How Do You Distinguish True Hyperactivity from 'Boys Will Be Boys?'

Updated on August 08, 2013
L.B. asks from New Rochelle, NY
13 answers

How do you distinguish hyperactivity from normal two year old behavior? In the last month, my 2.7 year old son has been more of a handful every day. At the suggestion of his preschool, I got him evaluated by EI. He qualified for two sessions of physical therapy and one session of occupational therapy a week. He has not been diagnosed with anything, but the phrase sensory seeking behavior has been thrown around. I have read several books since then on sensory processing disorder, but they still fail to address my questions about what is normal for boys that age and what isn't. The physical therapy has helped him enormously with his delays in jumping and climbing, but I am not really sure what the goal of OT is. Believe me, I talk to the therapist every time, and she tells me things like, give him deep squeezes, but I feel like we are only scratching the surface of my concerns. So my questions... How do you know when over active behavior has reached the point of being abnormal or pathological? Should I seek the services of a developmental pediatrician? EI told me not to bother. I am worried his behavior points to ADHD, and I wonder if there's any way to do kind of an "early intervention" for that. He seems different from boys his age on the playground and in toddler school, and I want to make sure I am doing everything I can to steer him on the right path. I am willing to pay for private therapy and evaluations, but despite the fact that he qualified for some EI, his pediatrician, his father, his grandparents, etc. dismiss me and say its all normal for toddler boys. He has trouble falling asleep and staying asleep. From the moment he wakes up for the day he is a nonstop chatterbox. He bangs and touches everything in his reach. He is very tactile and rubs and squeezes me all day. He listens to and comprehends long stories, but he flops around the whole time we are reading. It drives me batty, but is it my issue or his? When a stranger makes the mistake of saying hello to him, he won't leave him or her alone afterward! Meanwhile, his three month old brother seems to sleep twice as much as he did, and I barely exaggerate. I am so tired; I am on call with this kid 24/7 because dad works long hours. So I don't know if it's my fatigue and frustration talking or there is something off. What can I do? I plan to post a question soon about his eating habits, because I need help on that, too, but although he doesn't eat healthfully, alas, he also doesn't get red dye 40. I have heard this can cause these issues. He is also sensitive to cows milk and gets eczema from it, so he drinks goats milk, but he gets the cow milk other sources in moderation. I know milk/ casein is a topic of much interest today, so if dietary eliminations have worked for you, please share! I really value the advice I get on here, which first alerted me to the whole sensory processing disorder idea, and I look forward to your answers.

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answers from Detroit on

all 2 year olds are active.. all are inquisitive and touch and pull and push and break things.

If you have real concerns.. go to a developmental pediatrician... have an evaluation.

let the dr do an eval and see what they think.. they do not normally diagnose ADHD in 2 year olds as they are not expected to sit still and listen they move.. all the time. my dr will not diagnose ADHD until the child is in first grade and having significant problems functioning in the classroom setting. and the teacher has to do an evaluation of the childs behavior in the classroom as well as the parent with the evaluation of the childs behavior at home.

3 moms found this helpful

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answers from New York on

I am a special educator with expertise in ADHD. I also have a son with ADHD and sensory processing disorder. My advice is that you should trust your mommy instincts. No matter what other people say, you are probably on the right track in thinking something is going on. ADHD is not a disability, it's a certain type of brain that is sparkly and exciting. But it can also make life difficult for the child and parent. Traditional discipline for a child with ADHD does not usually work so ignore those who blame your child's behavior on you. Seek out information and help from professionals that you trust. You may have a few rough years ahead, but it will get better!

5 moms found this helpful


answers from Hartford on

Honestly the only way to determine if he has ADHD/ADD and sensory processing disorder is to have him evaluated with a Neuropsychological examination/evaluation by one of the following: pediatric neurologist; child psychiatrist; developmental-behavioral pediatrician; child psychologist. Any of those professionals can diagnose him. At nearly 3 years old, it's not impossible to diagnose him. It sounds like he might have some other issues going on in addition to or instead of ADHD so an evaluation wouldn't be uncalled for.

EDIT [I meant to add that if a child has SPD, it's very common for them to have it co-diagnosed with another neurological disorder. It's very rare actually for there to be SPD completely on its own, just like it's very rare to have Nonverbal Learning Disorder completely on its own without Autism or ADHD or something else.]

One reason I would encourage you to get one done sooner rather than later is that especially if he has Sensory Processing Disorder, and if there are other issues in addition to ADHD, it's far better to get services in place and started now rather than later. Early intervention is key. He might need Occupational Therapy which is so much more effective the earlier it's begun.

Early diagnosis does NOT mean he would automatically be put on medication, and please don't assume that medication would be so that you can "deal with him." Medication should always be so that life is easier to cope with for your son, and when that happens life is easier for everyone around him. Don't let people that are anti-medication scare you, okay? Besides, the right doctor will not push you to put him on medication and they'll suggest therapies you can do at home, dietary suggestions, and holistic remedies before trying medications AND in tandem with them.

I know this because I have a daughter with ADHD and SPD. I also have a daughter that has Autism, ADD, and SPD and a host of related issues.

4 moms found this helpful


answers from Springfield on

It is very common for 2 year olds to be very active with short attention spans. Some aren't as active, but that doesn't mean it's abnormal to have the need to move quite a bit. Some kids (especially boys) seem to have a need to constantly move those muscles.

I think I would give it a little more time but really start taking notes. Notice specifics about his diet - what he eats, when he eats. Also notice when the concerning behavior occurs. Is it after he eats, before he eats, times when he might be hungry? What kinds of routines you have, especially before naptime and bedtime. See what kinds of patterns you notice. This will help you be able to tell the pediatrician what your concerns are.

I think part of the reason you aren't getting the response you expected from the therapists is that it is so hard to know at this age. It really is common for 2 year olds to need lots of activity, so it's just so hard to know.

It really is good to mention it to the ped now (get it on the record) and answer some of his/her questions. That way you can make a comparison at the next visit and see if you still have the same concerns.

3 moms found this helpful


answers from Chicago on

The official guidelines do not recommend diagnosing a child with ADHD until they are at least 6 years old. I do, however, know of many children who have been diagnosed earlier. Truth be told, I could tell by about age 3 or so that my oldest (now 6.5) had much more energy than the other kids his age. He wasn't diagnosed until after his 6th birthday, as both his neurologist and neuropsychologist will not test for ADHD until that age.

Which books on SPD have you been reading? My son also has some SPD issues, and does quite a bit of sensory seeking as well. The book "The Out of Sync Child has Fun" is quite good.

2 moms found this helpful


answers from Honolulu on

Does your Toddler, ever NAP?
You did not mention... his nap schedule or sleep/bedtime.

He needs to nap. A kid this age, needs to nap.
Sometimes, a kid is not put to nap, because a parent may think that if they make their kid overtired, then he/she will sleep better at night.
But this is wrong.
Because, an OVER-tired child, will actually sleep WORSE/not be able to sleep well/and will wake more.

My son is such a typical boy. VERY active.
BUT... (and I KNOW this about him), when he is tired or over-tired, he actually becomes MORE HYPER. Because- he is trying to keep himself AWAKE. And pushes through his tiredness by getting MORE active. AND talkative. And my son is already very talkative.
But, ever since he was born, he was a REGULAR napper, EVERYDAY, and often napped for at least 2 hours. And he did this, up until after he started Kindergarten.
And, I taught him, to use his words and TELL me, when he is tired. And that being tired and napping is not a "bad" thing. It is for his body.

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answers from Oklahoma City on

I really tried to read all this, truly, paragraphs can be your friend....

If a pre-school person told you they had observed some behaviors they were concerned about then he's showing things that are beyond normal. They see hundreds and hundreds of kids in their career. They know something is off because they work with your kids every day on educational goals. They know if they're not able to meet them.

So you did a good thing listening to them and having him evaluated. The docs have told you to not worry about all the little details and you want to know all the little details.

Perhaps you can make one appointment with the therapist when kiddo is NOT there and ask your questions. The reason to do this is each moment you are talking to her is time away from her clients. Your son, the next appointment, etc....she is busy. If you have questions then you need to make an appointment and visit then.

The way I describe how being held close helps is this. A kid feels too open, exposed, out there, etc...then when they get held or wear a weighted vest or get wrapped in a blanket burrito style they feel contact on every part of their body. This sends signals to their brain and it gives them comfort, it makes connections from point a to point b. Water is also a good way to address this. Swimming can be wonderful for SPD kids.

I also suggest you visit with an educational psychologist that can help you understand this diagnosis because from what you're saying it is one that I would expect.

1 mom found this helpful


answers from Dallas on

My son is a sensory seeker (he's 6), but he is also on the Autism Spectrum with PDD-NOS. He was a HORRIBLE sleeper - didn't sleep through the night until his aunt made him a weighted blanket and now he sleeps through the night 80-90% of the time. Here's the pattern link -

Sensory processing and Autism don't always go together, so don't cross that bridge till you come to it.

Trust your mommy gut - I'm the main care-giver and our son was evaluated by the school district when he was 4. Hubby was "ok" with it, but at the same time, he had doubts because our son doesn't fit the stereotype behaviors of Autism. But recently he has noticed the "quirky".

1 mom found this helpful


answers from Dallas on

All of it does sound very normal for toddlers.You have a 2 yr. and 3 mos. old, no wonder you are tired and frustrated.

He's too young to even be trying to determine if he is hyperactive or ADHD. He's 2 - their active and yes sometimes overactive but that does not in anyway mean he will be hyperactive. All kids are different so do not compare your kids. It does sound a lot like you are overtired and wanting a diagnosis but it wouldn't help w/ his actions if you had one. He's 2, he can't be medicated for ADHD. If you're expecting him to be still while you read to him at his age while reading for a long time (should be no more than a few minutes at a time), you will always be frustrated.

It really just sounds like you need some help so you can get some rest. Good luck!

1 mom found this helpful


answers from Fayetteville on

when they are older than 3... don't worry until maybe 6 or 7, or kindergarten if it turns into a problem. Don't let anyone tell you that son has something he doesn't and don't automatically put him on some type of medication to "deal with it" because on medication he will never learn how to "deal with it"



answers from New York on

Four words: he is only two!!!!! Give him a chance before you start labeling him. Let him grow at his own pace. 2 year olds are notoriously wild lol. They are learning so much. Just enjoy him for who he is. Worry when there is something to worry about.



answers from Cleveland on

I would explore the allergy angle more myself. I haven't had to do that but I would think it would be helpful.


answers from Williamsport on

A lot of times hyperactivity is genetic and normal for most boys, and it's also to do with discipline. Have you taught him to sit still when necessary with firm, calm, consistent discipline, but yet he still cannot ever stop flopping around when you read? Most of my friends insist it is physically impossible for almost 3-yr-olds to sit still and be non-hyper EVER as per child development books, yet every Amish and Mennonite child you'll ever see (we live in central PA) is sitting through long church services quietly at that age. They're not genetically different, it's just a very different custom of discipline. Without knowing how or if you modify his behavior, it's hard to know how normal it is. It's very normal for kids this age to be VERY hyper. If you sense something is off with him beyond being a hyper boy toddler (I had one who was very tough to discipline and hyper but I was firm, calm and consistent getting him to behave and I knew he had no difficulty understanding things) then keep professionals on the case. But if you don't have a very effective discipline structure, more likely than not he's just a boy who is almost three.

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