Adhd treatment in toddlers

ADHD Awareness | CDC

Did you know that many children with severe symptoms of ADHD are diagnosed before 6 years of age? Young children with ADHD need the right treatment for ADHD. Learn about using behavior therapy first to help young children with ADHD.

ADHD is one of the most common enduring conditions of childhood and affects many children, including very young children. Those with more severe symptoms are often diagnosed earlier. Read about trends in diagnosis and medication treatment for ADHD.

Being easily distracted, impulsive, and highly active is normal for young children, but when the symptoms are severe and persistent, it can cause problems. Young children with ADHD are more likely than those without ADHD to have difficulties in early education programs or school, including problems with peer relationships, learning, and a higher risk of injuries.

My Young Child has been Diagnosed with ADHD, Now What?

For older children, the best treatment is often a combination of behavior therapy and medication. But for children under 6 years of age, experts recommend that ADHD be treated with behavior therapy first, before trying medication. Behavior therapy is the recommended treatment for ADHD in children under 6 years of age. The type of behavior therapy that is most effective for this age is parent training in behavior management, meaning that therapists work with parents and teach them the skills needed to help their child better manage their ADHD.

How Can Parent Training in Behavior Management Help my Child?

Children who have ADHD act in ways that are often challenging for parents. Children may forget things they are told, be overly active, and act before thinking. They might not be able to get positive attention the way that other children can; they tend to misbehave and might be punished more frequently than other children. Even if children with ADHD really try to follow rules, they might not be able to. This can have a negative impact on their self-image, and cause them to give up trying or to act up more often.

A therapist skilled in behavior management can help parents understand how ADHD affects their child. Parent training in behavior management is used to help change problem behaviors by building parenting skills, improving the relationship between parents and their child with ADHD, and helping children manage their own behaviors.

Others (daycare providers, preschool teachers, and other caretakers) can also help to manage the behavior of preschoolers who have ADHD by becoming educated about the disorder and by being trained in behavioral techniques.

The Recommended First Choice

Behavior therapy is the recommended ADHD treatment for children under 6 and should be used first, before medications that treat ADHD.

Children under 6 are more likely than older children to experience side effects from ADHD medications, such as increased heart rate and blood pressure, trouble sleeping, loss of appetite, and a loss of energy.
The long-term effects of ADHD medications on children under 6 are not known since ADHD medications have not been well-studied in young children.
Behavior therapy works as well as medication in young children with ADHD in helping to manage symptoms. Studies have shown that families who receive training in behavior therapy notice improvements for several years after treatment.

Parent training in behavior management has evidence as an effective treatment. There are several programs that meet the criteria of the Agency for Healthcare Research and Quality for effective treatments. Read more about these behavior therapy training programs for parents of young children.

What is CDC Doing?

CDC works to help families get the right care, at the right time.

CDC is working with states and partner agencies to increase awareness as well as to identify best practices in support of behavior therapy for ADHD.
CDC is using national surveys to understand how many children have ADHD and how they are treated.
CDC is learning more about how children with ADHD are diagnosed.
CDC funds the National Resource Center on ADHD to provide evidence-based information about ADHD to families and professionals.

What You Can Do:

Talk to your doctor about behavioral therapy first.
Share information about behavioral therapy for ADHD with other families.

Treatment of ADHD | CDC

Get information and support from the National Resource Center on ADHD

My Child Has Been Diagnosed with ADHD – Now What?

When a child is diagnosed with attention-deficit/hyperactivity disorder (ADHD), parents often have concerns about which treatment is right for their child. ADHD can be managed with the right treatment. There are many treatment options, and what works best can depend on the individual child and family. To find the best options, it is recommended that parents work closely with others involved in their child’s life—healthcare providers, therapists, teachers, coaches, and other family members.

Types of treatment for ADHD include

Behavior therapy, including training for parents; and
Medications.

Treatment recommendations for ADHD

For children with ADHD younger than 6 years of age, the American Academy of Pediatrics (AAP) recommends parent training in behavior management as the first line of treatment, before medication is tried. For children 6 years of age and older, the recommendations include medication and behavior therapy together — parent training in behavior management for children up to age 12 and other types of behavior therapy and training for adolescents. Schools can be part of the treatment as well. AAP recommendations also include adding behavioral classroom intervention and school supports. Learn more about how the school environment can be part of treatment.

Good treatment plans will include close monitoring of whether and how much the treatment helps the child’s behavior, as well as making changes as needed along the way. To learn more about AAP recommendations for the treatment of children with ADHD, visit the Recommendations page.

Behavior Therapy, Including Training for Parents

ADHD affects not only a child’s ability to pay attention or sit still at school, it also affects relationships with family and other children. Children with ADHD often show behaviors that can be very disruptive to others. Behavior therapy is a treatment option that can help reduce these behaviors; it is often helpful to start behavior therapy as soon as a diagnosis is made.

The goals of behavior therapy are to learn or strengthen positive behaviors and eliminate unwanted or problem behaviors. Behavior therapy for ADHD can include

Parent training in behavior management;
Behavior therapy with children; and

Behavioral interventions in the classroom.

These approaches can also be used together. For children who attend early childhood programs, it is usually most effective if parents and educators work together to help the child.

Children younger than 6 years of age

For young children with ADHD, behavior therapy is an important first step before trying medication because:

Parent training in behavior management gives parents the skills and strategies to help their child.
Parent training in behavior management has been shown to work as well as medication for ADHD in young children.
Young children have more side effects from ADHD medications than older children.
The long-term effects of ADHD medications on young children have not been well-studied.

Behavior Therapy for Younger and Older Children with ADHD [PDF – 466 KB]

School-age children and adolescents

For children ages 6 years and older, AAP recommends combining medication treatment with behavior therapy. Several types of behavior therapies are effective, including:

Parent training in behavior management;
Behavioral interventions in the classroom;
Peer interventions that focus on behavior; and
Organizational skills training.

These approaches are often most effective if they are used together, depending on the needs of the individual child and the family.

Learn more about behavior therapy

Learn more about ADHD treatment and support in school

Read about the evidence for effective therapies for ADHD

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Medications

Medication can help children manage their ADHD symptoms in their everyday life and can help them control the behaviors that cause difficulties with family, friends, and at school.

Several different types of medications are FDA-approved to treat ADHD in children as young as 6 years of age:

Stimulants are the best-known and most widely used ADHD medications. Between 70-80% of children with ADHD have fewer ADHD symptoms when taking these fast-acting medications.
Nonstimulants were approved for the treatment of ADHD in 2003. They do not work as quickly as stimulants, but their effect can last up to 24 hours.

Medications can affect children differently and can have side effects such as decreased appetite or sleep problems. One child may respond well to one medication, but not to another.

Healthcare providers who prescribe medication may need to try different medications and doses. The AAP recommends that healthcare providers observe and adjust the dose of medication to find the right balance between benefits and side effects. It is important for parents to work with their child’s healthcare providers to find the medication that works best for their child.

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Parent Education and Support

CDC funds the National Resource Center on ADHD (NRC), a program of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). The NRC provides resources, information, and advice for parents on how to help their child. Learn more about the services of the NRC.

Tips for Parents

The following are suggestions that may help with your child’s behavior:

Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime.
Get organized. Encourage your child to put schoolbags, clothing, and toys in the same place every day so that they will be less likely to lose them.
Manage distractions. Turn off the TV, limit noise, and provide a clean workspace when your child is doing homework. Some children with ADHD learn well if they are moving or listening to background music. Watch your child and see what works.
Limit choices. To help your child not feel overwhelmed or overstimulated, offer choices with only a few options. For example, have them choose between this outfit or that one, this meal or that one, or this toy or that one.

Be clear and specific when you talk with your child. Let your child know you are listening by describing what you heard them say. Use clear, brief directions when they need to do something.
Help your child plan. Break down complicated tasks into simpler, shorter steps. For long tasks, starting early and taking breaks may help limit stress.
Use goals and praise or other rewards. Use a chart to list goals and track positive behaviors, then let your child know they have done well by telling them or by rewarding their efforts in other ways. Be sure the goals are realistic—small steps are important!
Discipline effectively. Instead of scolding, yelling, or spanking, use effective directions, time-outs or removal of privileges as consequences for inappropriate behavior.
Create positive opportunities. Children with ADHD may find certain situations stressful. Finding out and encouraging what your child does well—whether it’s school, sports, art, music, or play—can help create positive experiences.
Provide a healthy lifestyle. Nutritious food, lots of physical activity, and sufficient sleep are important; they can help keep ADHD symptoms from getting worse.

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ADHD in Adults

ADHD lasts into adulthood for at least one-third of children with ADHD¹. Treatments for adults can include medication, psychotherapy, education or training, or a combination of treatments. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health

More information

For more information on treatments, please click one of the following links:

National Resource Center on ADHD

National Institute of Mental Health

Information for parents from the American Academy of Pediatrics

References:

Barbaresi WJ, Colligan RC, Weaver AL, Voigt RG, Killian JM, Katusic SK. Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: A prospective study. Pediatrics 2013;131(4):637-644.

Parents typically attend 8-16 sessions with a therapist and learn strategies to help their child. Sessions may involve groups or individual families.

The therapist meets regularly with the family to monitor progress and provide support
Between sessions, parents practice using the skills they’ve learned from the therapist

After therapy ends families continue to experience improved behavior and reduced stress.

what is it, types, symptoms, treatment

"They make up diagnoses! You just need to be stricter with him!" - this is what parents of a child with ADHD most often hear from strangers. It is difficult for such children to sit in one place, they fuss too much, talk out of place, run around non-stop - they behave as if they have a small motor behind their backs. But it's not about bad upbringing or bad character. The reason is a real behavioral disorder - attention deficit hyperactivity disorder.

What is ADHD

Attention Deficit and/or Hyperactivity Disorder (ADHD) is a neurological behavioral disorder in which a person has poor self-control skills. It is difficult for children with this diagnosis to wait, endure, restrain emotions, keep track of time, plan things, "play by the rules" of society and put off what they want until the goal is achieved.

A child with ADHD is not a naughty, naughty tomboy. He knows the rules of conduct, but cannot follow them. When adults say to such a child, "Pull yourself together," "Well, finally try, can't you?" He really can't. Scolding him for hyperactivity and absent-mindedness is the same as reproaching a short-sighted person when he does not see the tenth line at an appointment with an ophthalmologist.

Children with ADHD often wear out parents and teachers at school. But it is important to understand that they themselves suffer from their own illness, get tired of their behavioral difficulties. It is physically difficult for them to control themselves, the lack of treatment increases their vulnerability to the development of depression, psychosis, PTSD.

ADHD statistics

The Russian Federation does not officially keep records of patients with ADHD. If we focus on world practice, an average of 10% of children suffer from symptoms of attention deficit and hyperactivity. In 2021, 1.4 million children were born in Russia, which means that 140 thousand of them may suffer from this behavioral disorder.

It used to be thought that ADHD was a childhood disease that a child would outgrow with age. Only 10 years ago, the world community recognized the existence of this disorder in adults. It has been scientifically proven that only 30% of children cope with Attention Deficit Hyperactivity Disorder. The remaining 70% carry symptoms into adulthood.

Most of all people with ADHD suffer from the fact that they cannot achieve their desired goals and realize their talents. For example, a child does not try hard at piano lessons, although he loves music, makes a lot of mistakes in dictation, and at the same time knows the rules perfectly. In adult life, it is easy to recognize former children with ADHD: they drop out of high school after high school, change jobs once a month, and often do not finish the work they take on.

Types of ADHD in children

In the classification of diseases, there are three types of ADHD in children:

Hyperactive-impulsive type. Such children are in constant motion, it is difficult for them to restrain their speech flow and emotions.
Inattentive type. These are distracted children who are constantly distracted by external stimuli, lose things and cannot concentrate on one lesson.
Mixed type. Most common when a child has symptoms of hyperactivity and attention deficit at the same time.

Sometimes ADHD is misunderstood. The term "attention deficit" is misunderstood as "the child lacks interest from adults. " In fact, it means that it is difficult for a person to concentrate his attention for a long time.

Symptoms of ADHD: how to recognize hyperactivity in a child

The term ADHD includes two groups of symptoms: hyperactivity/impulsivity and inattention. Consider what is included in each of them.

Manifestations of hyperactivity in a child:

Is in constant motion: running, jumping, trying to climb somewhere, climb everywhere. Moreover, he is active in places where it is inappropriate: in a store, at a doctor's appointment.
Constantly fidgeting, fidgeting, cannot sit still, even if tired.
Restlessly moves head, hands, feet.
Gets up from her desk in the middle of class and cannot stay where she is when she has to sit and wait.
Unable to play or engage in hobbies for long periods of time.
Sometimes too talkative.

Manifestations of impulsivity in a child:

Suffers from mood swings during games and school activities: sometimes calm, sometimes impulsive.
Shouts out answers without thinking, without listening to the end of the question.
He does not have the patience to wait for his turn.
Clings to others, interferes in other people's games and conversations.

Manifestations of inattention in a child:

Due to carelessness and distraction, he makes many mistakes in school assignments.
Cannot concentrate in studies, games.
In a conversation, it seems that he does not listen to the interlocutor: the child does not look in the face, but his gaze wanders.
Does not follow generally accepted rules in kindergarten, school.
In conversation and activity, he is often distracted by extraneous matters.
Loses and forgets things at regular intervals.

If you notice a third of the listed symptoms in your child, this is a reason to see a doctor. Several specialists should diagnose ADHD at once: a neurologist or neuropathologist and a neuropsychologist or child psychiatrist. To make a diagnosis, doctors need:

record at least 6 manifestations of hyperactivity/impulsivity and 6 manifestations of attention deficit;
establish that the symptoms are observed within 6 months and in different situations: not only at home or at school;
exclude other mental disorders.

Symptoms must be severe, occur frequently, and be inappropriate for the age of the child. Otherwise, every kid who just got up and started talking can be attributed to ADHD.

Differences in ADHD between boys and girls

It used to be thought that the disorder was more common in boys than in girls. In a study of the situation of ADHD in Russia, professors of the pediatric faculty of the Russian State Medical University fix conduct disorder in 11% of the first and only in 2.5% of the second.

Today, neuropsychologists say that the gender statistics of this disorder are highly distorted. The fact is that ADHD manifests itself differently in boys and girls. The prominent symptoms of hyperactivity and impulsivity that are most commonly diagnosed are rare in girls. They are characterized by a type with a manifestation of attention deficit. In such cases, the symptoms of ADHD are mistaken for personality traits, and the girl is considered a dreamy person, hovering in the clouds.

Hyperactivity in these children often goes in the direction of hypersensitivity. They are overly emotional, they can change the tone in a conversation, run away during the game, react sharply to words and events. In rare cases, when a girl is hyperactive, she is called a "tomboy in a skirt" and the energy is written off as a boyish character.

ADHD Treatment

ADHD can be treated with a variety of medications that can help a child overcome behavioral difficulties: stop, reduce irritability, fight temper tantrums and depression. But drug treatment is prescribed only by a doctor after he makes a diagnosis and draws up an individual neurocorrection program.

Some neuropsychologists and child psychiatrists ask parents of children with ADHD to stop taking pills, believing that they only suppress the symptoms, not fight the cause. One way or another, the modern approach involves taking care of two much more important points that will greatly simplify the life of a child with this disorder.

The first is to inform everyone around these children about what ADHD is. It is important that adults understand that this is a disease, and not just a harmful child, and decide: they will not obey mom and dad. Most of the impulsive actions he performs unconsciously.

Also inform the school about the child's characteristics and explain to the teachers how to help the child overcome difficulties. For example:

It is better for such a student to sit closer to the teacher, on the first desks. This will encourage him to be less distracted.
If the teacher notices that it is difficult for the child to sit still, you can allow him to walk around the classroom during the lesson, conduct a physical education session or ask him to distribute notebooks.
Since children with ADHD quickly get tired of the routine, it is necessary to reduce the number of tasks of the same type for such a student.
The teacher should not make demands on handwriting and accuracy, but look only at the content and evaluate the correctness of the solution.

After 10-11 years of age, doctors advise telling the child about his/her peculiarities. He must understand what is happening to him. It is good if you can visit a psychotherapist, preferably a CBT specialist who works with behavior.

The second is the adaptation of a child with ADHD to life. It is about creating a comfortable environment: such an environment and conditions in which he will feel on a par with ordinary children. Here are some tips for parents to make life easier for a child with ADHD.

1. Follow the daily routine

A child with ADHD has the whole world out of focus. A clear schedule can become for him that island of stability that he lacks. Schedule the child's schedule for time: when he wakes up, when he does homework, when he plays on the tablet.

2. Live by the timer

Children with ADHD are those "happy ones who don't watch the clock." They do not have a sense of time. Therefore, it is difficult for them to distribute free hours between tasks and keep up with everything. Enter into the life of the child the rule that he does every lesson on a timer: he brushes his teeth, eats breakfast and solves math problems.

3. Remove irritants

A child with ADHD is easily occupied with every little thing. It is important that nothing distracts him during classes, games and meals. Remove all unnecessary items from the table, turn off the TV and put the phone on silent mode.

4. Break big tasks into small tasks

To do one big thing, you need to have high self-control skills and keep a lot of information in your head. It will be much easier for a child with ADHD to do a few small things and still not lose focus.

5. Add sports to your child's life

This should be an activity that will not exhaust the child even more, but will help him relieve nervous tension. Calm sports will do just fine with this: swimming, dancing, children's yoga. But it is best to ask the child himself what he wants to do.

Look for advice from professionals working with children with ADHD. If you adapt the environment and lifestyle to the characteristics of the child, both he and you will forget about the diagnosis. Attention Deficit Hyperactivity Disorder is not a sentence. With the right tactics and perseverance of parents, the child will be able to socialize, please you with high marks and cope with behavioral difficulties in adulthood.

How to treat ADHD in children?

In almost every class there is a child who behaves impulsively, is constantly distracted and does not listen to the teacher. Usually such children are labeled as hooligans, loafers and lazybones. However, most often the child behaves this way through no fault of his own. These behaviors are a collection of ADHD (Attention Deficit Hyperactivity Disorder) symptoms and can be corrected with carefully chosen treatment.

Attention deficit hyperactivity disorder began to be investigated relatively recently - in the 70s of the twentieth century. One of the main reasons for the appearance of this syndrome in a child is the incorrect development of certain parts of the brain. The prerequisites for this disease can be seen from a very early age, but the clinical diagnosis is usually made at 7-8 years of age. At this age, a child with ADHD enters the educational process, and symptoms of the disease begin to actively manifest in him:

Restlessness and impulsiveness. The child cannot calmly study in the classroom, he constantly fidgets, gets up, talks, whispers with classmates and, as a result, receives comments. At home, it is difficult for him to sit still and do his homework.
Carelessness. It is very difficult for a child to concentrate on some material and concentrate on one boring activity for a long time, such as drawing or studying.
Difficulties in memorization. It is difficult for a child to remember what was in the lesson, as he cannot concentrate on the material. It is especially difficult to remember the details of a task and their sequence.

A child with ADHD is different from other children, and this further worsens his behavior and worsens relationships with others. He constantly receives remarks from teachers and ridicule from classmates. As a result, the gap between the child and the whole class widens. The child feels this, he becomes very ill and offended by this, and he begins to behave even more impulsively.

Although drugs can have side effects, it is up to the specialist to select the right drugs and their dosage for a particular patient.

See also

Fear of exams

To diagnose a child with Attention Deficit Hyperactivity Disorder, you need to go through an in-depth clinical interview. This will help identify specific attention deficits and understand when it is difficult for the child to concentrate and what distracts him. After that, you can start treatment, which consists of several components:

Medical treatment. As a rule, the specialist prescribes stimulants - special drugs that improve the functioning of the areas of the brain responsible for concentration. Although drugs can have side effects, it is up to the specialist to select the right drugs and their dosage for a particular patient.
Behavioral Therapy. The specialist works with the child and positively reinforces the behavior that needs to be developed. For example, a child is praised for focusing on some material for a longer time than it was before. Such therapy is very effective, and is necessarily added to drug treatment.

After starting therapy, it becomes easier for the child to sit in one place, listen to the teacher and concentrate on the lesson.

Family consultation. Children who suffer from ADHD often irritate their parents, act up and behave aggressively. The specialist works with the child's family and explains how to properly respond to the active manifestation of symptoms so as not to stimulate the development of the disease.

Treatment that includes all three components leads to amazing results. After starting therapy, it becomes easier for the child to sit in one place, listen to the teacher and concentrate on the lesson. The child feels that it is easier for him to perceive and remember the material. With age, a person develops behavioral, cognitive and emotional techniques that allow him to cope without drugs with boring, difficult and tedious activities and not show symptoms of the disease.

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