What to Expect the Toddler Years (66 page)

Does he resist adult authority and persist in misbehaving, despite warnings? Is his play with others regularly punctuated by fights and disagreements?

If you responded “yes” to at least three of those questions, consult your child’s doctor. Be aware that it’s unlikely that he or she will even consider a diagnosis of ADHD at this age. Research has only recently provided guidelines for the diagnosis of ADHD in preschool children, though it should only be done with great caution by an experienced clinician. A formal diagnosis may be made by age 5 or 6 with the criteria for ADHD that have been developed for those of school age. Nevertheless, the doctor may want to assess your toddler’s behavior by taking a thorough family history, observing him, and performing some standard psychological tests.

Right now you need some help in minimizing the effects of your toddler’s out-of-control behavior on himself and on your family more than you need a diagnosis. Preventive management today may help to head off full-blown ADHD and avoid the damage to your child’s self-esteem that frequently results from this condition. These suggestions will help with any particularly wild toddler, not just those who are destined for a diagnosis of ADHD:

Examine what’s going on in the family to be sure that stress or the illness (emotional or physical) of a family member is not triggering your child’s symptoms. Seek help from your doctor or
your child’s doctor if you or another family member is depressed or otherwise not well.

Emphasize the routine; schedule meals, naps, outings, snacks, bath at the same time each day. Injecting order into your toddler’s life may help slow his frenetic pace. So will calm and quiet in the home.

Don’t set your toddler up for failure by putting him in impossibly demanding situations (a formal dinner in a fancy restaurant, tea in Aunt Fanny’s antique-filled living room, a long movie or live performance, a lengthy religious service) where sitting still and/or keeping quiet are a must and where he is certain to have difficulty.

Avoid using physical punishment or physical restraint, such as tethers (except when life and limb are at risk), but do set limits (see page 47). Even more than most children, the hyperactive child, with his runaway impulses, needs help with control—it is frightening to the child to be out-of-control. Your careful controls will help him begin to develop his own. Limits, of course, should be reasonable. You can’t expect any toddler, particularly one who is very active, to sit still for extended periods. Anticipate and allow for plenty of activity, and hold off your commentary unless it spills out of bounds. Discipline should be consistent and firm, but loving (see page 119). State reprimands positively rather than negatively: “Jumping on the bed is not safe. Let’s see if we can pretend to sleep on the bed,” or “Can you jump on the carpet?” instead of “Stop jumping on that bed!”

Help your toddler to gradually improve his attention span. One way is to set short-term goals and help him meet them. For example, sitting at one task for two minutes. To increase your chances of success, pick a time when your toddler is relatively calm and well rested. Be sure there are no distractions (radio, TV, other children, an open window, or a favorite action toy). Then say, “Let’s see if you can sit in your seat until the buzzer goes off. You can draw or look at a book or do a puzzle or play with a game. When the buzzer goes off, you will get a dinosaur sticker” (or other suitable reward). Set the buzzer for two minutes and encourage compliance. When your toddler shows he can sit and focus for two minutes, increase the time gradually, a minute at a time, up to ten minutes—or even more, if that seems realistic. Make a game of it and your toddler is likely to want to succeed.

Praise quiet play. If your toddler spends a few minutes looking at a book or playing with a puzzle, give him the applause he deserves. Encourage such play, even if it only lasts for brief periods.

Help your toddler improve his basic skills. Frustration often leads to wildness. Learning how to dress himself, ride a tricycle, or catch a ball, for example, will help reduce his frustration with not being able to “do it myself” and help to lower the overall level of frustration.

Give your toddler methods to cope with his feelings. When he’s sad (or angry, scared, or frustrated), assure him that it’s okay to have strong feelings, and help him find ways he can help himself feel better. Suggest: running, jumping, climbing in the backyard; hitting a punching bag or inflated figure; dancing; lying down to listen to a favorite tape; and some of the other ideas on page 171. Tell him he can always come and cuddle in your arms.