.webp)
Most experts agree that the tendency to develop attention-deficit/hyperactivity disorder (ADHD) is present from birth. However, signs of ADHD often do not become apparent until children start school.
One reason for this delay is that many preschool-aged children naturally display some behaviors associated with ADHD—such as inattention, impulsivity, and hyperactivity—as part of typical development.
For most children, these behaviors gradually diminish as they grow older. In contrast, children with ADHD continue to exhibit these behaviors, and they interfere with daily functioning. Over time, this difference becomes increasingly noticeable, making it easier to identify ADHD as children progress through school.
A child’s challenges with inattention, impulsivity, and hyperactivity often become more noticeable when they start school. Classroom settings demand greater focus, patience, and self-control than home or playgroup environments, where these expectations are less frequent.
By around age 7, many parents begin to notice that their child’s level of activity, impulsiveness, or inattentiveness is higher than what is typical for their age.
In some cases, signs may appear later, especially in bright children whose main difficulty is sustaining attention rather than hyperactivity. However, it is uncommon for ADHD symptoms not to be present before the age of 12. If attention or behavioral issues only emerge in the teenage years or adulthood and cannot be traced back to before age 12, it is more likely that another condition is responsible rather than ADHD.
You might notice that your child struggles to focus on tasks, such as a workbook, even for a short period, despite your guidance. Or you may feel just as exhausted at the end of the day with your highly active 8-year-old as you did when they were a toddler.
Some children ask questions repeatedly, to the point where it feels unusual, or they may struggle with social cues that their peers are starting to understand—like respecting personal space or taking turns during conversations.
For parents, it can be challenging to determine whether these behaviors are simply part of normal development—“Many six-year-olds get bored with workbooks”—or if they indicate a deeper issue requiring structured boundaries. The key questions often are: Are these behaviors more severe than typical? Will they improve as your child grows, or might they signal ADHD or another underlying concern?
To diagnose ADHD, experts like the American Academy of Pediatrics (AAP) recommend examining a child’s behavior in more than just the home. This often includes gathering input from teachers or other school professionals.
Looking at behavior across two or more environments helps distinguish between normal developmental challenges—such as a “difficult” temperament or adjusting to a classroom setting—and ADHD. It also allows providers to determine whether the child’s symptoms are consistently interfering with their ability to function, which is a key factor in making an accurate diagnosis.
Understanding the medical terms used for ADHD can be confusing for parents. We rarely describe our children as having “hyperactive-impulsive problems”—we might simply wonder, “Why can’t they ever sit still?”
Over the years, the terminology used by doctors has changed. The term “ADD” (attention deficit disorder) was once common and typically referred to children with inattentive symptoms only. These children aren’t overly active, and their challenges may go unnoticed because their behavior isn’t disruptive.
Children who displayed hyperactivity were sometimes described as having ADD “with hyperactivity.” Today, all these cases fall under the broader diagnosis of ADHD, which is now divided into three subtypes: inattentive, hyperactive-impulsive, and combined. This change helps professionals better describe and address the different ways ADHD can present.
Many parents notice behaviors in their children that make them wonder if something more than typical childhood energy is at play. While all children occasionally struggle with focus or self-control, kids with ADHD display these patterns consistently and over long periods, often long after their peers have outgrown them.
For children with predominantly inattentive ADHD:
For children with predominantly hyperactive-impulsive ADHD:
Recognizing these patterns across time and settings can help parents understand whether their child may need further assessment for ADHD.
If you have concerns about your child’s school performance, social skills, behavior, or overall physical and mental development, be sure to discuss them with your child’s pediatrician. Early guidance and support can make a significant difference.
