Early Signs of ADHD in a 19-Month-Old? Looking for Other Parents’ Experiences

[OliviaKrof]

Hello,
My question is mainly for mothers of children with ADHD.
Our little boy is 1 year and 7 months old. After he turned one, he started becoming very strong-willed. He cries and has tantrums over the smallest things.
A week ago, we saw both a neurologist and a psychiatrist because he is a very difficult child to manage. He gets upset, cries, and becomes frustrated over very small things. For example, if we do not let him bang on a pot, open and slam the fridge door, or do similar things, he immediately has a tantrum.
I can usually calm him down fairly quickly by showing him something more interesting. He has also started hitting us, and sometimes he hits himself too, although only lightly. It seems more dramatic than an actual attempt to hurt himself.
Both the neurologist and the psychiatrist told us that they see some red flags for ADHD. He does not really play independently, and if he is offered more than one toy, he cannot keep his attention on one thing. He picks up one toy, then another, then goes back to something else, and so on. Sometimes he does become absorbed in play, but this happens very rarely.
He started walking at one year old. He had a slight delay in sitting independently and started crawling on all fours at 10 months. At the moment, however, there does not seem to be any developmental delay. He says words, understands a lot, and follows instructions. He has no sleep problems. He has a few sensory sensitivities, but nothing severe or clear enough to say that they are causing a problem.
What worries us is that we also see quite a few signs of hyperactivity, mainly the tantrums and the fact that when there is more than one stimulus, such as several toys or objects, he constantly switches from one to another and cannot stay focused.
What were the first symptoms you noticed in your children with ADHD? How long did the tantrum phase last, and were you able to calm them down? Did your children have any developmental delays?

He’s 19 months old. There are no markers for ADHD as behaviour is developmentally appropriate . You may have a strong willed child, but 19month olds are meant to be active, limited attention, struggle to listen and understand, no awareness of danger etc. I’m very surprised a neurologist and psychiatrist said that about your baby and I work in that field.

That’s true, but he really does seem different from other children. He is more easily agitated, and his movements are different too—very quick and abrupt. They only told us that they could see some red flags, but that a diagnosis could not be made until after the age of four.

He’s 19 months old!!
Sounds like a perfectly normal strong willed child - I too am amazed that any professional spoke to you this way?

I would focus on developing the tools you need as a parent to manage behaviour. Do you need advice about accessing services? I’m happy to help

All of this sounds very similar to my DS2 at the same age. He also hit other kids which was really stressful for me. He was a really tricky toddler, but is now a lovely teen, no sign of neurodivergence, doing well at school with lots of friends. Hopefully this is just a phase for your DS as well.

I don’t think you can actually get an adhd diagnosis until 7, at 4 it could just be typical development. ADHD looks different for each child, I wouldn’t say there was anything significant about his presentation now (context: parent of autistic/adhd children).

This is completely normal behaviour for a young toddler.

Kindly, I would look at the health of your own nervous system, before trying to pathologise your child.

You can really see a difference compared with other children. He does not even walk most of the time—he is always running. Sometimes he briefly walks on his tiptoes, which the neurologist said may be a form of sensory seeking.
Overall, this is not considered a major concern in his case, especially since they do not see clear signs of autism. He understands a lot, communicates both verbally and non-verbally, and follows everything I ask him to do.
His paediatrician noticed from the age of five months that he was extremely curious. He wants to touch and explore everything, and now this is even more noticeable. When we are in a shop, he wants everything he sees, and in most cases, even if you give him the thing he wants, he immediately wants something else. It just goes on and on, without him settling on one thing.

He seems very young to see both neuro and psych over tantrums.

Are you in the uk? Was this private care?

Some of what you’ve typed IME are early indicators of Autism.

The repetitive behaviours and sensory needs but are also very common in some babies.

I would say they are indicators alongside other signs. Have a look at MCAT.

Here in the U.K. they don’t normally (NHS) assess and diagnosed ADHD until 7yo as that’s when children have moved onto a higher degree of cognitive and emotional development and the differences can be put down to diagnosis of ND rather than delay of skills.

no. This is absolutely absurd. He’s 19 months. Fast entering terrible twos. There is nothing unusual in what you’ve described. At all.

I’d agree with this. Seeing a Neurologist and a Psychiatrist for a 17mth old who’s behaviour is entirely age appropriate suggests that you are either very anxious, or looking for a problem/ diagnosis. I’m very surprised either suggested red flags at this age - that really isn’t appropriate. You would be much better off speaking to your health visitor about behaviours and development, and how best to help your son’s development. Possibly speaking to your GP if you are over anxious. Even if your son eventually is diagnosed with ADHD, the best you can do for him is by supporting his general development at this early stage, and not over analysing/ pathologising every behaviour.

No, we are not in the UK. We have done the M-CHAT screening, and the result showed no risk.
Overall, he does not really display much stereotypical or repetitive behaviour. Both the neurologist and the psychiatrist were completely certain that he does not have autism.
He uses words with a clear purpose, points with his finger, shows us things, and actively seeks our attention. When he learns how to do something new, he calls us over to show us. He wants us to praise him, say “well done,” and clap for him.
He loves being around other children. He is comfortable stroking them, hugging them, and holding their hands. He even tries to get their attention by standing in front of them and looking in the same direction they are looking.

Completely agree. Toddlers are savage. They take no prisoners. They smell weakness. They do not negotiate.

stop looking for an excuse and start working on managing the behaviour. Particularly distracting before he kicks off. Always have food on you. Always. And a drink.

He sounds like a pretty normal 19 month old to me! It's very common to have tantrums when they're stopped from doing something they want to do. They are starting to assert their independence and obviously have no awareness of what dangers might result from slamming fridge doors etc. Going from toy to toy is pretty normal at this age, try giving one toy at a time so he's not overwhelmed with choices. Use distraction rather than saying no where you can. If he's having a tantrum, make sure he's safe and not near any sharp corners or anything, then ignore and don't fuel it, let it play out. Once the tantrum is over, just say cheerfully 'Oh have you finished? Shall we go in the garden/read a book/have some lunch now? The less attention you give him during a tantrum, the better. Give lots of attention when he's behaving well and praise him.

Try not to pathologist and focus on whether he may have ADHD or not - try and relax and have fun with him. He's still only a baby and he will do a lot of developing between now and when he's 4.

he's 19 months old, babies develop at different rates and have different personalities so it could just be the. Generally, ADHD diagnosis isn’t until age 6 as there’s so much variation before then. My 6 year old dd has been referred for both ADHD and ASD assessment.

I do see some similarities when she was your DS age, but also a huge amount more than what you’ve written. For example, you say you can distract DS when he tantrums with something more interesting, as a toddler my dd would melt down for a long time and not be distracted from it, she’d literally be on the floor shouting and crying for 30 mins before she’d calm down. She has always had issues with sleep which is one of the common ADHD traits. She takes hours to go to sleep and we’re tried everything over the years, she was the same as a baby and toddler. What you say about your DS is more in line with my friends children who are NT.

Did your child show any signs of ASD at that age? Were they talking, pointing, seeking attention, and so on?

I just wanted to add some personal context so it doesn't sounds like i am just being a dismissive arse. My ds as a toddler was strong willed, determined, independent, hard work, would be difficult if i did not do something he expected to happen. He was always FAR worse when hungry. My gran said he reminded her of my (company director level) uncle when he was a child. And a friend of mine used to say he would make an excellent businessman! I had him in different classes. Kept him busy and used energy in a focused, productive way. He even accidentally split my lip once when he came in to hug me too hard and fast. I also had him seen by a consultant and she said there was nothing wrong with him, it was normal behaviours and offered me parenting classes. I also had his ears tested at the hospital. Turns out he was ignoring me.

He is a teen now and not ND. Not at all. He is smart. He is focused.

Some toddlers bring new levels to ‘headstrong.’

You have to be joking . Why would you want to label a child that sounds like a pretty “normal “ toddler ?. ADHD could not be diagnosed until at least age 6 . Focus on learning parenting methods to deal with tantrums and bad behaviour.

This is bonkers. All kids are different. He might just be really active or have a certain personality type. Stop comparing and start living!

Please stop focusing on your child in this way. It’s unhealthy and is distracting you from looking for parenting strategies etc
You need to learn to parent your very normal sounding toddler, before you start looking for a diagnosis for their behaviour.

I see this all the time in my profession and it’s frustrating and sad in equal measure!

'Kindly, I would look at the health of your own nervous system, before trying to pathologise your child.'

Completely agree with this. I used to work with children of this age and you are describing a perfectly typical child. He's very active, he gets very frustrated when he can't have what he wants, his attention is single channelled, he's curious about his environment and seeking sensory input, he looks for adult reactions. He's a handful sometimes! He sounds like a lovely little boy who is developing just fine

I would be much more concerned about your anxiety and desperation to find a label / diagnosis for him

DD2 (now early 20s and diagnoses with ADHD) was also very emotional. She walked fairly early and was incredibly physical. She unzipped her sleeping bag and climbed out of her cot from 9 months. DD1 could not even do this at 2 years old. She also removed all gloves and socks in winter from the age of about 6 months and absolutely refused to wear socks or tights as a preschooler. One of her two preschools reported me to social services twice - once for not dressing her properly (not sure how they expected me to get socks on her when she just removed them) and again for having lots of bruises (bruising easily is common with ADHD. She wasn’t badly bruised anyway).

The other thing that was very notable was lack of sleep. She gave up her daytime naps at 9 months and from around that same age wanted to get up every day at 4am. To this day, she rarely seems or looks tired and doesn’t sleep very much. However, her morning wake up time did gradual shift to a more acceptable hour. She is now a student and regulatly gets up at 6am.

preschoolers are sometimes diagnosed but it is unusual.

This all sounds like my toddler (26 months) at the same age, and as far as I know, they are a typical two year old. Keep your little one physically busy at the park!

She showed some signs but she did point, communicate, seek attention. She had a very slight speech delay but mainly hit the milestones in her 2 year check. The main signs we saw were the huge meltdowns, sensory issues, took a long time to toilet train, very emotional, hit and kicked (over time we’ve managed to train her in to never doing this to her friends, but still does it to us when frustrated or overwhelmed). She’s ‘high functioning’ as in she goes to mainstream school and does well academically and is social, but has huge struggles in some areas.

I also think you're describing "normal" toddler behaviour and I am concerned about the ethics here:
"Both the neurologist and the psychiatrist told us that they see some red flags for ADHD"
Firstly in the term "red flag" and secondly that they are indicating a diagnosis directionally at this young age.

For context, I am a late (40s) diagnosed woman with ADHD with a toddler son. My son does lots of the things your son does but I understand that it is far too early to tell. Myself, I was an early walker, talker and reader and strong-willed but displayed no issues with attention span.

Either way, he needs sensory stimulationa and physical activity, good nutrition and sleep, and support to learn to self-regulate because he can't do that yet. Maybe focus on helping him with those things and, as PP say, manage your own anxiety.