What to Expect the Toddler Years (65 page)

There are many theories as to the cause of ADHD, though at this point, the causes of most cases are unknown. It’s likely that there is more than one type of hyperactivity, each with a different set of contributory factors. Such factors may include:

Immaturity
. Slower development of impulse control, emotional control, and fine motor coordination is common among children with ADHD. As these children mature, their behavior improves.

Genetics
. The fact that ADHD is seen more often in some families than others
indicates that heredity may play a role; in a small percentage of children with ADHD the problem may be an inherited defect in the way the body responds to thyroid hormones.

Gender
. ADHD is four to seven times more common in boys, who tend to mature more slowly than girls.

Pre- or Postnatal Environment
. In some children, ADHD can be traced to the mother’s alcohol abuse, smoking, or use of other drugs during her pregnancy; in others, to an early-childhood illness, such as encephalitis or meningitis. There are some who believe that sensitivity to certain foods or food additives play a role in certain cases of ADHD.

Oversensitivity to stimuli
. Some experts suggest that ADHD is the result of a child experiencing a bolt of nervous energy when exposed to seemingly normal stimuli (sights, sounds, people). That nervous energy, or tension, is vented in inappropriate ways, such as wild behavior, emotional outbursts, and recklessness.

Sometimes, a toddler is “hyper” and shows other signs of ADHD, but doesn’t actually have the condition. Occasionally the overactivity is a normal manifestation of high intelligence teamed with surplus energy. Or the behavior may be a response to stress in a child’s life that he doesn’t understand and is unable to cope with. Perhaps his parents have an unsatisfactory relationship; or one or both are overstressed, depressed, or abusing alcohol or drugs; or the family is living in difficult, overcrowded conditions.

If you’re concerned about your toddler’s behavior, first compare it to that of his peers. Observe him at play group, watch him at the playground with other children, talk with his sitter or teacher at day care. What you will probably note is that many of the others are just as wild as he. If, however, your child seems more out of control than the others, watch his behavior more closely. The following questions depict behavior that are common in ADHD children. Bear in mind, however, that they are present in all toddlers to some degree; only in the extreme do they point to a potential problem:

Does he seem to have an even shorter attention span and even more difficulty paying attention than his peers? (When a story is being read, for example, does he get up halfway through and move on to another activity, while the others stay put until the end?) Is he more easily distracted from whatever he is doing—whether it’s a game, a television show, or a meal?

Does he seem to have more difficulty following simple instructions than do others his age? Does he appear
never
to listen? Keep in mind that language disorders sometimes masquerade as ADHD.

Is he overly talkative, demanding, and emotional, with frequent outbursts of crying, screaming, hitting, or other signs of frustration that seem out of proportion to the triggering event? Does he often interrupt or intrude on others? (This behavior may also surface in toddlers whose mothers or primary caregivers are depressed.)

Does he have more trouble sitting still than most toddlers? Is he constantly “on the go,” taking no rest periods? Does he sleep very little? Is his sleep restless, with a lot of flailing and kicking?

Does he often behave recklessly (running into the street, grabbing for a hot cup of coffee, punching a strange dog), without considering the possible consequences of his actions?

Does he demand constant attention?