Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Four-Year-Old Suddenly Having Trouble Focusing | | | QUESTION | | | Dear Dr. Needlman,
My daughter is four years old and has always been interested in coloring and playing with her Barbies. But just recently I have noticed that she does not have the patience to sit down and do these things anymore. She cannot keep still even for two minutes, and she has trouble laying down for bed at night time and has told us many times that she can't be still. I do not allow her to drink soda or eat chocolate, and she only eats candy maybe once a week. I was wondering if I should have her tested for ADHD or is this just normal behavior? She will not listen to me, and when I ask her to do little tasks, she screams and throws a fit.— Baby Bird in Philadelphia, PA | | | ANSWER |
November 7, 2001 | | | Dear Baby Bird,
It's important to realize that there are many causes for hyper or distractible behavior in a child other than Attention Deficit Hyperactivity Disorder (ADHD). Most children with ADHD have been hyper or at least very active from a young age. It's not that common for a child who had been able to sit and play quietly for a long time to all of a sudden not be able to do that any more. Many children throw fits, but when a child who has not previously thrown a lot of tantrums starts throwing fits, it suggests to me a problem other than ADHD.
There are medical problems that can do this, such as hyperthyroidism or lead poisoning. None of these is very common, but it's important to make sure that you don't miss them, because they require specific treatments.
Psychological problems also can cause a child who was previously able to pay attention to all of a sudden have trouble focusing. This could be a response to something frightening, such as observing a violent act or being threatened, or being anxious about the threat of terrorism. It's also possible that a fairly minor incident or issue--for example, a child who is bothering her at school--has caused your daughter to lose her focus temporarily. A skilled professional may be able to help figure out what the issues are in your daughter's situation.
So, as a first step, I think it would be important to arrange for your daughter to have a very thorough medical and psychological evaluation. A behaviorally oriented pediatrician (either your regular doctor or one your doctor refers you to) may be the best professional to do this.— by Robert Needlman, M.D., F.A.A.P. |
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