Can a 2-year old have ADHD?

According to the Centers for Disease Control and Prevention (CDC), about 11% of children aged 4 to 17 years old have been diagnosed with ADHD as of 2011. The average age of ADHD diagnosis was 7 years of age, but there is recent evidence that toddlers as young as 2-years old are being diagnosed with ADHD and placed on stimulant medications. A study by the CDC estimated that 10,000 toddlers — children age 2 and 3 years old — are receiving medication for ADHD. This is despite the fact that the American Academy of Pediatrics has very specific criteria for the diagnosis of ADHD, but the guidelines do not apply to children younger than 4 years of age. Even for younger patients diagnosed with the disorder — those 4 to 5 years old — the CDC recommends behavioral treatment first and medication only after behavior interventions don't result in any improvement.

"A 2-year old who is hyperactive and difficult to control doesn't necessarily have ADHD," says Dr. Firas Rabi, a pediatrician who treats children with ADHD in Ohio. Some doctors say ADHD medications could be a last resort physicians turn to when toddlers might harm themselves, but others note having lots of energy and acting out is simply a part of being a young child. "Toddlers are naturally curious, strong willed, fidgety and come with never-ending energy," adds Dr. Rabi.

“Treating babies with stimulants is based on no research, is reckless and takes no account of the possible harmful, long-term effects of bathing baby brains with powerful neurotransmitter drugs,” Allen Frances, a professor emeritus at Duke University, wrote in a piece for the Huffington Post regarding the CDC’s recent findings.

Until we have more data regarding the long-term effects on neurostimulant medications on the developing brains of toddlers, and until physicians are better able to differentiate ADHD symptoms from those of the anxious or depressed toddler, it is best that current ADHD medications not be prescribed to those younger than 4 years old.