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What Age Can You Diagnose ADHD?

Posted Nov 13 2012 2:34pm


Earlier this morning our Facebook page, Help Your ADHD Child , Maria asked, “Can anyone tell me if two year [old] kids can be diagnosed
with ADHD?

This raises a very important question, that for me also touches upon a recent trend in diagnosing children with ADHD.

It also leads to a number of questions that I have:

  • How early can you diagnose ADHD?
  • At what age can you begin to see symptoms?
  • Should you diagnose ADHD before a certain age?

Here are the facts, ADHD is defined as a neurological, or sometimes a neurobehavioral, condition characterized by the symptoms of
hyperactivity, impulsivity, and inattention.

Typically, ADHD is said to affect anywhere from 4-10% of school aged children.  And for a long time, it was believed that ADHD really was a childhood condition.  Today, we know that ADHD never really goes away and it impacts adults over the course of their life.

But… the trend that concerns me is this recent development, or at least more publicly talked about position of diagnosing children as early as age 2, and certainly before age 7.

The diagnostic criteria for ADHD, clearly laid out by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), suggests that symptoms of ADHD must be present before age 7.

But does that mean we diagnose at age 7?

Can we accurately identify and diagnose ADHD before age 7?

My answer is very simple…NO!

I am NOT okay with making an ADHD diagnosis before the age of 7.

Can we do it?  YES

But that doesn’t mean we should.

Should we diagnose ADHD at age 2 or 3?

In my humble opinion, absolutely no way!

Of course there are always exceptions to every rule.  There will be instances, on a case by case basis, where a diagnosis can be considered.

But still, from what I have learned about ADHD and seen in my patients, you’re playing with fire making a diagnosis of exclusion at that young of an age.

At age 2, a child is still developing.  There is too much happening, at such a rapid pace, that there is just very little way to get an accurate
portrayal of a child this young.

Heck, I don’t even like making this diagnosis around the age of 5 or 6, when a colleague of mine (who I trust with my life) says that we can do it, but that doesn’t mean we should.

Listen, the cold hard facts are that, yes, you can tell at a very early age something is going on with your child.  In a lot of cases, mother’s intuition tells us that something is wrong.

I have heard countless anecdotes and reviewed scores of clinical histories where Mom even knew during her pregnancy that a child was a little hyperactive.

But that doesn’t guarantee anything.

We just are not able to accurately and consistently predict that a child will have ADHD based on these facts, anecdotes, and intuitions.

Plus, let’s not rule out some other very important facts:

  • ADHD is a diagnosis of exclusion
  • ADHD symptoms are common to many other condition sand illnesses
  • Children at an early age are rapidly developing

So What’s A Mom To Do?

If you think something is off with your child, by all means, consult a doctor, therapist, or psychiatrist.

Please be sure you see a specialist who understands ADHD and childhood development.

If a doctor recommends medicating your child at this age (before age 5), please put up some red flags and give this a great deal of thought.  And defintiely get a second opinion.

Yes, medication can help.  I am NOT opposed to it.  However, I am opposed to the unnecessary medicating of our children, particularly at such an early age.

Like it or not, ADHD medication is actually not supposed to be the first recommended treatment option.

But it happens all too often.

Resources To Consider From This Post:

ADHD Diagnostic Criteria
: Be sure you are familiar with the diagnostic criteria. Review them online. Print out a copy to take with you.

ADHD Myths Presentation (Sign up in the top right corner of this site): Find out the Top 10 (12 actually) Most Misunderstood Facts Of ADHD

Help Your ADHD Child : Get a copy of the exact blueprint I use when working with my individual patients and clients. This book is a must have for all parents (see the reviews and judge for yourself).

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