many questions in a row, but lose interest before getting answers
• Constant movement
  • May run in circles until they tire themselves out
  • Cannot sit still and may kick, fidget, or squirm in their seat
• Getting along with others
  • May be aggressive towards others, sometimes even hitting, kicking, or biting
  • May interfere in someone else’s play without asking or grab a toy out of another kid’s hands
• Impulsivity
  • Has trouble controlling their impulses
  • Tends to get injured more because of their risk-taking behavior
  • May climb, run, and leap without thinking, even in dangerous situations

Since the line between common preschooler developmental changes and symptoms of ADHD is blurred, this poses many diagnostic challenges. Although it’s unusual for children to be formally diagnosed with ADHD before elementary school, a growing number of health professionals recognize the benefits of early diagnosis and treatment. 

According to the American Psychological Association and the American Academy of Child and Adolescent Psychiatry, children with ADHD should be treated according to the severity of their symptoms.

Environmental changes

For children who play well with others and have healthy self-esteem, small changes in their environment may help with their ADHD symptoms. Environmental changes may include:

• Smaller classroom
• Less stimulation
• Structure and routine

ADHD behavior therapy

There is increasing evidence that treating ADHD symptoms in preschoolers can be extremely effective if parents are involved in their child’s therapy. Examples of therapy may include:

• Behavior therapy
• Parenting skills training
• Social skills training

Medications

Methylphenidate is the most commonly prescribed medication to treat children diagnosed with ADHD, but it is not approved by the U. S. Food and Drug Administration (FDA) for use in children under the age of 6. 

Children ages 4 and older may be prescribed low-dose ADHD medications. It’s important to your doctor about your preschooler to see what they recommend.

Combination therapy

Studies and research show that symptoms of ADHD in preschoolers may improve with combination therapy, which combines behavior therapy with medications.