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Early Signs of ADHD in Children

Most experts agree that the tendency to develop attention-deficit/hyperactivity disorder (ADHD) is present from birth. Yet, ADHD behaviors are often not noticed until children enter elementary school.

One reason for this delay is the fact that nearly all preschool-aged children often show some core behaviors or symptoms of ADHD—inattention, impulsivity, and hyperactivity—as part of their typical development.

But as other children gradually begin to grow out of such behaviors, children with ADHD do not. Also in children with ADHD, those behaviors interfere with how well the child can function. This difference becomes increasingly clear as the years pass.

When do symptoms of ADHD start to show?

Starting school can highlight a child's challenges relating to inattention, impulsivity, and hyperactivity. That's because classroom activities demand an increased amount of focus, patience, and self-control. These types of demands are not as frequent at home or in playgroups, so in those settings, the child may have had fewer problems.

Usually by the time a child with ADHD reaches 7 years old, their parents are aware that their child's inattentiveness, level of activity or impulsiveness is greater than typical.

Sometimes these suspicions start later. This is particularly the case with bright children whose problems are mostly with paying attention and not hyperactivity. But it is unusual for ADHD symptoms to not have occurred before 12 years of age. So, if symptoms are not observed until the teen years or later, and can't be recalled before age 12, it is likely that something other than ADHD is causing the issues.

How are ADHD symptoms different from typical childhood behaviors?

You may have noticed that your child finds it nearly impossible to focus on a workbook for even a very short period, even when you are there to assist them. Or you may still feel as worn out at the end of a day with your overly active 8-year-old as you did when they were 2.

Your child may ask adults questions so often that you have begun to suspect it is not "normal." Or, you may have noticed that they do not seem to be picking up the nuances of social interaction that their playmates are beginning to adopt, such as respecting others' personal space, letting other people have a turn to talk.

It can be difficult for a parent to tell whether such behaviors are just part of the normal process of growing up ("Plenty of six-year-olds get bored with workbooks!"), or whether your child needs stricter boundaries ("Maybe I've been too inconsistent with setting limits."). Are the behavior problems severe enough to indicate a concerning problem? Will they improve as your child matures?

How does your child behaves in different settings?

For a child to be diagnosed with ADHD, the American Academy of Pediatrics (AAP) advises health care providers to gather information about the child's behavior in at least one other major setting besides their home—including a review of any reports provided by teachers and school professionals.

By comparing the child's behavior in 2 or more settings, the provider can begin to differentiate among such varied reasons for attentional problems as a "difficult" but normal temperament, ineffective parenting practices, inappropriate academic setting, and other challenges. The provider can also clarify whether the child's behavior is interfering with their ability to function adequately in more than one setting—another requirement for diagnosis.

How ADHD terminology has changed over the years

It can be hard to match the behavior we see in our children with the formal terms used by pediatricians and other medical professionals. We rarely think of our kids as having "hyperactive-impulsive problems." Instead, we think, "Why can't they ever settle down?"

To confuse matters, the terms that doctors use for these behaviors have changed over the years.
The term "ADD" (attention deficit disorder) was once common, and referred primarily to the form of ADHD with "inattentive only" symptoms. These children are not overly active, and their symptoms may even go unnoticed by dults for a while because their behavior is not disruptive.

To most children with ADHD, the qualifying description of "with hyperactivity" had to be added to ADD. Now, all children with this condition are considered to have ADHD. However, within that diagnosis there are 3 subtypes: inattentive, hyperactive-impulsive, and combined subtypes.

ADHD symptoms & behaviors: what parents may notice

Look at the lists below and ask yourself how many times per day or week you say or think the same things yourself. All parents make these sorts of comments about their children now and then, of course. But parents of children with ADHD continue to see the same behaviors on a daily basis and for extended periods-long after other children have progressed.

Parents of children with predominantly inattentive-type ADHD say:

  • "They seem like they're always daydreaming. They never answer when I talk to them. I wonder if they hear me."

  • "They lose everything. I've had to buy four new lunchboxes since school started."

  • "I'll ask them to go up to their room and get dressed, and 10 minutes later I find them playing with their toys with only their shirt on."

  • "They can't remember what they learn because they miss instructions and explanations in school. Even though we work so hard on their schoolwork at night, by the next day they've forgotten everything."

  • "Some teachers have called them their 'space cadet,' an underachiever, an "airhead' or their 'random student.' "

Parents of children with predominantly hyperactive-impulsive–type ADHD say:

  • "They never slow down. You can never get them to sit down to finish a meal or get ready for bed."

  • "They interrupt constantly. You can't have a decent conversation when he's in the room."

  • "They never think before they act. They know they shouldn't run across the street before stopping to look, but they do it all the time. I worry about them being safe—they just aren't."

  • "They operate out of order—like, 'ready…fire…aim.'"

  • "Their classmates don't like them. He's always 'getting in their face.' No one invites them over to their house. They always have to be first and things always have to be their way."


Talk with your child's pediatrician if you have concerns about your child's progress at school, social interactions, behavior or any other aspect of healthy physical and mental development.

Last Updated
American Academy of Pediatrics (Copyright @ 2024)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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