ADHD? - school says no

[Maidmummy]

DS is 4 and currently in nursery doing 3 hours a day 5 days a week. I've been worried about his behaviour for the last couple of years, I've been on the NHS website and he displays all the classic signs of ADHD, he can't follow instructions, he's very energetic and hyperactive, he constantly disrupts people's conversations, the second something goes wrong for him he screams like a banshee crying and jumping up and down on the spot, he won't concentrate on one thing for more than 2 minutes, he'll go from watching his tablet to 5 seconds later rugby tackling his sister to the floor, he has zero sense of danger the list goes on and on with him yet I've spoke to school this morning and his teacher says she hasn't noticed anything like that to put him on their pathway or any concerning behaviour that warrants more investigations the only thing she's noticed is he needs more help with writing and a few other things but she didn't say what they were.

She's going to give me a call later in the week to have a better discussion about it but if she's saying his behaviour is normal at school and he follows their routines then I have no hope of having him seen by his GP. They only have a 3 hour snippet a day of DS so they don't see the full extent of what he's like. At home it's like walking around on eggshells with him waiting for that little thing to set him off and once he's off I can't control him, every day he's getting harder and harder to cope with 😔

Is it possible for him to have ADHD but not present at school?

Children with ADHD are unable to mask it. They simply cannot control their behaviour. For a diagnosis, they need to display the behaviour both at home, and in a school setting.

A lot of the things you've described are present in a lot of 4 year olds. Many will grow out of these symptoms, some will not.

If he is behaving at school, maybe he likes the routine and structure there? Do you have structure at home?

Yes it is possible. But often the signs of these conditions have to show up in more than one setting (school/home/social/childcare...) before they trigger a referral. He is only 4 and there is a very wide range of normal at 4, so if the "structure" of school suits him then to the teacher he really may just seem like a lively boy. It is quite possible that in a couple of years' time the school will start to see the problems too - I know that at DS's school there were two stages when teachers looked out for ADHD and other problems, one when chidren first arrived and another around 7/8 years.

There are two things to think about. There is getting an ADHD assessment, which is a long game. And there is getting some support for parenting your DS in the here and now. You can go to the GP, describe his behaviour and ask for help. You might not get a referral for assessment especially if the school are not seeing a problem, but you might get pointed at a parenting group or similar support, which may or may not help. Stick with it because if it doesn't help then that it is one more piece of evidence that your DS needs the referral and then you can go back to the GP.

My DD was very similar. She was at a nursery rather than pre-school. It probably had less structure than a pre-school and she was happy there so the staff never noticed any issues. She fell apart in foundation. I got our GP to refer her for ADHD diagnosis at 6. Turned out to be ASD. I do know some other children who were a real handful who just grew out of it. Worth seeking advice as a PP mentioned as this will add to your evidence if it doesn’t resolve itself with time and maturity.

Just FYI CAMHS won't assess for adhd until he's 6 unless it's a really really extreme case. This is because of what PPs have said about normal developmental ranges.

I'm absolutely sure that you're right and preschool haven't clocked it / he's holding it together within the structure at the moment. You may just need to wait and in the mean time you can support him at home using strategies you can Google.

It difficult at this age, as much that you have described can be age appropriate. However, if you think that "something is not quite right", by your description of his behaviours it could be autism rather than ADHD as a previous poster suggested. Children with ADHD, while impulsive and lack general concentration also tend to be able to concentrate for long periods of time on subjects of interest.

My dd2 is like this - much worse at home.
I think it's because tiredness from school contributes.
Maybe mine is just very strong willed, also dc1 is difficult too so lots of arguments between them.

Also dc2 is worse if uncontained so out walking etc which they dont do at school she is crossing road etc.