Is My Toddler Displaying Normal Temperament, ADHD, or Another Mental Health Condition?

Normal (Neurotypical) Toddlers

The most common misdiagnosis of ADHD is actually due to normal temperament. At times, all toddlers will demonstrate behaviors associated with ADHD- irritability, aggression, hyperactivity, impulsivity, and inattention.

For example, a two-year-old child should only be able to hold attention to an activity for three to six minutes- not fifteen! A three-year-old will inevitably tantrum over something less severe than a seven-year-old would tantrum over. We don’t want to mistake either of these things for ADHD in two and three-year-old children. 

Overlapping Symptoms: ADHD and Autism Spectrum Disorder (ASD)

Autism spectrum disorders and ADHD have some overlapping symptoms in this age range. They both tend to struggle with things such as but not limited to: transitions, inflexible thought patterns, excessive meltdowns, social skill deficits, and wandering-off behaviors (which can be very dangerous).

The same symptoms all have some similarities and differences within each disorder. For example , ASD kids typically struggle with social skills because they don’t understand how to read facial expressions, they have a lack of imaginative play, reduced sharing of experiences, etc. Kids with ADHD lack in social skills more so because of their impulse control issues.

Overlapping Symptoms: ADHD and Bipolar Disorder

In this particular age range, juvenile-onset bipolar disorder and ADHD also have some co-occurring symptoms. They both can involve excessive tantrums, difficulty sleeping, stealing, defiant behavior, over-excitability, destructive behavior, unfocussed behavior, and irritability.

The tantrums typically have different origins in each disorder. A child with bipolar disorder may tantrum when a simple limit is set. “No, you can’t have more ice cream.” A toddler with ADHD may tantrum over this, but these children tend to tantrum more so over overstimulation and emotionality. Toddlers with bipolar disorder may tantrum and remain in that state for up to one to four hours, whereas a toddler with ADHD typically recovers within thirty minutes.

The other co-occurring symptoms in the two disorders also have some differences in origin and/or expression. The two disorders also have some very distinct features as well; for example, ADHD is more choric and bipolar disorder is more episodic.

Overlapping Symptoms: ADHD and Oppositional Defiant Disorder (ODD)

ADHD and Oppositional Defiant Disorder can have co-occurring symptoms too. Both disorders can present with an irritable disposition. These children struggle to follow directions, and they use undesirable behaviors.

It’s critical to notice if the child struggles to follow directions during transitional periods, when suffering from sensory overload, or when sustained attention is expected; these children most likely have ADHD but will present as ODD instead.

When children with ODD and ADHD use undesirable behaviors, it’s important to note that ODD kids typically present as more vindictive in nature. A child with ADHD is typically just lacking impulse control and uses negative behaviors without the direct intent to use negative behaviors.

Other Overlapping Symptoms with ADHD

Other disorders will present with some of the same symptoms as ADHD too, such as anxiety and depression. It’s also important to note that children with ADHD have a higher chance of developing anxiety disorders and depression- and if they do not develop actual disorders, they possibly have symptoms of anxiety and/or depression.

Because ADHD can also co-occur with the other disorders mentioned in this article, it’s challenging to discern if the child’s behavior is coming from normal temperament, ADHD, a different mental health condition, or ADHD in addition to another mental health condition. That’s why it’s crucial to have a mental health clinician evaluate the child.

Published on: June 19, 2014
About the Author
Photo of Donna Mac

Donna is the author of Toddlers & ADHD: Relief for Parents, A Guide for Clinicians and Teachers . She has a background in early childhood developmental psychology and has worked professionally with ADHD as a teacher, as a nature-based summer camp director, and currently as a licensed clinical therapist.

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Recent Comments

My 23 month old granddaughter is constantly having meltdowns when she cannot have what she wants she fusses at me and points her finger at me and look under her eyes, she started with having tantrums at 15 months old and now it seems that her behavior for her age is not going away, my daughter seems to talk baby talk to her instead of her using her adult tone of voice at this time my granddaughter should be talking more instead of having these tantrums each day I bring her home from day care the day care says she does not do this type of behavior when she is there what could my granddaughter be experiencing at this age. I call out to her sometimes she pretends she does not hear me call he name. Is this part of a behavior problem starting at an early age?

I don’t think so.
Your granddaughter sounds like a typical 23mo.
She’s testing boundaries.
At a guess I would say she’s less likely behaving this way at day care because there are lots of things to keep her stimulated in that environment.
If her behaviour was consistently bad between home life and school/day care that may suggest a long term behavioural problem.