Improve the Behavior of Preschoolers With ADHD

Toddler and mother playing together

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Raising a child with ADHD is tough, especially when symptoms are already obvious at a young age. Most children aren't diagnosed with ADHD until they are school aged. However, 2.4% of children ages two to five are diagnosed with ADHD, according to the American Academy of Pediatrics.

If you learn to recognize the signs of ADHD early, you will know what you are dealing with and can get interventions in place. 

Environmental Changes

Whenever there is an abrupt change in a child’s behavior, the first question to consider is whether or not there have been any recent changes that may create more stress in a child’s life such as a move, a loss, a new baby, changes in the routine, or lack of sleep.

Kids with ADHD often have a difficult time adapting to changes or new situations, so you’re likely to see escalating behaviors including increased defiance and tantrums.

Need for More Intense Interventions

Your child may initially respond to your interventions but may subsequently need more intense interventions. This might include more frequent redirection and feedback and more immediate and more powerful rewards. It also helps to be aware of triggers and plan for problem situations including roleplaying and teaching appropriate skills. Continue to be consistent, as well.

Proactive Parenting Strategies

Kids who are impulsive have a really hard time controlling and inhibiting their behaviors and responses. They react without considering consequences. They also often don’t connect their actions to the consequences that will follow, especially at this young age.

That’s why proactive strategies like redirecting, frequent reminders, preparing for transitions, keeping the day very structured, channeling extra energy with physical movement, offering choices to give him a sense of control, giving one-step directions, and teaching calming strategies, can really help.

Close Supervision and Monitoring

Continue to monitor your child closely. He will need constant supervision around younger siblings. Try to identify triggers to your child's outbursts so you can intervene and redirect in positive ways before the behavior becomes destructive and aggressive. Do meltdowns seem to occur at a particular time? Around transitional times? When the child is overstimulated? Overtired? Frustrated with a task or in trying to verbalize or communicate desires?

Remain Calm, Get Support and Don’t Forget Self-Care

It is hard, but try to remain as calm as possible. Sometimes what happens with kids with ADHD is their behaviors can become so difficult and exasperating that the parents may begin to respond in ways that may not be quite as effective (perhaps responding with inconsistency or disapproval and anger).

This, in turn, escalates the child’s acting out. It cannot be reiterated enough that parenting a child with ADHD is tough. It requires even more patience and supervision and creative interventions on the part of the parent.

It can be draining, so work with your partner or network of family and friends to figure ways to take care of yourself. That way, you have the energy to parent calmly and productively. Make sure you are consistent and if in a two-parent household, make sure you are on the same page parenting-wise.

It often helps to connect with a professional for parent support and training. You can look for a CHADD Support Group in your area.

Communicate Openly With Your Child’s Doctor

It can be difficult to decide whether to start your preschooler on medication for ADHD. For children ages 4 or younger, with significant hyperactivity, inattention, and behavioral concerns who have not responded to behavioral therapy and/or changes to parenting approaches, medication might be an option.

Share your concerns with your child’s pediatrician. A low dose of stimulant medication may be recommended if environmental changes and behavioral approaches are not enough to significantly improve symptoms.

If your child is placed on medication, it will be important to monitor closely and communicate frequently with the doctor to make sure side effects are minimized and your child’s health is good. If your child is already on medication, an adjustment may be recommended. Either way, open communication with the doctor is essential.

1 Source
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  1. Danielson ML, Bitsko RH, Ghandour RM, Holbrook JR, Kogan MD, Blumberg SJ. Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents. J Clin Child Adolesc Psychol. 2018;47(2):199-212. doi:10.1080/15374416.2017.1417860

By Keath Low
 Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD.