The summertime is a wonderful time to help your child learn how to write sentences and paragraphs, which follow a logical sequence and include interesting details.

Children typically need to be encouraged to write. Students who believe they have interesting ideas and can write well generally develop their written language skills at a faster rate.

The initial step in helping your child to develop their written language paragraph writing skills is to ask your child to examine and study a picture you choose for them. Most written language assignments will include a picture to write about at the elementary and middle school level.

Spark Ideas

Ask your child the question, “What do you see in the picture?” Then ask, “What is happening in the picture?” Then ask your child, “What can you say about what is happening in the picture?” As your child answers your questions orally write down some of their answers on a scratch piece of paper. Next, go over their answers with your child and talk about their perceptions of the picture. If your child added details that are not in the picture, then nicely point out which details do not fit the picture.

Help Getting Started

Next, show your son or daughter how to write a quality opening sentence that describes the picture on their assignment. Numerous students with learning issues or those who struggle in school do not always understand how to write an excellent opening sentence. Talk about the opening sentence with your child and prompt them to study what is happening in the picture for a minute or two.

Instruct your child to include the main idea of the picture in their opening sentence.

The Middle

Ask your child to focus their middle sentences on two or three main ideas or details found in the assigned picture. The middle sentences can be made more interesting if they include a cause and effect or “because statement”. Often children can say the sentences orally better then they can write them.

Hint: If writing is a difficult area ask your child verbally to tell you the detail and stop them and say the detail back to them as they write it.

Tools

Use a thesaurus to help them locate two or three strong nouns or verbs, which can replace the more common ones they used.

Next, the student may wish to add a detail sentence or two about the sentences they have already written. Aim for five to seven sentence paragraphs and in some cases nine sentences.

The Ending

Lastly, ask your child to close the paragraph with a good sentence that answers the why or restates the opening sentence. Some students may wish to make a prediction about the subject of the paragraph in their closing sentence.

Parents it is important to complement your child on their effort and reread their paragraph with them for clarity.

If sequencing changes should be made, then nicely point out why the order should be different.

Thanks for joining me this past week on DrGreene.com. I wish to complement all the readers of my posts for your diligence in researching information to help your child reach their scholastic potential.  May you have a happy, fun-filled, educational summer with your children.

Grammar game time can help students enjoy learning grammar concepts they will use throughout their journey to be educated. Short grammar games can help students master grammar concepts during the summer while they are having fun.

Parents, when students, whether they are Dyslexic, ADD, ADHD, struggling, or average students are having fun learning they typically are absorbing more information at faster rates.

When children become active learners, they also become more excited about learning. A fun way to teach and reinforce grammar concepts is by playing the following grammar game a few minutes several times a week.

“Name It” Game Makes Nouns Fun

Pick two or three objects such as a soft ball, spring flower or objects you or your child chooses. Next, you need a small white board and erasable markers. If you do not have a white board plain paper, and a washable marker is fine.

Ask your child to look at each of the items one by one. As your child studies each item ask them, the name of the item and write the name of the item on the white board. Then write the word noun after the name of the item. Next, ask your child to tell you three describing words about the item. Allow only one describing word to describe the color of the object.

Then write the three describing words under the name of the item on the white board. Label the three describing words adjectives.

Adjectives and Verbs

If your child wishes to name more describing words, you can make another game out of how many adjectives they can come up with to describe the object.

Next, ask your child to name two or three uses for the objects you are describing. As an example of this, if your child is describing a soft ball, three uses can be throwing, catching and hitting. Label the two or three uses for the object as verbs.

Adverbs and Prepositions, Too

In a few minutes, your child can practice nouns, adjectives and verbs. As your child masters nouns, adjectives and verbs then add adverbs to the game. Ask the child to name three adverbs that modify the verbs and in some cases adjectives and clauses. Remind the child adverbs describe the verb’s action.

Next, teach prepositions such as: in, on, over, about, above, across, after, around, for, past by helping the child list several of them that apply to the nouns, adjectives, verbs and adverbs they have on their white board.

Children who are Dyslexic, ADD, ADHD, struggling or average students usually really enjoy learning grammar when they play grammar games. 

Summertime is an ideal time to reinforce the past grade math concepts and pre-teach upcoming grade math concepts. Dyslexic, ADD, ADHD, struggling or average students can improve their math skills and be more prepared for the next school year by working on math during the summer.

As children enjoy summer days, math skills can grow at an accelerated rate. Parents set aside fifteen to twenty minutes a day to work on math concepts, and the addition, subtraction, multiplication and division facts with your child. Everyday provide your child with ten to twenty math facts depending on their upcoming grade level to work on learning and retrieving at a faster rate.

Students who are going into third grade through middle school should work on all four categories listed above. Remind your son or daughter the best math students are the ones who know the math facts.

Make It Fun

Create a contest for your child to see how fast they are able to complete ten to twenty math facts either on paper or using flash cards.  Time your student on how long it takes him or her to complete the ten to twenty math facts correctly. Afterwards record the time in a calendar and encourage your child to beat their pervious time each day.

When your child knows each of the ten to twenty math facts within two seconds then change the facts. Parents you can purchase a math facts workbook at a teacher supply store. Cut the pages in the workbook into thirds or fourths for your child to complete each day.

Summer Time is a Great Time for Review 

Parents of younger school-age students, please review addition and subtraction with carrying and borrowing during the months of summer. If your child is in the third, fourth or fifth grade, then review two, three and four-digit multiplication and long division problems with them.

Write out four to six problems with carrying, borrowing, several digit multiplication or long division on a white board for your child to do each day. Review the steps for addition and carrying with your child using washable markers to demonstrate the steps on a white board. Then ask your child to repeat the steps orally to you each day as they work the math problems.

Students should alternate every other day the steps for addition and carrying and subtraction with borrowing. This will help students be able to retain the regrouping steps and perform them at a higher scholastic level.

Older elementary or early middle school students should review the steps of several digit multiplication and long division on a white board. Ask the child to use different color erasable markers for each math step. The use of different colors for each step provides children with a visual review of the steps needed to perform the mathematical operations.

Begin the daily math reviews as soon as the school year comes to a close.  Dyslexic, ADD, ADHD, struggling and average students with math issues can improve their skills while having fun learning.

Parents what are some creative ways you have used to help your child learn the math facts?

Here’s some great summertime news — Dyslexic, ADD, ADHD, struggling or average children can learn to be better spellers during the summer months. Here’s how:

Each week of the summer children should have a spelling list consisting of eight to twelve words. Make the word lists using phonetic rules such as the short vowels, ee, ea, au, aw, oy, oi, and two sight words your child is unable to spell.

Some suggestions for sight words this month are: there, their, they’re, where, would, should and could. Some younger students may wish to learn: are, air, care, only, over, upon was, wear, said, been, and ready.                                                                                          

Practice Makes Perfect

Provide time for your child to practice the word lists on a small white board or large paper. Children generally like writing their spelling words on a white board or large paper. Next, analyze the written words with your child to help your son or daughter see patterns or categories, which the words fit into. An example of how to do this is, ask your son or daughter to place all igh words in a list, all of ite words in another list and so on.

Spend time helping your son or daughter memorize the word patterns or commonalities found in the weekly spelling list.  Also, place the weekly spelling words on cards written in colors. Use one color for the vowel rules and other colors for consonants.

While looking at the words on the cards, ask your son or daughter orally to spell the words using a rhythmic beat. Chant the words with your child in a set of four repetitions. Make sure you concentrate on spelling one word to a rhythmic beat four times before moving on to the next word to be learned. Adding a rhythmic beat to oral spelling review time helps increase the brain’s ability to retain information.

Learning Tricks

Next, ask your child to write the spelling words inside an outline of a picture such as a soccer ball, baseball, flower or ballerina shoes drawn by you or found online. Your son or daughter should write the words at least four to six times a piece or type them if writing is difficult.

The words can be easily reviewed by chanting them when extra time arises and before bedtime. If the word lists are too long for your child to learn all at once, then help your son or daughter learn partial lists.

Every Little Bit Helps    

The word lists should be divided and learned in sets of four to six words at a time. Then add the next set of four to six words to the list which has been learned. Learning the entire weekly spelling lists may take several days to accomplish. The rate you are able to add sets of four to six words will depend on your son’s or daughter’s ability to retain spelling patterns.

ADHD and Spelling  

For more active children ask them to add movements while spelling the words orally, on paper or on a white board. Some of you parents may even wish to have your son or daughter verbally practice spelling while playing a game of catch if it is not too distracting.

Every parent wants their child to be healthy.  One of the biggest barriers to this today is the fact they are born on planet Earth.  We humans have polluted this planet to such an extent that every baby born today almost certainly has more than one thousand (more likely many thousands) man-made chemicals in its body.  We have no idea what most of these chemicals can do to the developing fetus, much less what sort of combined effects they may exert in combination.

These chemicals include pesticides, solvents, herbicides, formaldehyde, fragrances, styrofoam (styrene), phthalates, flame retardants, plasticizers, PCB’s, PBDE’s, PFC’s and the list goes on.  Most parents and expectant parents are unaware of the problem and its potential for adverse health effects in themselves, much less in their baby or developing fetus.

Some awareness of this problem is reaching the public in recent years, but only as a series of isolated problems that can be easily dismissed as uncommon or of little importance by themselves.  One example of progress is recent research showing increased risk of ADHD with higher levels of organophosphate pesticides in their blood or urine.  The American Academy of Pediatrics recently stated publicly that because of this and other noted adverse effects of pesticides, we should try to make sure our children are not exposed to pesticides.  Agreed; but how do we do that?

The problem is much larger than pesticides, or any other single type or category of chemicals.  It is the mass of exposures taken together as a whole.  It is what we refer to as the “total load” phenomenon in environmental medicine.  We use the concept of a rain barrel to depict the diverse toxins going into us from our environment.  This includes man-made chemicals, naturally occurring toxins, heavy metals, electromagnetic radiation, excess sugar, psychological stress and everything else that is bad for us.  Eventually that rain barrel can overflow and manifest as some sort of chronic illness condition, or multiple apparent conditions.

This is one general cause behind the massive increases we are seeing in neurological and neuropsychiatric problems in our young children today.  Conditions like autism and related disorders have skyrocketed in incidence over the last generation, and will likely continue to rise.  ADHD and other conditions requiring special education are rising dramatically in our schools as well, and it’s not just because we are looking for them.  It seems that more children are having seizures, mood disorders and cancers; and the environment is a major cause of this collective epidemic.

The purpose or theme of my guest blog series is to alert parents and expectant parents to the presence of some of the more common and avoidable environmental toxins, to point out their sources, discuss their health effects, offer strategies for avoidance, discuss means of toxin elimination, and encourage readers to help move public policy more toward the interests of human health in this regard.

[Re-source-ful-ness, adj. looking at other student’s papers; asks lots of questions; blurts out answers before their called upon; impatiently takes matters into their own hands.]

When I was in special education growing up, my greatest desire was to be normal. Being looked upon as different by teachers and students hurt me a great deal. I knew my mom loved me no matter what, but her opinion of me wasn’t enough to counteract everyone else’s. Teachers seemed to talk to me differently from how they talked to “normal” students. At least, that was my perception. I stood out and became a target for kids to tease and harass. After years of putting up with this, my single goal in life was to get out of special education and get into the mainstream classes.

Unfortunately, my solution was not a good one. I became a cheater. I couldn’t understand and retain the information that I was being taught (learning disabilities + ADHD = double whammy). Let me explain. Being a good people person (most ADHD people are) I became a resourceful little kid. I bugged all of my classmates for answers and help to problems I didn’t understand. Before each test I would collect as much information as possible and put it on cheat sheets. This was a great plan until I finally got caught. I think my teacher was superman or at least he had x-ray vision. How he saw my cheat sheet, I’ll never know. It was such a tiny piece of paper. Would you believe only 2”x2”? Plus, I hid it up my shirt sleeve. This was a technique I had used countless times. When I got caught I prepared myself for the worst, but instead, my teacher saw it as a teachable moment and took full advantage of it.

He was extremely impressed that I got so much information on the tiny piece of paper. So, instead of reprimanding me or talking to my parents, he started asking me questions that were on the test. I actually knew the answers without the aid of my cheat sheet. My teacher recognized that in the process of composing it, I ended up learning everything that was on it. From that point on, he required me to write up a “study sheet”, instead of a cheat sheet, and turn it in before every test. My resourcefulness enabled me to discover a study tool that was invaluable in learning the information I needed to pass my tests.

The point is that being different, and having to survive, means that people with ADHD learn how to be resourceful early on. I believe this gives us a distinct advantage over our peers to whom many thing come easily. While, as you saw from my story, sometimes this resourcefulness does not express itself in the best way, it is important that you recognize it for what it is and find ways to encourage it while steering your child to make wise choices.

If you had it to do over again, would you still give ADHD drugs to your child? About half of parents (52 percent) felt strongly that they would, according to a July 2010 survey of the parents of almost a thousand kids by Consumer Reports Health. About half (44 percent) strongly wished that there was another way to help their child besides the medication.

More parents were highly satisfied with the medication (41 percent) than felt strongly that they were concerned by the side effects of the medication (32 percent).But clearly this is a balancing act between benefits and costs.

What other strategies did parents report helped a lot?

• Changing schools to one better suited to help with ADHD (45 percent)
• Giving one instruction at a time (39 percent)
• Using a tutor or learning specialist (37 percent)
• Providing structure and schedules (35 percent)
• And seven other strategies, from changing class seats to taking fish-oil pills (12 to 27 percent)

An important key to managing ADHD is to set specific, measurable goals at home and at school. Then, when you try an intervention you can monitor progress, evaluate the treatment, and readjust the plan.

If you are considering ADHD medications, read this important brief post about long-term success and permanent side effects.

To me, the role of medications is not to “solve” ADHD, but rather one possible way to provide a window of relief and focus for a year or two in which to pursue lifestyle changes that can make a long-term difference. These might include changes in nutrition, in physical activity, in sleep, in chemical exposures, in peer groups, in study strategies, in parenting strategies, and in school environments.

Related concepts:

Attention Deficit Disorder, ADD, Hyperactivity

Introduction to ADHD:

Over-diagnosed? Under-diagnosed? Probably both – and certainly real. ADHD affects children’s school performance and their relationships with others. Parents who are wondering if their children have ADHD are often exhausted and frustrated.

What is ADHD?

ADHD is a problem with inattentiveness, over-activity, impulsivity, or some combination of these. Scientific studies, using advanced neuroimaging techniques of brain structure and function, show that the brains of children with ADHD are different from those of other children. These children handle neurotransmitters (including dopamine, serotonin, and/or adrenalin) differently from their peers.

While we still don’t know exactly what causes ADHD, it appears that it is often genetic. Whatever the specific cause may be, it seems to be set in motion very early in life as the brain is developing. Other problems, such as depression, sleep deprivation, specific learning disabilities, tic disorders, and oppositional/aggressive behavior problems, may be confused with or appear along with ADHD. Every child suspected of having ADHD deserves a careful evaluation to sort out exactly what is contributing to his concerning behaviors.

Who gets ADHD?

There is a lot of controversy surrounding the actual number of children with ADHD. The Diagnostic and Statistical Manual (DSM-IV) suggests that it occurs in 3 to 5 percent of all children. Other estimates are far higher or lower. It is diagnosed much more often in boys than in girls.

Most children with ADHD also have at least one other developmental or behavioral problem.

What are the symptoms of ADHD?

The Diagnostic and Statistical Manual (DSM-IV) divides the symptoms of ADHD into those of inattentiveness and those of hyperactivity/impulsivity.

Inattention

1. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
2. Often has difficulty sustaining attention in tasks or play activities
3. Often does not seem to listen when spoken to directly
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
5. Often has difficulty organizing tasks and activities
6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
7. Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
8. Is often easily distracted by extraneous stimuli
9. Is often forgetful in daily activities

Hyperactivity

1. Often fidgets with hands or feet or squirms in seat
2. Often leaves seat in classroom or in other situations in which remaining seated is expected
3. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
4. Often has difficulty playing or engaging in leisure activities quietly
5. Is often “on the go” or often acts as if “driven by a motor”.
6. Often talks excessively.

Impulsivity

1. Often blurts out answers before questions have been completed
2. Often has difficulty awaiting turn
3. Often interrupts or intrudes on others (e.g., butts into conversations or games)

Is ADHD contagious?

No

How long does ADHD last?

ADHD is a long-term, chronic condition. About half of the children with ADHD will continue to have troublesome symptoms of inattention or impulsivity as adults. However, for many children, the symptoms of ADHD may improve with time.

How is ADHD diagnosed?

Too often, difficult children are incorrectly labeled with ADHD. Some of these children may actually have other mental illnesses or learning difficulties that are not being appropriately managed.

Others may be unfairly judged based on their age.  Recent studies show that children who are young relative to the other children in their class are much more likely to be labeled as having ADHD than children who are older than their classmates. (Journal of Health Economics 29 (2010) 657–673)

On the other hand, many children who do have ADHD remain undiagnosed. In either case, related learning disabilities or mood problems are often missed. The American Academy of Pediatrics (AAP) has issued guidelines to bring more clarity to this issue.

The diagnosis is based on very specific symptoms, which must be present in more than one setting (including at school). Every evaluation should include a search for possible additional conditions including conduct disorder, oppositional defiant disorder, mood disorders/depression, anxiety, and learning disabilities.

To be diagnosed with ADHD, children should have at least 6 of the attention symptoms or 6 of the activity/impulsivity symptoms listed in the DSM-IV. They must display these to a degree beyond what would be expected for children their age.

The symptoms must be present for at least 6 months, observable in 2 or more settings, and not caused by another problem. The symptoms must be severe enough to cause significant difficulties. Some defining symptoms must be present before age 7.

Older children who still have symptoms but no longer meet the full definition have ADHD in partial remission.

Some children with ADHD primarily have the Inattentive Type, some the Hyperactive-Impulsive Type, and some the Combined Type. Those with the Inattentive type are less disruptive and are easier to miss being diagnosed with ADHD.

How is ADHD treated?

The American Academy of Pediatrics (AAP) has developed evidence-based guidelines for the treatment of ADHD:

• ADHD is a chronic condition and must be treated as such.
• It is important to set specific, appropriate target goals to guide therapy.
• Medication and/or behavior therapy should be started.
• When treatment has not met the target goals, it is important to evaluate the original diagnosis, the possible presence of other conditions, how well the treatment plan has been implemented, and the use of all appropriate treatments.
• Systematic follow-up for the child with ADHD is important to regularly reassess target goals, results, and any adverse effects of medications. Information should be gathered from parents, teachers, and the child.

ADHD is a frustrating problem. A number of alternative remedies have become quite popular, including herbs and supplements, chiropractic manipulation, and dietary changes. While there is evidence suggesting the value of a healthy, varied diet, with plenty of fiber and other basic nutrients (the diet that would be best for most children), there is little or no solid evidence for many remedies that are marketed to parents. The most promising specific nutritional actions include getting adequate iron and omega 3 fats in the diet, and possibly avoiding certain artificial dyes and chemical preservatives. Adequate sleep has been proven to help ADHD symptoms.

Children who receive both behavioral treatment and medication often do the best. Medications should not be used just to make life easier for the parents or the school. There are now several different classes of ADHD medications that may be used alone or in combination.

How can ADHD be prevented?

New links are being discovered between ADHD and environmental triggers. Avoiding prenatal tobacco, lead, or organophosphate pesticide exposure, for instance, has been linked with lower rates of ADHD. Minimizing unnecessary exposure to known neurotoxins and maximizing healthy food and sleep may prevent ADHD, but this has yet to be proven.

Early identification and treatment can prevent many of the problems associated with ADHD.

Related A-to-Z Information:

Depression, Enuresis (Bed-wetting), Sleep Apnea, Tourette’s Syndrome, Tonsillitis

Dr. Greene’s Answer:

After a long day in the office, when I would be ready to wind down with a quiet evening, my youngest son, almost 3, is switching on his turbo jets! Together, as Batman and Robin, we race around the house chasing imaginary villains. We catch up with them, tie them up, untie them, and sprint again more times than I can count. Sometimes we get tied up, and Mommy rescues us. In between we jump on Casper, his broomstick Bat Horse, and gallop around the town to say “Hi!” to the pirates. When we pass the basketball hoop, we pause ever so briefly to play a game of basketball, before zipping outside to hit some baseballs and run. A dash to the front yard to throw rocks and play hockey, then back inside for Batman and Robin to make a tunnel and hide, vibrating with excitement, for Mommy to find.

Where does he get that boundless energy?

When a toddler enters that stage of zest and fascination, it’s almost a parental rite of passage to discover this force of nature, as if for the first time, and remark, “If only we could bottle that energy and sell it, we would be rich!” or “I could sure use a transfusion of his energy (and he could stand a little less),” or “Youth is wasted on the young!”

A three-year-old’s normal fountain of energy delights and exhausts, and sometimes frustrates and worries, modern-day parents. Perhaps our world doesn’t accommodate this explosion of energy as well as the pioneer or farming days of old might have. Today, we hear about the medical condition called Attention Deficit Hyperactivity Disorder (ADD or ADHD), and wonder if our children might be hyperactive. By age 4, about 40 percent of children act in a way that makes their parents and teachers concerned about ADD (Developmental and Behavioral Pediatrics, 6, 339-348, 1985).

Some people are very tall, some are short, but most are of average height or close to it. As with most things in life, something of a bell-shaped curve also applies when it comes to toddler energy levels. There is a normal, average period of extreme energy that lasts about a year and often includes the 3rd birthday. This phase in normal children actually fits the official definition of ADHD.

There are several good, “official” definitions of ADHD, but I find the definition in the DSM-IV the most useful (Diagnostic and Statistical Manual of Mental Disorders, 4th edition). This definition differentiates symptoms into two categories: “Inattention” and “Hyperactivity-Impulsivity.” Children with a diagnosis of ADHD should meet A-E of the criteria below:

A. Either 1 or 2:

1. Six or more of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

• a. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
• b. Often has difficulty sustaining attention in tasks or play activities
• c. Often does not seem to listen when spoken to directly
• d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
• e. Often has difficulty organizing tasks and activities
• f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as homework)
• g. Often loses things necessary for tasks or activities (toys, school assignments, pencils, books, or tools)
• h. Is often easily distracted by extraneous stimuli
• i. Is often forgetful in daily activities

2. Six or more of the following symptoms of hyperactivity- impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity

• a. Often fidgets with hands or feet or squirms in seat
• b. Often leaves seat in classroom or in other situations in which remaining seated is expected
• c. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
• d. Often has difficulty playing or engaging in leisure activities quietly
• e. Is often “on the go” or often acts as if “driven by a motor”
• f. Often talks excessively
  Impulsivity
• g. Often blurts out answers before questions have been completed
• h. Often has difficulty awaiting turn
• i. Often interrupts or intrudes on others (such as butting into conversations or games)

B. Some hyperactive, impulsive, or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (such as in school or work and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or another psychotic disorder and are not better accounted for by another mental disorder (such as a mood, anxiety, dissociative, or personality disorder).

Children meet the criteria for “ADHD, Predominantly Inattentive Type” when they have met inattention criteria (section A1) for the past 6 months. They meet criteria for “ADHD, Predominantly Hyperactive-Impulsive Type” when they have met hyperactive-impulsive criteria (section A2) for the past 6 months. When a child meets criteria for both section A1 and A2 for the past six months, he/she meets the criteria for “ADHD, Combined Type.” Now, parents who have tried to take a 3-year-old out for a leisurely dinner in a quiet restaurant (especially with other adults whose opinions they value) can quickly learn that normal children at this age can exhibit all of these behaviors.

Perhaps a good way to tell whether a child’s development is normal would be to ask his daycare providers, preschool teachers, or religious teachers. These adults see at close range a larger sampling of children. If your child is more active, more restless, less attentive, and more impulsive than the rest of the class, then he might have ADHD. However, ADHD is a very difficult diagnosis to make in children younger than school-age.

Less than half of those actually diagnosed with ADHD at age three, and only 10 percent of those who concern their early teachers, will be the ones who turn out to have ADHD in the long run (Journal of Child Psychology and Psychiatry, Sep 1990). The toddler full-tilt exuberance usually gives way to the dawning self-control of a preschooler at about age four. Different children go through this energetic stage at different ages. Those who still fit the criteria for ADHD at age 4, though, have a greater chance of truly having ADHD.

There is still no reliable way to make the diagnosis of ADHD in a 3-year-old. Researchers are only now beginning to look into how to properly make the diagnosis in these younger children (Journal of Developmental and Behavioral Pediatrics: Feb 2002, 23(0), S1-S9)

Thus, I would be more concerned about problems of social interactions with peers than with a short attention span, more concerned with those for whom it is difficult to obtain a babysitter than with those who are always on the go, and more concerned with those who consistently disrupt other children’s play than with those who fail to listen.

This afternoon, we took our almost 3-year-old son to a community theater production of Big River. He sat fairly still and fairly quietly through the first act. His whole body danced with each musical number on stage. During intermission, several friendly onlookers commented on his energy and enthusiasm. He charmed them with his smile. By the end of intermission, though, it became clear that the time to end his first theater experience on a positive note had arrived. So we went outside for a walk and to play golf on the sidewalk. As much energy as it takes to keep up with him, I shall dearly miss these days when they are over.