How can I tell the difference between ADHD and normal kid behavior?

Real Mom Problem

“How does one differentiate between normal boy behavior and ADHD? My son is definitely way more high energy than most of his peers. We are not looking to officially label him, but to help him.”

by karamille karamille

Quick Tips

  • 1. Young children are naturally energetic, but if your child's behavior is negatively impacting his school experience, you might want to speak to a professional
  • 2. Some common ADHD symptoms may be tied to food sensitivities, learning issues, discipline problems, or other concerns outside of ADHD
  • 3. Always speak to your child's doctor if you have concerns about her health
  • 4. Typically, ADHD is not diagnosed until a child reaches school age

Real Mom Solutions

Sometimes, what feels normal to us can raise red flags to others. If your child is particularly energetic, you may be wondering if his activity level or inability to concentrate is reason for concern. Let a pediatrician, and some experienced moms, help you put things in perspective.

Dr. Anthony Rao Dr. Anthony Rao

Our Expert Says...

What's normal and what's ADHD? This is one of the most frequent, yet difficult questions we experts get. In short, it depends on who's observing your son, who the teacher is (a male or a female), and where you live in the country. We'd like to believe that there are good tests and agreement on ADHD, but truth is, there isn't. There are no objective tests whatsoever. There are major biases in how kids get labeled.

Parents report ADHD much less often than teachers, and female teachers see it more than male teachers (who apparently aren't as bothered by boy behavior that occasionally is assertive and active). And yes, where you live matters. Rates of diagnosis are higher in the South, Midwest, less on the West Coast, and also less in the Northeast. But the rates of diagnosing differ county to county too. Why? Again, there are no real tests for it. Even us experts disagree widely about how and when to say a boy has ADHD (most often it's boys who get the ADHD label - at rates 3+ times more than girls).

Genetics is important. I've reviewed the research on this - and the here's the latest (see my article). In short, what genetic components there are to ADHD are actually very small. So, we have to be cautious seeing this diagnosis as a pure medical or brain issue.

Whenever possible, I ask parents to delay making the diagnosis until a boy is past five or six. That gives your son more time to experience normal, healthy brain growth. New studies are showing that ADHD is developmental (meaning the vast majority of kids who fall into an ADHD diagnosis, will grow out of it).

In my book, The Way of Boys, I discuss at length ADHD - as it's become a major pediatric issue in the country. I offer parents behavioral approaches and techniques that the research shows can be as effective (and longer lasting) as medications.

For more than 20 years, Dr. Rao worked in the Department of Psychiatry at Children's Hospital and served as instructor at Harvard Medical School, where he trained psychologists and physicians in the use of Cognitive Behavior Therapy, or CBT. Dr. Rao has been the featured expert on documentaries for the A&E series "Investigative Reports" and MTV's "True Life" series. Dr. Rao has been interviewed for articles in "The New Yorker," "Parents Magazine," "The Boston Globe," and" The Washington Times." His editorial letters and opinions have appeared in "Newsweek," "Scientific American," "The New York Times," and "New York Magazine." His book, "The Way of Boys: Promoting the Social and Emotional Development of Young Boys," is about the crisis in American boyhood. Dr. Rao answered questions for moms in our Kids' Health group here.

The Moms of CafeMom Say...

  • Heather_the_Mom

    I'm going to share my son's story. For the longest time I thought sports and other activities would make it better, and had the attitude of "boys will be boys." He is a very bright child, and almost always happy. The first word most people use to describe him is ENTHUSIASTIC! While he was in preschool, I chalked his behavior up to his age, being new to a preschool program, and figured it would be something that we could muscle through without any intervention. Then he started kindergarten.

    He had a very rough go. He couldn't focus on any task. He was constantly up and down, up and down, up and down.... He did not understand about personal space, and appropriate play behavior. His impulsiveness was causing a problem with the other students. He ended up getting picked on and bullied because of the social awkwardness.

    What really pushed me to have him evaluated was the frustration he would feel and TRY to voice when it came to playing. No other kids wanted to play with him. He couldn't focus on a game long enough to enjoy it, and even at home couldn't sit still long enough to build with LEGOS, color in a coloring book, or play with his "guys."

    Finally we had him evaluated, and diagnosed. We decided to try meds, and they worked wonders. He is still hyper, but now knows how to channel it appropriately, his school work has improved drastically, and he now has friends. One night while I was laying down with him, I asked him how he felt now that he was taking his medicine. He told me, "Mommy, when I feel my focus medicine wash off of me, I don't like it. I feel like my head is doing this (insert spinning fingers), and my brain is going crazy. I like to be able to think good, and I like that I do good in school now and have friends."

    I definitely think it is misdiagnosed, but people need to realize that it is a real problem. I am a very hands-on mom, and very involved with my children. And for us, medication has worked. Do I think every child with a diagnosis of ADHD needs to be medicated? No. Do I think that homeopathic remedies can work for some children? Of course. Do I think it is fair that people judge me and my child because of his diagnosis and medication? Absolutely not.

  • FabDarling

    My youngest daughter can't sit still...ever. When she was younger I had several people ask me "Do you think you should bring her to a doctor to get checked for a hyperactivity disorder?" NO. She's smart and does fine in school...other than chattiness and a lack of ability to sit in her seat for too long.....but she gets better at it every year. I think a lot of parents...especially newer ones ...look for perfection...and when it's not there they look for a way to make it so. I respect a teacher's opinion but after 14 years now of being a mom I also know that it's not the ONLY opinion of how to handle a problem, a child or any issue that comes up. I think a lot of us older moms who grew up in the 70's might have had 'issues' that were never labeled in school and in a lot of ways I think we ended up OK because no one ever told us constantly what was wrong with us.

  • ditsyjo

    Before you jump to a developmental problem make sure you have eliminated all possible physical causes... have you had her eyes and hearing checked...what about her tonsils and or adenoids... there a several possibilities that can cause ADHD symptoms but can be cured rather than just treated. How does she sleep ... do you get abnormal tantrums? ADHD is more than just difficulty sitting still and/or focusing.

  • jhslove

    Five-year-olds are SUPPOSED to be hyper. They're not SUPPOSED to sit still for hours and focus on one thing for extended periods; that's not how young children are wired. I really think that a lot of kids who are labeled as ADHD could be improved simply with a change in diet, more physical activity and a more predictable daily routine. I've seen several cases where those measures alone have resulted in significant improvement. If you're really concerned, don't let people on the street diagnose her. Find a really good developmental specialist and get her evaluated.

  • RheaF

    My son has ADHD. For him it was the fits that lasted for more than an hour, his energy level, inability to focus on anything even for a few seconds, etc. We are controlling it through diet and exercise. He cannot have any artificial dyes; we seriously limit high-fructose corn syrup, no BHT(a food additive), etc. I make sure he gets good quality active play every day, and we stick to a routine.

  • LNLMommy

    My daughter - almost six - was recently diagnosed with ADHD and before getting her tested I was pretty adamant and dismissive of ADD and ADHD because I felt that doctors and teachers were just over diagnosing children but I am very happy that I got her evaluated. My daughter is not only hyperactive, she is very impulsive. There is no thought process there at all. People will tell you that there is no such thing as ADHD and all they need is discipline but some children really do need extra help. There's no harm in getting your child evaluated. You don't have to choose whatever the doctor recommends but I think it's worth looking into.

  • Dreaming87

    Diet is very important. See what he is eating and drinking. No soda or too much sugar. If he is under five, do not be alarmed just yet. They are active at this age anyway. If he has?hyperactivity, and attention deficit it could be ADHD. But be careful and have him tested for everything. Try to figure out if there is anything that runs in the family that could be causing it. Also I have found Lyme disease can cause many of these things. So if it is possible that he has been exposed to ticks, rule this out.

  • cbodonnell

    There are too many people that jump to ADHD right off the bat....and when it comes to boys some just go there tooooooo quickly. There are many issues I would review long before going to ADHD. Do you know that one in five people have dyslexia, and did you know dyslexia IS NOT simply a reading problem? A child with dyslexia carries A LOT of anxiety about not being able to process information as quickly as those around them. Dyslexia is a processing disorder not a reading problem and with it come several issues. Schools and teachers are NOT doctors and they are quick to jump to ADHD. I am a teacher so I know what I'm talking about there, also I know a great deal about boys getting labeled ADHD and how greatly the younger generation of parents are pushed into believing that is all there is in the world.

  • simplysarahd

    Before he was using medication, my son was simply too intense and too much for the kids in class to take in and he was an outcast. Also kids didn't want to hang out with him because he needed more reminders than the other students. He was miserable and felt completely misunderstood by everyone. THIS school year he has TONS of friends and is excelling academically. He is being recommended by his teacher for "star student" of the month! My son's self esteem is soaring and he believes in himself now. Medication is not magic and ADHD is never an excuse, my seven-year-old understands he has to work harder than most kids to pay attention and behave.

  • 2boysmommy.js

    I have two very wild, active boys. I have people constantly telling me they have ADHD. If their activity level or anything ever got in the way of their education we would look into natural remedies, but as of now they my son has no problems in school. So we are letting him be himself; even if he's a little emotional sometimes and can get a little wild.

  • DDDaysh

    Sometimes when I mention to people who don't know my son that he has ADHD, they start going on and on about how it's just the school being too rigid, and that little boys need to just be able to run it off, etc. I usually don't bother arguing, but I find it hilarious since the thing that finally tipped the scales for me in deciding that ADHD was a real possibility was the fact that my son couldn't succeed in sports! Here was a perfect opportunity to get out that energy, and he couldn't focus long enough to play. His T-ball coach would have to physically pick him up and turn him to face home plate every few minutes, he'd be running after a soccer ball and suddenly veer off in another direction because something caught his attention, he just couldn't focus. My son isn't hyper, he's fidgety. He understands the rules and obeys at generally the same rate (probably a little higher rate) as other little boys his age - when he remembers. His teachers have said he is always eager to please. He just struggles to focus; he struggles to follow multi-step directions because he just forgets midstream. These are things that we are using behavior techniques to help him conquer, but they aren't things that can simply be "parented out of him" the way people talk about it. Medication has been needed to help my son be able to finish a school paper and not leave off spelling a word half way through.

  • Jinx-Troublex3

    I'll be the first to admit I TOTALLY believed that 90% of the ADD/ADHD labels were wrong and MOST of those parents were lazy parents that didn't want to deal with their children being children. Then God gave me my son! Anyone who doesn't think God has a sense of humor is SO wrong! I'm a very strict parent, work hard to make sure my kids have manners and good behavior, supported the public schools 100% when I shipped him off... what a nightmare! He wouldn't focus, hid under tables, wandered off (to the point we had to have sheriff search for him), etc. No amount of rewards/ bribery, punishment or threats could help. We finally got him diagnosed with ADD in first grade.

  • DDDaysh

    Many people who have been introduced to my son and have seen him in non-structured activities wouldn't think ADHD. They might notice he's a little different than the other kids, he might seem a little immature for his age, but nothing would really stand out. (Other KIDS would actually notice his differences far more, and this is one of the reasons ADHD can be difficult socially.) You'd probably think I was crazy for trying to medicate that! But then you'd get him into a classroom, or onto a sports team, and it would be a very different story. You'd tell him to cut out the pictures and glue them in the boxes. 20 minutes later you'd come back and one picture would be halfway cut out, two others might be colored, and he'd be twisting the glue stick up and down. You might ask him, "Is that what I told you to do?" and he'd look at you blankly, since his working memory is practically non-existent making his short-term memory also problematic. Medication doesn't solve all the issues. However, with medication he's now got about a 95% chance of at least having all the pictures cut out, and be holding his glue trying to remember what the next part of the instructions were. With multiple prompting, visual cues, etc., things get better and better.

  • Hottubgodess

    I think it is overly diagnosed. My son is easily distracted by anything going on around him. He is not ADHD/ADD. I have seen kids labeled as such because they are wiggly boys, and the teacher cannot deal with them/parents cannot deal with them. So instead of giving them physically active things to do, they expect them to sit still, which boys have a very hard time doing. But are there kids that are ADD/ADHD? Absolutely.