The topic of diagnosing ADHD in preschoolers is very contentious. One of the problems is that there is plenty of contradictory research and information out there, and even top ADHD researchers and experts have different opinions.
As a doctor who treats ADHD, and as the mother of a son with ADHD, this issue is important to me both personally and professionally.
At best, the contrasting information is very confusing to well-meaning parents who simply wish to help their children. At worst, children can be improperly diagnosed or go untreated.
According to the American Academy of Pediatrics, ADHD can be diagnosed in children as young as four years of age. This is a change from their previous guidelines which stated that ADHD can be evident as early as age 6.
Attention Deficit Hyperactivity Disorder is diagnosed based on the criteria listed in the Diagnostic And Statistical Manual Of Mental Disorders (DSM).
The current diagnostic DSM guidelines for ADHD state that ADHD symptoms should be present "on or before age 7."
One of the proposed changes being considered for the next edition of the DSM is to update this criteria to "on or before age 12."
They claim the reason for this change is that research indicates that the age of onset of ADHD is typically noticed or recalled between the ages of 7 and 12.
How To Tell If Your Child Has ADHD
Diagnosing ADHD in preschoolers is complex. Most four year olds can be highly active, have short attention spans, and behave impulsively. To be diagnosed with ADHD, however, certain specific criteria must be met (See Diagnosing ADHD.)
Children must exhibit a majority of these ADHD symptoms for at least six months, and these symptoms must severely hinder a child's functioning in multiple areas (home, preschool, etc) and result in marked deficits in learning, peer relationships, etc.
The Pros And Cons Of Early Diagnosis
The positive elements of early diagnosis mean that a child can be assessed and treated early. ADHD treatments typically include a combination of medication and behavioral therapy.
Earlier treatment results in better long-term outcomes. Untreated ADHD often results in poor academic functioning, poor peer relationships, low self-esteem, and present life-long challenges with respect to adult responsibilities and relationships.
On the other hand, diagnosis of any mental illness often results in harmful and needless stigmatizing of individuals.
As a result, labels such as ADHD, learning disorders , or mental illness should not be given lightly, especially to children, given how society often poorly treats those who are perceived to be different.
You Can Always Get A Second Opinion
Any mental health professional should give pause before diagnosing ADHD in preschoolers. It should only be done after extensive assessments and diagnostic testing, and typically only reserved for more severe cases of ADHD.
If you are not convinced with current diagnosis, it is always your right to get a second opinion. It couldn't hurt to seek out ADHD experts in your area and hear their opinions.