ADHD awareness month, Part 1: Early signs and diagnosis

National and World

According to experts, 7 is the average age of diagnosis, but can it be detected in toddlers and babies?

BAY COUNTY, Fla. (WMBB) — According to the A.D.D Resource Center, seven is the average age a child is diagnosed with ADHD in the United States of America.

But can it be predicted in toddlers or babies?

From an early age, I noticed something was unconventional with my son. When he was a baby, I had to bounce him on an exercise ball to get him to sleep, or hold him in the palm of my hands and slowly raise him up and down. People would say, ‘How in the world does he go to sleep like that?”

Christopher Sarampote, Chief of the Biomarker and Intervention Development for Childhood-Onset Mental Disorders Branch at the National Institute for Mental Health said symptoms can appear as early as age three. But earlier discovery is hard, primarily because there isn’t a simple test that can prove it.

We don’t have a blood test, we don’t have a brain scan that you can say, ‘ah that child has ADHD’,” Sarampote said. “It takes a while for us to kind of see within the context of that child’s own ability and then other children and different contexts whether they have symptoms that are well outside the range of normal.”

Saramote said development of self-regulation skills is always unique to the individual child.

“Anywhere, kids from two to five years of age, that window of development is quite large or what we consider normal behavior is quite large,” Sarapmote said. “It’s really around age five when we start narrowing down what we consider to be normal behavior.”

He said after receiving an official diagnosis, a lot of parents recognize that the signs might have been there all along.

“A lot of times when we talk to parents at that age they’ll say, ‘you know, looking back I can remember at even a young age he seemed to be pretty wired or something like that,” Sarampote said.

My early suspicions were confirmed when my son started preschool. He stood out from the other kids and not necessarily in a positive way. As a mom, this was hard to face and I knew I could no longer pawn it off on his age alone.

Rita Olek, mom of three boys and one girl said all four of her children, ages 26 to seven, have ADHD.

Her 7-year-old twins were pretty typical toddlers. It wasn’t until they reached kindergarten, that she suspected they might have ADHD too.

“It took them longer to finish things, they didn’t comprehend questions sometimes that were a little more complicated, they needed re-direction,” Olek said. “I knew that I wouldn’t try to have them tested until at least first grade.”

Sarampote said school-age is usually when ADHD gets diagnosed and that staying in contact with your child’s teacher is a critical component to a proper diagnosis.

“Can they do circle time, can they stay focused in kindergarten, can they play with other kids in a way that doesn’t require a lot of redirecting, a lot of feedback, a lot of structure, sitting at mealtimes, ” Sarampote said. “Kids are squirmy and fidgety anyway, we all can be but particularly at those times when they need to be in their seat. Can they stay there, do they get up frequently, do they run around the house?”

At 4-years-old, my son still used a high chair because, without it, he simply couldn’t stay seated.

1:10 “They were fidgety, more-so than just your normal fidget,” Olik said. “Your typical ADHD signs where they couldn’t sit still in school and focus.”

“When it becomes problematic and impairs their ability to stay focused and get their school work done, that’s when we really start thinking about ADHD,” Sarampote said.

But how extreme does a child’s behavior have to be to receive an official diagnosis? Sarampote said there is a cluster of symptoms to look for.

“We think of two general clusters of symptoms with ADHD, one is inattentive. So these are kids that have difficulty paying attention, focusing attention, staying on task, remaining organized,” Sarampote said.

“And then we have a second cluster of symptoms that are called hyperactivity and impulsivity. So these are kids that have high energy levels, they often seem as though they are on a motor that doesn’t stop,” Sarampote said. “They can be quite talkative, they can act without thinking. So these are usually kids who act first, think later.”

Sarampote said this subtype may result in more accidents. I’ve lost count of how many times a day my son trips over something, runs into the wall, or bumps his head. Accidents are a daily occurrence in our home and they usually result in him learning absolutely nothing because the next day, he does it all again.

Sarampote said almost anyone can struggle with staying on task or sitting still at times. But ADHD takes over and that most kids fall into one of three sub-types.

“One, that primarily inattentive sub-type; two, the hyperactive or impulsive sub-type; and a combined sub-type which is most common where kids have difficulties in both domains,” Saramote said.

Saramote said, over time, the symptoms can change. As children get older, they’ll generally struggle more with focus and staying on task, rather than the hyperactivity.

Olek said that’s precisely what happened with her two older children, they learned to accommodate as they grew up.

“Some can have more intense symptoms in one cluster than others,” Sarampote said. “You could have kids that are just really head in the clouds daydreaming, that’s one child. And another child, they can kind of pay attention and focus but they just can’t stop moving so they are running around in class and getting into trouble that way.”

Olek said her twins’ symptoms seem to be a little less severe than her daughters were but they still fall into the combination sub-type.

As for my son, his lack of focus is less severe than his hyperactivity but he has a problem with both aspects. And, even though I believe that my son’s symptoms were present early on, Sarampote said there’s currently no scientific proof that supports this.

“We caution people in terms of over-interpreting symptoms or signs at that very young age,” Sarampote said. “But usually around three to five is when we start to see symptoms.

In the next two weeks, come back for parts two and three of News 13’s coverage of ADHD Awareness month: Treatments and managing symptoms & Strengths and misunderstanding.

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