ADHD Symptoms in Children: What Signs You Should Look For

Young children have an amazing amount of energy. If you have a 4 or 5 year old at home, you might have wondered if their energy level is normal or if all that activity is a symptom of  attention-deficit hyperactivity disorder (ADHD). It can be tough to tell signs of ADHD apart from normal behavior in 2 to 5 year olds. But, according to the CDC, 388,000 children ages 2 to 5 years old had been diagnosed with ADHD in 2016. 

Let’s take a look at the symptoms of ADHD in toddlers and preschoolers and what steps to take if you’re concerned about your child’s behavior. 

What are the different types of ADHD?

There are three types of ADHD:

• Predominantly inattentive ADHD: Children with this type of ADHD have trouble focusing, concentrating, and finishing tasks. 

• Predominantly hyperactive-impulsive ADHD: Children with this type of ADHD are constantly “on the go.” They move and fidget and can have a hard time controlling their impulses.   

• Combined ADHD: Children with this type of ADHD have symptoms of both inattentive and hyperactive-impulsive ADHD. 

The different types of ADHD are associated with different symptoms, which we discuss in more detail below. ADHD symptoms can be hard to spot in 2 to 5 year olds because symptoms overlap with regular behavior. So parents and caregivers need to pay special attention to children’s behavior and whether they’re showing ADHD symptoms. 

ADHD in toddlers (ages 1 to 3)

ADHD symptoms in toddlers and 3 year olds can be very tough to spot. Some experts even say it’s impossible to tell the difference between regular behaviors and ADHD symptoms in young children. 

For this reason, ADHD diagnosis guidelines from the American Academy of Pediatrics only start at 4 years old. 

But it can be hard to ignore an instinct you have as a parent or caregiver when a child seems to respond differently to their environment. And there’s evidence that some children with ADHD showed symptoms of ADHD when they were 3 years old, or even younger, as babies or toddlers. 

If you have concerns about your child, pay attention to the way their behaviors disrupt their daily life. In toddlers and preschoolers, aggressive behaviors are often the first visible symptoms. For example, your child’s day-care provider might express concern that their behaviors are interfering with their ability to learn and interact with their peers.

So, if you’re concerned about your child’s behavior, talk to their healthcare provider. While it may be too early for an ADHD diagnosis, it’s not too early to find ways to help your child reach their full potential. Your child’s healthcare provider can help you find early intervention programs that can help you understand your child’s behaviors and how to best support them if they’re having a hard time at home or in daycare or preschool. 

Symptoms of ADHD in young children (ages 4 to 10)

ADHD symptoms will be easier to recognize by age 4. Here are some of the symptoms that children with ADHD may have.

Symptoms of inattention in children with ADHD

Children with ADHD may show inattention symptoms. They may:

• Seem to make careless mistakes 

• Have trouble holding attention on tasks or play activities

• Not seem to listen when spoken to directly

• Not follow instructions as well as other children of a similar age

• Often lose things (such as toys or comfort objects)

• Get distracted more easily than other children of a similar age

• Be forgetful in daily activities

Symptoms of hyperactivity/impulsivity in children with ADHD

Children with ADHD may show hyperactivity or impulsivity symptoms. They may:

• Fidget or squirm 

• Leave their seat in situations when remaining seated is expected

• Run about or climb when this isn’t appropriate  

• Have a hard time playing quietly

• Often be “on the go,” acting as if “driven by a motor”

• Seem overly chatty 

• Blurt out an answer before a question has been completed

• Have more trouble waiting their turn than children of a similar age

Identifying ADHD symptoms in children early and getting them help as soon as possible can help children do better in school, at home, and with their peers. 

ADHD symptoms vs. ‘normal’ behavior

Even in older children, it can be hard to tell the difference between ADHD symptoms and typical behavior. Children with ADHD symptoms usually have trouble in at least two areas in their life — like home, school, sports, or with friends.  

If you’re worried about your child’s behavior, talk to their healthcare provider about your concerns. They will ask you questions to better understand your child’s symptoms. Your provider may also ask you and your child’s other care providers or teacher to complete written questionnaires to better understand your child’s symptoms. 

The information from your discussion with your child’s provider and from the questionnaires may be enough to decide whether your child’s behaviors are due to ADHD, another condition, or part of normal childhood development.

What causes ADHD in kids?

It’s not clear why some kids develop ADHD. Researchers believe a combination of things cause a child to develop ADHD. 

Genes play a role in whether a child develops ADHD. Children are more likely to develop ADHD if a close family member has ADHD, too. 

But a child’s environment and life experiences also play part in whether a child develops ADHD. Children are more likely to develop ADHD if they were exposed to certain things before or after birth, like:

• High levels of maternal stress

• Large amounts of caffeine

• Alcohol, tobacco, cocaine, cannabis, or heroin

• Lead poisoning

• Trauma or adverse childhood experiences

How do you diagnose ADHD in children?

Healthcare professionals can use validated screening tools to diagnose ADHD in children who are at least 4 years old. One of the most commonly used tools is the Vanderbilt Assessment Scale. These screening tools go over different symptoms of ADHD in children and ask you to rate your child’s symptoms and behaviors. 

These screening tools are designed to get input from you, other caregivers, teachers, and coaches. This is so your healthcare provider can perform a more complete assessment to figure out if your child may have ADHD.  

If the results aren’t clear, your child may need to see a child psychiatrist or psychologist for more in-depth testing. This can include more questionnaires for the adults in your child’s life and direct observation of how your child pays attention. 

There aren’t any blood tests or brain scans that can determine if your child has ADHD.  

How can you help a child with ADHD?

If your child has ADHD, there are many things you can do as a parent to support them. Some things that can help your child include: 

• A regular routine: A regular routine can provide valuable structure and predictability for children diagnosed with ADHD. This can include regular times for meals, sleep, and scheduled activities. 

• Exercise: Some studies have shown that exercise might help decrease symptoms such as hyperactivity. Exercise does not have to be organized or planned. For toddlers and preschoolers, playing should provide plenty of physical activity. Bonus points if the exercise gets your child outside each day.

• Restful sleep: The National Sleep Foundation (NSF) recommends that toddlers (1 to 2 years old) get 11 to 14 hours of sleep each night. The NSF recommends that preschoolers (3 to 5 years old) get 10 to 13 hours of sleep each night. Poor sleep has been linked to both attention and behavior problems in children.

• A well-balanced diet: Researchers continue to explore which foods may contribute to ADHD symptoms in some children. Making sure your child gets a diet high in fruits and vegetables and low in processed foods may help with their ADHD symptoms. It will also improve their health overall.  

• Limited screen time: Digital media can affect  a child’s ability to focus and sustain attention. The American Academy of Pediatrics recommends that you limit screen time for 2 to 5 year olds to no more than 1 hour each day.

Children with ADHD have natural skills and talents that can help them excel in life. With the right support, children can learn to use those talents in a constructive way. This lets them succeed in school, sports and activities, and in their relationships with family and friends. 

Why trust our experts?

Written by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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