This blog explores techniques and ideas that come from the Positive Behaviour Support Framework which you can read more about here
When you have a child that is always moving, can’t sit still, or acts without thinking, you may be wondering whether your child is just hyperactive or has Attention Deficit Hyperactivity Disorder (ADHD).
It could be both, neither or a genuine diagnosis of Hyperactivity or ADHD but the signs are often quite subtle in difference.
So let’s take a deeper look at what hyperactivity and ADHD are, how they are similar as well as different from one another, and how to tell if your child has ADHD or is hyperactive.
Once we can say for sure, we can help your child thrive regardless of their diagnosis with practical tools and advice you can start using today.
Symptoms of Hyperactivity and ADHD
In order to figure out whether a child has hyperactivity or Attention Deficit Hyperactivity Disorder (ADHD), we need to have a clear understanding of what these two things are exactly. Each one has different behaviours and symptoms that children may exhibit.
Hyperactivity is when children have trouble sitting still, paying attention, or controlling their impulses. It is normal for all children to be hyperactive at times especially if they have not had enough sleep, exercised enough or feel stressed.
As children mature, they learn how to moderate these feelings (and their body’s motor functions) in a process of learning supported by adults. Put simply, in time, children learn to sit still.
While most children do develop this ability over time, hyperactive children often struggle.
Examples of Hyperactivity
These are examples of hyperactive behaviour in different scenarios but it’s worth saying that they are just examples and not to be taken too literally. The nature of hyperactivity is that the child’s actions, movements, noises and words might be quite unpredictable or unique.
That said, you will probably recognise the hyperactive child in these examples if you are supporting one yourself.
A quiet book reading
If instructed to sit quietly and listen to a book being read, the hyperactive child might make sudden noises or talk over the reader. Assuming the activity is age appropriate, non-hyperactive children will be able to maintain focus on the book reading for longer and remain still and quiet whereas the hyperactive child will likely not.
Floor time play or activity
Instead of focusing on the play objective or activity presented, the hyperactive child will roll around on the carpet or roam the room aimlessly trying to touch everything in sight.
They might grab toys from a toy basket in a haphazard manner without playing with any of them properly, or climb on furniture.
Adolescent with friends
A hyperactive adolescent having lunch with peers will likely fidget, fiddle with something like their cutlery or condiments, squirm and reposition constantly in their seat.
Hyperactive adolescents also experience excessive mind-wandering (daydreaming) and this affects their ability to take part in conversations. They may, therefore, not appear to be fully engaged in jokes or stories being told in the group and will often interrupt or suddenly take over the conversation with new context.
Can you observe similar behaviours in typical scenarios like this at home, playgroup or school? Can you find time to observe these behaviours and make a few notes?
Note - if you make notes, refer to the child (or children) you are observing anonymously.
Next, let’s take a look at ADHD.
ADHD (Attention Deficit Hyperactivity Disorder)
The American Psychiatric Association describe ADHD as a type of neurodevelopmental disorder.
This means there is atypical growth and development of the brain or central nervous system resulting in their abnormal functioning.
Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) (American Psychiatric Association, 2013)
The DSM-V is a handbook used by professionals around the world to diagnose mental disorders.
ADHD is defined by a pattern of behavior involving inattention, disorganization, and/or hyperactivity-impulsivity which is why it is so often hard to distinguish ADHD from Hyperactivity.
An individual can have symptoms in one or both categories of inattention and/or hyperactivity/impulsivity to receive the diagnosis of ADHD. The diagnosis is generally made by the age of 12 and ADHD can continue into adulthood.
It is also important to understand that there are three presentation types of ADHD:
- ADHD Combined type
- ADHD - predominantly impulsive / hyperactive type
- ADHD - predominantly inattentive type
There are many similarities between a child just being hyperactive and those that have ADHD. Here is a list of ways that hyperactivity and ADHD are similar:
- Has problems slowing down. In many cases, it looks like the child is just going and not thinking ahead of what he/she is about to say or do.
- Will talk non-stop. They may have a difficult time taking turns in conversations, thinking before speaking, or just knowing when to stop talking.
- Fidgets with items near them (i.e. twirling their hair, playing “drums” by using pencils to tap beats on their desk or constantly playing with something in their hands.
The main difference between hyperactivity and ADHD is that hyperactive behavior is can usually be controlled. This is achieved with verbal prompts and guidance from their families and school staff.
ADHD occurs when the child can not control several types of behaviors (including hyperactivity). So control of hyperactivity is key. Children with Hyperactivity can learn to control it, children with ADHD are likely to achieve less control of their hyperactive behaviour.
A child with ADHD will have “a chronic, pervasive problem with their ability to regulate activity level and impairment in their ability to inhibit and control their impulses,” Source: Verywell Mind.
Many children with ADHD will struggle with the following: processing information, regulating their emotions, utilizing their executive functions, and behaving less maturely than their peers.
Regulating emotions and behaving less maturely can sometimes be observed as characteristic of hyperactivity but a hyperactive child is more likely to be able to regulate emotions and behave maturely (even if they are moving around a lot) whereas a child with ADHD might not.
Different ADHD Symptoms for Boys and Girls
ADHD symptoms are exhibited differently in boys and girls.
Girls usually exhibit the inattentive aspects of ADHD. For example, many girls with ADHD will demonstrate the following symptoms: low self-esteem, anxiety, problems focusing and paying attention, withdrawal from others, and struggling academically.
This doesn’t mean this is the case for all girls because some will still exhibit fidgeting, impulse control and hyperactivity.
Boys typically demonstrate more hyperactive and impulsive behaviors.
These extroverted symptoms in boys with ADHD may include the following: being impulsive and hyperactive, having problems with paying attention, becoming physically aggressive towards others, talking nonstop, and interrupting others frequently.
Can we tell Hyperactivity and ADHD apart yet?
Unfortunately there just isn’t one thing we can point to that says ‘yes it’s Hyperactivity’ or ‘yes it’s ADHD’.
Understanding the child involves observations and reviewing this relationship between being hyperactive but also whether the child exhibits additional symptoms of ADHD and whether the child can learn to control their hyperactivity.
Depending on the age of the child you are observing, those techniques for regulating the hyperactive behaviour may not have been learned yet so we need to allow room for those skills to develop.
Hopefully though this guidance helps shine some light on how to start telling the two conditions apart.
However, regardless of whether your child is hyperactive or has ADHD there are a number of simple practical strategies you can implement at home or in school that actually work well for both conditions.
Helpful Strategies for Children with Hyperactivity and/or ADHD
- Create a visual checklist for your child to check off completed tasks.
- Chunk big tasks into smaller ones.
- Provide breaks throughout the day with movement (i.e. go outdoors to play, take the dog for a walk, participate in a sport),
- Provide step-by-step instructions to complete a task.
- Give your child a fidget toy that will not make noise (i.e. playdoh, Rubik’s Cube, stretchy toys),
- Have an adult sit nearby to provide guidance, support, and verbal redirection when needed,
- Use a timer to let children know how long they have left to complete a task,
- Have the child sit in a spot where they will not be distracted or at least reduces the chance. In a classroom setting have them sit up front by the teacher away from the window and in an uncluttered area,
- Provide noise-canceling headphones,
- Allow children to decide how they want to complete academic tasks (e.g. out loud, on paper, through a project that incorporates body movement),
- Include opportunities to have children do projects and activities that are linked to their interests,
- Provide positive feedback to help them identify their strengths and successes.
This is just a small list of strategies that families can use to help their children with ADHD or hyperactivity. It is important to note that if you have any concerns regarding ADHD or hyperactivity, you should also contact your child’s medical provider.
If your child or children is exhibiting behaviours of concern we have a variety of support tools available on this website.
Our Attention Deficit Hyperactivity Disorder Support Online Course is a comprehensive course that will provide you with a toolkit of practical strategies to help individuals with ADHD achieve better communication, social, emotional, behavioural and learning outcomes. Our emotional regulation course Guiding the Development of Emotional Regulation Skills would be very helpful for those supporting children with ADHD and / or Hyperactivity.