My husband and I were just sitting here talking about our 3 year old son, and I wondered what you mamas think about our concerns. He is a very smart boy, always ahead of where he should be. He is moving and talking constantly. It is very hard for him to turn off and go to sleep. He sometimes will talk, sing, etc for an hour or more when he goes to bed. Naptime has always been a struggle...in fact, he never just falls asleep, not in the car on trips, not anywhere. He just never shuts off. I can tell when he's tired because his concentration and cooperation are terrible. I really have always been concerned about if he gets enough sleep, but we've tried everything and he still takes forever to fall asleep and wakes up pretty early. He is what I would call a very strong-willed child. He is very gifted but extremely difficult to parent. Family members have noticed these things about him too, so it's not just me worrying needlessly. We are very consistent with discipline. I feel like we have good control at times, and other times when he's in a mood, I am totally frustrated and feel like I have no control. I am really at a point where I don't think we need to be harder on him...I think he may have ADHD or something else.
Anyway, up until now it has been me, my husbnad, and family observations. But he goes to MDO two days a week for 5 hours a day. His teacher has some concerns about him very much like what we have noticed. Some days he is great, helpful, cooperative. And then other days he cannot sit still for circle time, he can't focus, he doesn't listen, etc. I am really becoming concerned about how he will be able to sit in a classroom all day when he gets to school age.
So, at what age can he be evaluated? If he does have ADHD or something else, I want to know so I can learn to deal with him better. Any ideas about what might be going on here? What should I do?
Thank you in advance for helping with this matter...it has been on my mind for so long and I'm ready for a diagnosis or a game plan or something :)
My 3 yr old sleeps better, listens better, and concentrates better when he's on a gluten free diet. It takes a while to get out of his system.
He sounds a LOT like my son at that age. He's 5 1/2 now and DOES have ADHD (combined type, he's also "suspected gifted" though I'm not having his IQ tested any time soon).
That being said, he doesn't sound TOO different than some other 3 year old I know/knew who grew into much more "typical" 5 and 6 year olds, who knows?
As for the sleep thing, I'd try getting him to sleep MORE, rather than cutting his naps at pp suggested (or if he isn't napping anymore, try getting him to start back up). Many symptoms of ADHD can be symptoms of sleep deprivation. I know we think that MORE sleep would lead to MORE energy, but that over-the-top, unfocussed, energy that drives you crazy can actually be his little body/mind trying to cope.
HTH
T.
I'm with you. From what you've written I'd say chances are about 80% your son is one of my people.
An eval this young will
1) Rule out things that MIMIC ADHD like
- allergies
- malnutrition
- illnesses or other medical causes (hormones, tumors, etc.)
- similar disorders
- situation based
If it's ANY of these things... it's NOT adhd (aka, -to pick the most common mistake by people who are unfamiliar with either adhd or neurological disorders in general- NO supplement will cure adhd. It WILL cure malnutrition... but it's sexier to say supplements cured my child's adhd, rather than supplements cured my child's malnutrition). Good nutrition is good for *everyone*, but it only cures nutrition illnesses, not neurological disorders. Ditto all the other things that can mimic ADHD. As a rule of thumb: if you ONLY have the negatives of adhd (like lack of focus, caused by sooooo many things) you don't have adhd.
2) look for adhd symptoms that are not age appropriate.
- They won't care much about the dispersed focus / lack of attention (which is totally typical for the age group) they'll be looking for the flip side: INTENSE focus and concentration that is atypical for the age (most toddlers can only do 15 minutes, tops... adhd kids can do *up* to several hours IF it's interesting to them). ADHD always always always comes with both hypofocus (low focus) AND hyperfocus (intense focus). It's one reason why adhd kids are so "erratic" in school. If it's interesting to them, they're on it like white on rice and you need a crowbar (and a meltdown or two) to pry them away from it (transitioning can be difficult from ANYthing they're interested in, although easy as cake in anything 'boring' or of passing interest). Hence some days circle time is fabu (because they're interested in what's happening in circle time that day) and impossible other days.
- Giftedness (adhd kids are nearly always gifted)
- Sensory "stuff" (adhd kids & adults nearly always have sensory quirks/ issues/ or problems... it's because of how our brains process and store information. It ***cracks me up*** when people say ADHD **AND** SPD. LOL, it's not AND it's JUST ADHD. Part and parcel. But it works as a descriptor for people who don't understand that sensory processing is part of the diagnostic criteria, which is most people.)
- Sleep issues (either the mind just doesn't 'turn off' or their
- CONSTANT _________ (motion or thinking or motion&thinking). Note... people who don't have adhd kids and say they have "active" kids have mellow ones 9times out of 10 compared to our kids. ADHD kids go-go-go for HOURS with *maybe* a 10 minute break (Most people with "active kids" have kids that will run around the house for a few minutes, stop, do something else, run some more, stop, run some more... do something quiet for an hour or two.... our kids DON'T stop until their bodies actually collapse. Even then, meltdowns are common because they don't WANT to stop, but they can't get their bodies or minds to keep going no matter how badly they want it. A few examples are NEVER needing a stroller. 3miles, 10 miles, whatever; they WILL go go go... or talking &/or singing without stopping for anything but breath for hours ... or drawing until they have blisters on their fingers, or throwing a tantrum (full on) for well over an hour, or, or. The constant motion (mentally or physically or a combo of both) is a facet of hyperfocus OR a facet of trying to feel calm. ((The motion isn't annoying or tiring to US, it's soothing. As soothing as a full body massage. LOL... just imagine getting a wonderful massage and having people keep snapping at you to "STOP NOW! STOP IT! YOU'RE DRIVING ME CRAZY!" Wha??? Why? Why on earth would anyone stop? Why is MY getting a massage driving YOU crazy?))
- Holy Grail "opposite stimulant reaction". No other disorder does the brain treat stimulants like sedatives. This is a holy grail test BUT it's really hard to preform on toddlers for the simple reason that toddlers get something known as "overtired" (older kids and adults rarely get this). It's the phenomenon of either getting "wired" or "cranky" (but unable to sleep) when they're overtired. ADHD babies and toddlers get overtired just like typical kids. So too "much" in the stimulant category ends up looking like a 'typical stimulant reaction' (wired, or cranky). The "coke test" is super easy to do with older kids, but it's hit or miss with toddlers (aka give them a can of coke and see if it mellows them out or hypes them up). Actual meds are fairly simple because the dose can be precisely managed... but many parents and practitioners are leery of giving toddlers meds UNLESS they are 99% sure of the diagnosis.
- as well as about 10 other aspects of ADHD that just aren't as well known as the (currently age appropriate) hypofocus.
Evals are lengthy processes (mostly because there are so many things to rule out), but they're worth it because ***things that "work" for typical kids do NOT work for adhd kids***. It's like yelling at a dyslexic to 'read already' rather than doing specific therapy. ADHD isn't an excuse by *any* means, but it DOES mean that things do need to be done differently to get the same results. Medication is only 1 tool out of many, and a diagnosis never means one *has* to medicate, although medication can make night and day difference it REALLY depends on whether or not the adhd is creating problems or not. (for many people it creates insurmountable problems, for many people it creates no problems whatsoever). Anyhow... meds are putting the cart before the horse, but it's just a good thing to keep in mind that meds are only 1 part of a multifaceted treatment, and they're totally optional (many people avoid evals because they think they'll "have" to be on meds. Not so. Not even the courts can order adhd meds, although they can order meds for many neurological disorders.). Personally I'm neither pro nor anti med. It's an option. Sometimes a good option sometimes a great option sometimes an awful option. What goes along with (or instead) of meds are known as 'coping skills'. And there are HUNDREDS of them. www.additudemag.com is a great place to really get an idea of some of the coping methods & coping strategies out there. ((Just a handful, as an example: gifted classes -to circumvent boredom, which is 'kiss o death' to adhd folk... playing music while doing homework... solution based discipline -instead of punishment based discipline... benedryl at bedtime -neither addictive, nor long term side effect... altering your environment instead of your actions- aka move your "keys bowl" or "backpack hook" to where you drop your keys or your backpack instead of trying and trying and trying/ failing and failing and failing to put your keys or backpack 4 measly feet from where they 'belong' ... etc.))
My daughter has severe ADHD and I knew she had it since she was 2 and everyone kept saying she is just active I am sorry but a regular kid wouldn't talk 24/7 even in her sleep. Took her to Kaiser her doctor sent a referral to get tested and she does have it. We have put her on medication she is 100 percent different. Her personality is still there but she can sit for dinner, watch tv, sit down and draw, not run around and talk nonstop WOW what a relief it takes a little to get the medication adjusted at that age. Her doctor specializes with kids that are that small and will only put them on 2 types of medications any other one is not suited for a child that small. I advise you to go because I have it and no one can understand how it feels it is horrible inside that your so hyper so your child is suffering also
My best suggestions are to try to reduce or eliminate the following from his diet as much as possible:
High Fructose Corn Syrup
Red 40 in particular and then Blue, Green, Yellow food dyes
These things are chemicals that the liver can't process and some children are more sensitive to these chemicals than other people are. The symptoms of the sensitivities can show up behaviorally (and even emotionally) rather than as a rash or vomiting and can mimic disorders such as Autisms and ADHD/ADD and other behavioral disorders (mildly, moderately, and sometimes severely) or they can make existing disorders worse than they really are.
They're toxic much like alcohol is a toxin in quantities that make people drunk. That's WHY people get drunk... alcohol is technically a toxin, a poison, and the liver can't process alcohol properly and they feel the toxic effects and feel drunk. This is the same process with HFCS and dyes, and the effects are similar until the body can expel the toxins rather than metabolize them (since it can't metabolize them). Yet while the body is waiting for the toxins to be expelled, the toxins go all throughout the body including the brain, which is where the behaviors come in.
:-)
You should also try to eliminate having the television and video games on for 30-60 minutes before bedtime because the lights from those technologies mimics sunlight. Our bodies recognize TV light as sunlight and extend the day and keep the body awake when it shouldn't, and it keeps the brain too active.
EDITED TO ADD: I meant to add this, but my husband was walking out the door with two of my girls to visit his dad. Okay, so you can do this elimination thing from the diet and the TV thing on a trial basis and see if there's any effect. If there is, then you know you've found the culprit. If there's no change in his behavior then you'll know that the HFCS and food dyes can't be blamed, though I would be my left butt cheek that while it might not eliminate his behaviors it will at least reduce them.
Also with the theories of food intolerances and sensitivities affecting his behavior, you could meet with a Pediatric Nutritionist who is familiar with behavioral effects from food culprits.
It's just very difficult to diagnose ADD/ADHD in a 3 year old because most 3 year olds exhibit these behaviors. The thing is whether or not you believe them to be excessive behaviors. You could have him evaluated but it might not do a lot of good until he's elementary school aged.
There is a great book with advice called "Delivered from Distraction". It also has some basic diagnosis info. My daughter has non attentive ADD and cannot fall asleep either, although she is not hyper her brain keeps on flitting around. She is prescribed Clonidine as a sleep aid which helps her fall asleep an hour after she takes it. Otherwise she would lay awake for literally 3 hours every night. We tried Melatonin but it seemed to give her very vivid and scary dreams. I do not know how early ADHD can be diagnosed but if you are concerned I would discuss it with your pediatrician, at least the sleep issue. Good luck.
I would try tossing naps. If he's taking that long to fall asleep, he sounds like he might not need to nap anymore (or maybe I read it wrong & he's not napping!).
I would also make sure he's getting a lot of active playtime...enough to help wear him out.
Then I'd also look into food allergies/sensitivities. I have several and some make it hard for me to sit still & concentrate & I'm an adult. I can't have much sugar at all, except rarely. I have to avoid msg and high fructose corn syrup. These are common things to cause reaction. A friend mention her children react to food dyes, especially red 5. I'm not saying that ADHD doesn't exist, but I think it's very rare and more likely caused by other things. I react very strongly to these things and I would try ruling it out first.
Bring up your concerns with your son's pediatrician and ask for a referral to a specialist. You won't get a diagnosis at three, but you can get help. Our son was getting help at three for his ADHD symptoms. Don't minimize your concerns. Riley has some super info. below about the realities of ADHD.
A lot of people told us our son was just an active boy at three, when the truth was that he had extreme ADHD-combined type (hyperactive and inattentive). Fortunately, the medical professionals at Kaiser took us seriously and knew what we were describing wasn't the norm. The fact that your son's teacher is also expressing concerns is a red flag because ADHD is a 24/7 problem. That can help in getting the doctors to listen to your concerns.
Check out the archives for ADDitude magazine for an article they did a number of years ago about ADHD in preschoolers. It's really informative.
Best of luck to you as you start this process!
I spoke with my pediatrician and did some reading when my DD turned 3 because of similar issues, though she DID sleep very well and requires a lot of sleep to not be majorly cranky. My peds reassured me and the reading I did was that many 3 year olds would fit criteria for ADD, ADHD and that they tend to not even start testing until quite a bit later. At the same time, I am a medical professional and have prescribed meds to other children at the demands of schools/parents/my own MD boss, and the more I read, the more I truly believe that these medications are WAY over-prescribed. Yes, it's true that they can help A LOT for some kids who truly need them, but there are some pretty serious side effects that can go along with them, so it shouldn't be first line. Also, look into the "artificial coloring" in the foods. My mother-in-law used to talk about it in regards to her youngest son and I thought she was FOS but research is now starting to find evidence of issues. I've been trying harder to stay away from foods with any "#" dyes (yellow #5, blue lake #1 or whatever) and I REALLY think it's helping my DD's attention and concentration and behavior. good luck!
Honestly because he does have good days where he does help, listen, pay attention etc. I'd look at his diet. Did he have extra sugar or food with dyes in it that day. Start writing everything down , from what he ate to what he did.Once you do this , for a week or two you will be able to see a pattern and be able to narrow it down. It could be something as simple as a messed up routine, to something like a sugar allergy or that he's getting a hold of chocolate /candy. Look into what he has for snack at MDO.
I have an ADHD child but I do not trust an ADHD dx for a child under the age of 7, simply because the behaviors in an ADHD child are age appropriate.
Pick up a book " raising your spirited child"
Please- Look up hyPOglycemia and hyPERrglycemia online, which have many similar symptoms of disease but are common and often overlooked.
IF Cortisol (hormone) is high or low , is keeps a person from being able to fall asleep. Blood sugar is CONTROLLED by cortisol levels. Hypoglycemia can cause sleep issues, especially night time waking around 2, or 3 am, when the blood sugar falls it will send a rush of adrenaline. Adrenaline is a hormone that comes from the adrenal gland, which will make a person very "wired" . High adrenaline has many causes, one being that the body uses adrenaline to control blood sugar when cortisol is deregulated. You SHOULD investigate this more. I beleive that many ADD and ADHD diagnoses are actually caused by a physical reason but are "covered" up with depressant ADD meds and such.
I am a 12 yr medical researcher. I have a daughter with cortisol issues.
Her blood sugar problmes do cause her to not be able to focus, not be able to remember things, She cant fall asleep at night, she cant nap during the day.
Cortisol is a hormone that regulates sleep.
Generally 'they' say that 3 yrs old is too young to accurately diagnosis ADHD-that being said however I don't think it's ever to early to be looking for signs. I have ADD-and my 3 yr old mirrors be in a lot of ways, so we can't say for sure yet, but I'd put money on him being diagnosed ADD in a few years.
I would recommend talking to your ped and getting a good referral and start there.
CHADD is a great organization for parents of children with ADD...google it.
This might help answer your questions. It is about ADD in pre-schoolers
http://add.about.com/od/childrenandteens/a/preschool.htm
Hope it helps- best wishes!
You could have described my 3 year old perfectly. We are having him tested for allergies and food allergies to rule anything out. I don't want to test for anything else until we start from the bottom and work up.
I would make him an appointment and get an allergy test.
hold firm with your pediatrician that you want him evaluated - the sooner you start getting some intervention - the easier things will be for him down the road.
we pushed and had our son evaluated at 4 - therapies and meds have made a world of difference.
good luck.
Many many sleep deprived children are diagnosed with ADHD as the symptoms are so similar.
I think the fact that some days he's fine and other's he's not may not necessarily mean ADHD.
Go an see a sleep specialist or your Doctor.
R. M. - Parenting Consultant and Children's Sleep Specialist
