Adhd - Portland,OR

I really think that age 3 is too young to be diagnosed with ADHD.
Three year olds are active and many are not ready for a pre-school like setting. Playing should be their main activity. I don't know about autism, but some of the behavior the teacher is seeing might be related to that.
I would look for a school that offered more playing and less expectations of group time and work.
Also I would cut media time as it would make for over stimulation and try to give him more outdoor and physical time.

3 is too young to be accurately diagnosed with ADHD. Most 3 year olds -especially boys -are squirmy, hyper and don't focus too long on anything! Did his preschool teacher bring up ADHD? If so, she should know better for this age group. I don't know what other children she has in preschool or how much experience she has, but I've found very few 3 year olds who focus and sit still for more than a minute or two. The ones who do usually only do it for cartoons and movies. I would wait until he is in kindergarten with an IEP for his autism before I started thinking anything about ADHD. For now, just concentrate on what needs to be done to help the autism.

Autism and ADHD are very very different, but they share some common symptoms/behaviors. Since your son has already been dx'd PDD-NOS, I would strongly suspect that what you are describing is part of *that* diagnosis.

Some people do try and get a different dx for every symptom... and in rare cases one really does find dual diagnosis, but more often one is a misdiagnosis.

Take ADHD (since that's what I'm most familiar with)...

ADHD *always* comes along with both sensory "schtuff" (from how our brains process and store information), and intense emotional swings. Some poor kids actually end up diagnosed adhd + spd + odd + even sometimes bipolar PURELY because their evaluator doesn't understand that adhd comes with sensory issues and emotional swings. (A big tell with adhd is that a person is NEVER adhd & bipolar, ever. They are mutually excluding diagnoses. It's often difficult to tell which it is without meds -one will work and one will make everything 10,000 x worse). So instead of being treated correctly for their adhd they end up being treated for tons of things they don't have.

If you suspect adhd, you may be correct. In that case, I would wonder if the pdd-nos diagnosis is actually correct. Unlike bipolar + adhd = false, it is possible to be both HFA and adhd... but dual diagnosis really is very rare. If you're leaning one way... I'd seek out a full eval by another developmental ped.

But as per your original Q...

Yup.

My son is adhd-c. I first started suspecting around age 3 when his teachers commented on his "ungodly concentration". One thing that always comes with adhd is hyperfocus. In a purely physical hyperactive (adhd-h) that might be running (or doing some other kind of physical activity) for 2 hours straight, in purely mental hyperactive (adhd-i) that might be some kind of academics for several hours, in combo mental+physical hyperactivity (adhd-c)... it could be either. I knew for sure when stimulants made him sleepy.

ditto... check out www.additudemag.com

He is just three years old.........

Children with autism also have ADHD-like symptoms but it is not ADHD. If you give that child ADHD medication -- typically a stimulant -- it will act like a stimulant for an ASD child, the opposite of how it works for a ADHD child.

You don't indicate whether or not your son has some kind of education or behavior plan. Is he receiving his pre-K through your school district's early intervention program? If not, I would contact them and set up an appointment ASAP. It sounds like he has some really strong skills but he may need additional supports while he is in the classroom and the teacher may need some additional training to learn how to redirect him when he is off task. If you receive these services now, it will probably make his transition into kindergarten and 1st grade far more smoother than it would be without this additional assistance.

Hope this helps. Wishing you and your son all the best.

I think if your son has a PDD diagnosis that there is an increased chance of him having ADHD, but I also think at age 3 it is too young to start him on medication, so there might not be a use in getting a formal diagnosis. I would try to use behavioral incentives and rewards, and see if he grows out of some of his focusing problems (he is a 3 yr old boy, after all) or if they persist. My son was just diagnosed at age 10, but we pretty much knew very early on. He always did well in school but it was things like CONSTANTLY forgetting his homework, his lunch, his coat, pants on backwards....things like that. Plus, he was extremely difficult at home with his siblings, very impulsive. He recently did begin ADHD meds and it has made a world of difference, but affected his appetite greatly.
Maybe you can sit in on his preschool and observe if he is in a setting that is appropriate for him. Are there lots of other high-energy boys, or is it a class with a lot of quiet girls doing crafts? Maybe he doesn't have enough of an outlet to let off steam, or maybe his teacher is just not the right fit. Is this a class geared towards kids that have special needs and teachers with experience in dealing with that? Good luck to you, it will get better in time.

Have you thought about looking into his diet? Sugar, preservatives and food coloring can cause kids to be a little hyperactive or have adverse affects on their personalities.

Be prepared for a lot of "he's a normal boy" feedback and anti-ADHD talk. I have found, though, that people who suspect ADHD tend to be right on in their hunches.

I have a son who was kicked out of preschool at three for signs of what we now know is ADHD. He couldn't sit still at all, couldn't follow instruction, would kick, hit and spit at kids and teachers (and me), couldn't focus, would run across the furniture non-stop at home, didn't respond to praise or punishment, didn't respond to traditional parenting techniques or consistency. It was off the charts BAD. Some people see the positives in ADHD, but for us it was a nightmare for a long time.

We started behavioral therapy at three, but this didn't help. Our son simply couldn't listen or sit still for any technique to work. That's when he was kicked out of school. When he was four and after some agonizing, we tried Ritalin. Wow! Amazing. Beyond positive, it transformed his life. He was pleasant to be around, focused and yet still was himself (no personality change in any remote way). He was able to join another preschool and has excelled in school ever since.

I would check out the website for ADDitude magazine. They did a story about ADHD in preschoolers a few years ago that might be archived there. Also look at the website for CHADD, which also is a good source of information.

If you want answers, get your son in with a specialist. A pediatrician can't diagnose but specialists like developmental pediatricians, psychiatrists and neuropsychologists can (you aren't likely to get a diagnosis at three, but you can still get help from these professionals. Kaiser said our son had "strong indicators" of ADHD at three and did help us.). You may already be familiar with this type of professional, so tap into your existing resources.

Good luck!

I agree that if he has been diagnosed PDD-NOS this is likely behavior that would fall under that diagnosis. Is the teacher aware of this diagnosis? Some people now believe ADHD is part of an "autism spectrum" which would put it very close to high-functioning autism. They do share many behaviors. An interesting book with this perspective is: Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies: The Groundbreaking Program for the 4-A Disorders by Kenneth Bock MD.

Edited to better answer your updated question...

I knew my daughter was different from birth. She was colicky as a baby and continued to be a very high maintenance toddler. Her older sister who is neurotypical and has a different biological dad was a very different child. I knew I had something biologically different on my hands, I wasn't doing anything differently as far as parenting techniques. In preschool no one ever mentioned ADHD, although they did toss around terms like "general defiant disorder" and potential ODD. Her behavior did look more like ODD as a toddler, and wasn't necessarily clearly ADHD until school age. The preschool teachers always wanted to pin her misbehavior on poor parenting or problems at home. I was a younger mom and unfortunately always had to bend over backwards to convince people that was not the case. They tried to tell me she had characteristics of "non-attachment" when I prided myself on attachment parenting. I knew my child was "attached" but that something else was amiss. I think it was actually difficult because of all the things I had done "right" she didn't have so many obvious health issues, people were more reluctant to diagnose her as anything but badly behaved. I found the book "The Explosive Child" by Ross Greene to be very helpful. Something I wish I started earlier was occupational therapy - my daughter has many sensory issues that this helps with immensely. They were much worse as a toddler, regardless, though - I wish I had found OT earlier. I commend you for starting early to help your child!

You have alot of good answers. I know if your child is autism they will probably treat the autism first. I have an extremely adhd kid, got kicked out of three daycares by the time he was four. Luckily I found one that worked, and there are ones out there that do work. Three is to young to medicate if you chose to, and probably get a diagnosis too. But I knew at two, mine was out there with the behavior. I had my son in early intervention. It is through the school district and you should see if you if your son qualifies to go there. With the autism you probably do. But when my son was three I was pulling my hair out. And they helped him and me survive those early years.