ADHD or just normal kid behaviour?

[SparkleFly]

4.5 year old does all of the below and as he's my first child I don't know if this is how kids behave at this age or if it's possibly ADHD. I'm aware that you don't get referred for an assessment until they're 6 so at the moment I feel like I'm just getting bounced between school, GP, health worker and am still none the wiser. What do you think?

Symptoms are:

Talks non-stop

Is absolutely obsessed with cables and connecting things to cables. He is always 'wiring things up' with string and old cables at home.

Very inquisitive. Literally asks questions all the time about how things work.

Will randomly shout or scream. Nothing I say or do can get him to stop, it's like it's a compulsion that he can't control when he's a bit excited.

When he starts 'playing up' it's impossible to get him to calm down and again, nothing we say or do will get him to stop. Things like saying silly words, making words up and barking them at people to get a reaction, making silly noises. Doesn't seem to care about consequences when he's like this.

Gets frustrated easily and if he can't do something the first time (could literally be something like gluing something together), the whole thing gets chucked across the room and he screams and cries. It's incredibly hard to get him to calm down when he has these meltdowns.

His speech and language has always been very advanced and he's doing really well at school with everything. No outbursts, no silly behaviour, he's the model student apparently. Says he hates school though and it's a battle to get him to go in.

Anyone else been in this situation? Teacher doesn't see the same behaviour we do, and the gp and health worker just direct us to parenting classes.

Please help 🙏

Sorry meant to add that he has no sensory issues and is fine socially albeit quite excitable.

It's hard to say. People with ADHD tend to get hyperfocused on things but find it hard to focus on other things. Living with my DD is like living with Tigger (she has combined type). She moves to sooth and always has done. But 4 is very young and part of the issues is that children grow out of things.

The best thing to do is if he's getting silly is to take him away from the situation and not let him get a reaction. If he gets frustrated and melts down give him a few minutes for you and him to calm down and then have the chat about behaviour.

It sounds similar to my children's behaviour who were later diagnosed with ADHD.

You say no sensory issues but the shrieking and "playing up" sound like sensory seeking behaviours to me. I don't know whether you get support with sensory seeking behaviour even with a diagnosis (I'm not in the UK) so you might have to do your own reading there. I have heard The Connected Therapist and The Out of Sync Child are good resources, and on social media I like Occuplaytional Therapist and The OT Butterfly.

If you look up resources which explain Dunn's model of sensory processing you will see that there is an idea that in general people have a sensory profile so what you are probably thinking of as "sensory issues" will be a sensory avoidant profile whereas trying to get MORE attention/input/novelty etc is more of a sensory seeking profile. I do think the profiles can be a bit simplistic and not really explain everything but it's a starting point.

The other thing which has been really helpful for me is understanding what happens in the brain when they are dysregulated, which could be emotional dysregulation e.g. the getting really upset when something doesn't go right, or dysregulation based on an unmet need e.g. my DC tend not to be very aware of whether they are hungry, thirsty, need the toilet, too hot/cold etc (that's called poor interoception if you want to look up strategies) or something sensory based so on the one hand with children who are sensory avoidant it could be overwhelm due to too much going on around them, for a sensory seeking child it can be that the stimulation around them is too little so they are looking to get more somehow. And a child who is sensory seeking plus doesn't know how to rest when they are tired can be a bit of a self-destructive loop.

When children are dysregulated they are more in the lower/primitive part of the brain (the limbic system which runs on emotion, memories and instinct) rather than the prefrontal cortex (which is the sensible bit, or the "self control" circuitry if you like, that allows us to forsee consequences, consider others, and make proactive decisions).

Young children do have less development in the prefrontal cortex anyway so this is normal to an extent, but with ADHD you see this happening even more slowly. Children with ADHD have approx a 20-30% delay in PFC development. So an ADHD child who is 4.5 may show emotional regulation and self-control closer to a typical 3yo than their own peers. Of course because there is a range of normal the difference isn't that great there and you might struggle to get anyone to assess at age 4 for that reason. But if you keep this as a rule of thumb IME you can see it yourself, and it can help with your own expectations and approaches.

If you want to learn more about dysregulation, Dan Siegel has a great model called Upstairs/Downstairs brain. Your school may also use a system which touches on regulation for their Social-Emotional Learning curriculum (you could ask them if there is any programme they follow to support children with emotional regulation skills, because it would help to find matching resources and language to help your child at home.) Zones of Regulation is commonly used in schools for example. Or you could look at the books by Mona Delahooke, or the best one I have found personally is Big Baffling Behaviours by Robyn Gobbel. That one uses animals so they call the sensible part the "Wise Owl Brain" and the silly or argumentative part the "Watchdog Brain" and then an emotional/ withdrawn response is the "Possum Brain".

All of the resources I've mentioned are non-ADHD-specific and I have found them useful.

I would also look into encouraging the interest in electronics in a safe way - maybe some circuitry kits he can play around and experiment with?

@BertieBotts thanks for your very comprehensive reply! 🙏 I'd never thought about it being a sensory seeking thing before, it does seem that way.

He does have wet accidents every day as he says he doesn't know he needs to go, but I've been thinking he is just too into what he's doing that he doesn't want to stop and go for a wee. I'm talking a slight leak, not full-on wetting himself.

He also wakes up in a bad mood most days and I've often wondered if he's waking up thirsty, or with a headache or something as he sleeps really well. It's not a great start to the day 🙁

I will do a bit of googling now based on your references, thanks.

Yes - for things like not realising they need to go to the toilet, drink etc until it's too late we just do a lot of prompting. Both 3yo and 6yo have "try for at least 5 mins for a poo" as part of their bedtime routine, initially because the 3yo would save his poos until he had his overnight nappy on, and then when we got rid of that he just wouldn't poo at all. But it's been helpful for both of them. And also counting to 10 when trying for a wee otherwise they would stand there for 2 seconds and then say they didn't need one.

Wees we prompt before things like leaving the house or before starting an activity which will suck in all their attention, like computer games. We try to have bottles of water available at all times which is a bit annoying but does seem to help them drink, and offer snacks little and often or I might be prompted to offer them a more enticing drink/snack if I notice that they are starting to show some of the lower level dysregulation type behaviours and I clock that I've forgotten to give them their bottles or the bottles look full or it's been a while since the last meal.

Thanks @BertieBotts all good advice there.