Always moving? Signs your child may need ADHD assessment

Early signs of ADHD may appear as persistent hyperactivity or difficulty staying still in children. [iStockphoto]

A watched pot never boils, or so it seems. When it comes to developmental milestones, however, parents should remain eagle-eyed about their children’s growth and behaviour.

Parents often celebrate milestones, such as a baby’s first social smile at six to eight weeks. By the age of five, most children can tell simple stories, count basic numbers and perform daily tasks with increasing independence. Any delay can cause concern, making close observation of a child’s behaviour essential.

Ideally, a child’s behaviour should appear balanced, neither excessively active nor unusually withdrawn. Withdrawn children may be more noticeable, but persistent hyperactivity can also signal underlying challenges. When either extreme is observed, consulting a paediatrician is advisable.

Dr Rachel Kerubo. [File Courtesy]

At three and a half years old, Kibet, Borah’s firstborn, appeared unusually active. He struggled to sit still, quickly shifted between activities and often grabbed toys from other children at playgroup. His behaviour differed noticeably from that of his peers.

Concerned, Borah consulted a doctor and was reassured that such behaviour could still be normal for his age. She was advised to observe him over time and seek further assessment if the behaviour persisted beyond age five.

However, the behaviour became more pronounced. At school, Kibet frequently misplaced pencils, shoes and his schoolbag, making daily routines challenging. His teacher observed that he moved constantly, talked excessively, struggled to wait his turn, fidgeted in class and often blurted out answers.

This time, Borah sought medical review again. A paediatrician, working alongside a psychiatrist, diagnosed Kibet with Attention-Deficit/Hyperactivity Disorder (ADHD) at the age of five.

ADHD is a neurodevelopmental condition affecting how the brain grows and functions. It is characterised by persistent inattentiveness, hyperactivity and impulsive behaviour. Symptoms usually begin before age 12, though diagnosis can reliably be made from age five, as younger children are naturally energetic and easily distracted.

Many adults also live with ADHD, often experiencing difficulties with attention, organisation and emotional regulation. Although ADHD has no cure, treatment can significantly reduce symptoms and improve daily functioning at school, work and home.

Children with inattentive symptoms may continue with current activities despite instructions to switch tasks. They are easily distracted by surrounding noise or movement, struggle to complete assignments and frequently lose personal items. Those showing hyperactivity may talk excessively, interrupt others, struggle to wait their turn, remain constantly on the move and appear restless even while seated. If six or more symptoms persist for longer than six months, professional assessment by a paediatrician is recommended.

Several risk factors increase the likelihood of ADHD, including a family history of the condition, maternal smoking or alcohol use during pregnancy, premature birth before 37 weeks, low birth weight, inadequate iron and omega-3 or omega-6 intake after birth, exposure to lead toxins, early childhood neglect and frontal brain injuries. These factors do not guarantee ADHD but raise susceptibility.

Preventive measures include avoiding alcohol and smoking during pregnancy, ensuring adequate nutrition rich in iron and healthy fats, such as fatty fish, nuts, seeds, legumes and meat, and actively engaging children through interaction and play during early development.

Dr Rachel Kerubo is the Resident Medical Officer – Department of Internal Medicine, Nyamira County Referral Hospital.