ADD/ADHD in Early ChildhoodAttention Deficit Disorder/Attention Deficit Hyperactivity Disorder, ADD/ADHD is a very real disorder that impacts both children and adults. After many doctor visits, mental health consultations, and even hospitalization, I was diagnosed with ADHD at the age of nine. Even now, I continue to feel its effects, although medication and therapy have made a tremendous difference. As I pursed my education in child development and early childhood education, I learned more about ADD/ADHD and the importance of a proper and early diagnosis.
During my student teaching experience in a public school kindergarten, I was astonished to learn how many children were being labeled hyperactive and sometimes treated for ADD/ADHD. When I became a teacher educator and consultant, I visited many different child care programs. More and more I observed teachers and providers easily labeling very young children as hyperactive. Sometimes this resulted in a referral to parents. Often times it colored the way adults interacted with the child. Expectations were lowered and the child was likely to be disciplined more often. Overall, I think what I was seeing was a rush to judgement.
The American Academy of Pediatrics does recognize that in a few cases ADD/ADHD behaviors may emerge before age six, but this is only in cases of extreme behavior and maladaption. In fact, only 10% of those who early teacher were concerned about or labeled actually turn out to have this disorder in the long run. More frequently than ever teachers are labeling children as young as age two! About 40% of young children will exhibit behaviors that will lead parents or teachers to be concerned about ADD/ADHD.
Why this rush to judgement? Along with an increased awareness of this disorder, there are two other factors; increased expectations and lack of knowledge of normal child development and behavior.
Expectations for young children have increased both at home and in child care settings. At home, children are spending more time in structured and planned activities such as music lessons, computer camps and gymnastics. All but gone are those open free times for running barefoot through meadows or playing with mud pies for hours on end. Many early education and care programs have been increasing expectations of young children both socially and academically. Too many programs get caught up in the push to make children ready for school rather than making schools ready for children.
Many of the criteria set by the DSM IV for ADD/ADHD diagnosis, indeed behaviors that are of concern to teachers, are in fact often developmentally appropriate behaviors for children under the age of six. A few of the fourteen behaviors that characterize this disorder include A) Has difficulty remaining seated when required to do so or is fidgety and squirms in seat. Young children, as a rule, have very limited attention spans. Guidelines for Developmentally Appropriate Practice suggest the young children are to be actively involved in child directed activities a great deal of the time. Requiring two and threes year olds to sit passively for circle time stories for a half-hour is sure to result in squirming, fidgeting and possibly worse. B) Often has trouble waiting one’s turn. Jean Piaget’s theory of cognitive development identifies young children as being egocentric. In other words, they have not yet reached a maturity level where they can see other’s perspective or be empathetic. This makes turn taking and sharing difficult for almost all young children.
When you have a child in your care that seems “hyperactive” it is possible they indeed have ADD/ADHD. But first, consider; Are your expectations developmentally appropriate? Is their behavior extremely off the mark in comparison to other children their age? And finally review the full DSM IV criteria before making a rush to judgement