Q: “I Think My 5-Year-Old Has ADHD. The Doctor Disagrees.”
“Ask your pediatrician to administer norm-referenced rating scales (the Vanderbilt Assessment Scale being the most common) that compare your child’s attention, behavior, impulsivity, and hyperactivity to that of other preschool-aged children. You and someone who knows your child in a separate setting, like at school or daycare, should fill out the rating scale.”
Q: “We suspect that my 5-year-old has ADHD, but the pediatrician says that my child is likely showing normal preschool behavior. They want to wait until my child is older to do a proper ADHD evaluation. What should we do?”
ADHD can be seen and diagnosed in children as young as yours, and the benefits of intervening early if your child does have ADHD are plentiful, from better academic performance and self-esteem to improved family life.
Your pediatrician may be well-meaning, but if you felt your concerns about your child were left unaddressed, you’ll need to advocate.
[Take This Self-Test: Could Your Preschooler Have ADHD?]
Document and Prepare for the ADHD Evaluation
Record your observations about your child’s specific behaviors and share those with the pediatrician in your next appointment. Have a frank conversation with them about what you’re seeing from your child across multiple settings.
Request ADHD Rating Scales
Ask your pediatrician to administer what are called “norm-referenced rating scales” (the Vanderbilt Assessment Scale being the most common). That means they compare your child’s attention, behavior, impulsivity, and hyperactivity to that of other preschool-aged children. The rating scales should be filled out by you and someone who knows your child in a separate setting, like at school or daycare. If your child screens positive or if you continue to have concerns, then you can ask for a more comprehensive evaluation. If you suspect delays in other areas of your child’s development such as motor or language skills, consider requesting broader testing.
You Are the Expert on Your Child
If your pediatrician still wants to take a “wait and see” approach, firmly and politely reiterate that you’d like to proceed with further evaluation. Keep this script handy:
I understand your perspective and I’ve looked into this, too. I know that symptoms of ADHD can emerge very early in childhood. What we’re experiencing as a family is difficult and challenging, and I would like to evaluate my child’s behaviors further.
[Read: Is Preschool Too Early to Diagnose ADHD?]
Seek a second opinion if your pediatrician doesn’t want to evaluate. Say:
If you don’t feel comfortable making a referral or sending out rating scales, then can you please direct me to somebody who might feel comfortable doing so?
Psychologists, psychiatrists, developmental behavioral pediatricians, neurologists, and other qualified mental health professionals can evaluate and diagnose ADHD. Regardless of provider, an ADHD evaluation should include direct observation of your child’s behavior and an in-depth developmental history with yourself and other caregivers.
Does My 5-Year-Old Have ADHD? Next Steps
- Read: Starting with Preschool, Strive for Kids Who Thrive
- Read: ADHD in Toddlers — Signs, Symptoms, and Treatment
- Read: Isn’t My 4-Year-Old Too Young to Be Diagnosed With ADHD?
The content for this article was derived from the ADDitude ADHD Experts webinar titled, “ADHD in Preschool: Early Diagnosis & Intervention for Young Children” [Video Replay & Podcast #516] with Alexis Bancroft, Ph.D., and Cynthia Martin, Psy.D., which was broadcast on August 8, 2024.
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