We all know that toddlers can be a handful. They don’t pay attention, they flit from one activity to another, they’re always into everything, and they are often defiant and difficult. If an older child acted this way, you might suspect Attention Deficit Hyperactivity Disorder, more commonly known as ADHD. But what if your child is just two or three?
There is a growing trend to medicate very small children with drugs intended to moderate ADHD behavior. This trend is most pronounced in families of low income, in which the children receive Medicaid assistance. A recent report noted that 15,000 American toddlers are being medicated for ADHD.
But here’s the thing: these medications – most notably Ritalin – have not been proven safe or effective for children so young. In fact, ADHD cannot even be diagnosed in children younger than four, following guidelines of the American Academy of Pediatrics and the Centers for Disease Control and Prevention.
So if your toddler seems out of control, what can you do?
First, assume that your child’s behavior is within normal ranges for her age. Little kids naturally push the limits because they aren’t really sure what the limits are. They also can’t very well control their impulses and manage their own behavior. So give your child some time to grow into better behavior.
Second, take the time to guide your toddler in developing what little self-control toddlers are capable of. Avoid giving in or using bribes to teach good behavior but also avoid being harsh. Remember that little kids don’t know what to do but need to be gently taught.
Third, give this time. Developing a fully-functioning, thoughtful, and self-disciplined human being doesn’t happen overnight. This development isn’t helped with medication. Remember that a toddler cannot be expected to act like an adult or even like a four-year-old.
Fourth, even if there is a family history of ADHD, be slow to engage in drug therapy. The best, most knowledgeable doctors will recommend behavior guidance at this age and will not jump to a diagnosis of ADHD with a child so young. You should do the same.
Finally, make certain your little one is getting enough sleep and is eating well. Sleep deprivation is a common cause of ADHD-like behavior and eating junk food, including caffeinated drinks and chocolate, affects behavior too.
There are no shortcuts to dealing with toddlers, no quick fix that will suddenly make your family life more serene. Raising children is hard work, requiring thoughtful parenting every day.
Give that to your very young child.
If you think your child might have ADHD or ADD, the first questions to ask are “why do you think so?” and “what else could cause that?” Let’s take a closer look.
ADHD – Attention Deficit Hyperactivity Disorder – and ADD – Attention Deficit Disorder – are caused by a brain difference. The brains of kids with these two conditions are wired differently than the brains of other kids. Kids with ADHD or ADD have trouble paying attention and may have trouble controlling their actions. These problems occur in every situation just about all the time (not just at school). These differences are hereditary, so if a parent has these conditions the children in the family might too.
So if one parent or the other has been diagnosed with ADHD or ADD and a child has difficulty with attention and self-control not only in school but at home as well, then, yes, the child might have ADHD or ADD. Talking with your family doctor is the next step.
But sometimes children who have poor attention and poor impulse control don’t have ADHD or ADD at all. In fact, most kids with behavior problems do not have ADHD or ADD. They just have behavior problems.
Telling the difference between children with ADHD or ADD and children who just behave badly is not always easy. But, luckily, addressing the behavior problems themselves helps both sorts of kids – those with and those without ADHD or ADD.
Here’s where to start:
- Cut way down on electronic media of all sorts. Strictly limit (to only an hour per day – can you do it?) television viewing, DVDs, video games, computer games, computer surfing, handheld game players and any other electronic media I might have forgotten to list. Not an hour each: an hour total. There is a clear link between overuse of electronics and bad behavior. Cut that link in your house.
- Increase physical exercise. Get kids out of the house and onto the playground for at least an hour every day – over and above whatever your child gets in physical education class or recess at school. Physical activity increases brain function and overall health. And well-exercised kids are calmer. Get your child outdoors!
- Feed your kids right. Nutrition is a zero-sum game: the more junk food the less room there is in a child’s tummy for good food. And while sugar may not “cause” bad behavior, poor nutrition does. Eliminate junk food from your fridge and pantry.
- Get your kids to bed on time. Tired children act badly. You knew this but have you connected the dots between your own child’s lights-out time and her behavior? And there’s not a TV in your child’s room, is there? Get it out of there!
- Teach your children how to behave. If you’re getting bad behavior, that means your kids don’t know what you expect. Punishment and yelling aren’t effective here. Instead, teach what you want your kids to do.
At a time when behavior is not an issue, discuss one scenario where you’d like see a change. Let’s say your child acts up in the car. Sometime when you’re not in the car, talk about car behavior. Remind your child of good car behavior just before the next car ride. Pull over the moment you get bad behavior. Drive only when the bad behavior stops. At the end of the ride, discuss again: how does the child think he did? What could he do differently next time?
Teach. Kids aren’t born knowing.
If just reading this short and simple list makes you tired, then you need to get serious. Good behavior, including paying attention and controlling impulses, is a key part of doing well in school and in life.
And notice that there aren’t any quick fixes. Medication, if properly prescribed for an actual medical condition, is effective and safe. But medication is never enough all by itself and is never appropriate for simply “bad behavior.” Medication doesn’t help kids understand how to behave in any given situation. Good parenting does that.
Whether your child has ADHD, ADD, or is just too frisky for her own good, it’s your job as a parent to guide her in the way to behave. Make no excuses. Your child can do better. Help get her there.