TUCSON, Ariz. — Little T.J. was a monster. There's no other way to say it.
Extremely hyperactive, the toddler ran around in circles, destroying everything in his path. He got kicked out of day care and banned from friends' homes.
His own grandmother called the 2-year-old a "monster." Friends told his family that T.J. — short for Terence Johnson — was destined to be "the next serial killer."
"He was so out of control, I was at my wits' end," said his mother, Heather Norton. "It is hurtful to realize nobody likes your child."
That was then. Today, as T.J. gets ready to turn 3, he is a changed boy. Lively, to be sure, but affectionate instead of mean.
"It's a total turnaround — this is a different child," Ms. Norton said. "Everybody notices the difference."
A frontal lobotomy? Electroshock therapy? Powerful drugs?
No, T.J. had his tonsils out.
The removal of a child's tonsils can, in some cases, significantly improve, even cure, severe hyperactivity often diagnosed as attention deficit hyperactivity disorder.
Now affecting more than 2 million U.S. children, ADHD most often is treated with psychoactive drugs, sometimes for a lifetime.
But in some children, simply removing the tonsils also has removed the diagnosis, by restoring normal behavior.
"Sometimes you get really great results, sometimes you see partial results in these children," said Dr. Damian Parkinson, the psychiatrist who suggested T.J.'s behavior might be related to his tonsils.
The key to making that connection is how the child sleeps. Snoring, restlessness, apnea, and gasping for breath during the night are clearly linked to hyperactive daytime behavior in very young children. And enlarged or infected tonsils and adenoids — immune-related tissue masses in the throat — most often are the cause of "sleep-disordered breathing."
In one recent study, at the University of Michigan, 22 children with ADHD and sleep-disordered breathing had adenotonsillectomies. After one year, 11 no longer battled ADHD.
"These improvements are remarkable because hyperactivity and inattention generally are expected to be chronic features in affected school-age children," the researchers wrote in a report published last year in Pediatrics.
As a result of this and other recent studies, "doctors conducting healthy-child checkups should always ask about snoring, poor sleep, behavioral and learning problems, and look for physical signs such as enlarged tonsils and adenoids," reads a summary published in the Journal of the American Medical Association in June.