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but like Oakley said, the first step is getting an evaluation done, and I think it would be responsible to try other techniques and be conservative with medications.
A lot of people will tell you that he's just a toddler being a toddler, and they might be right. But... my oldest is 10 now and was diagnosed with ADHD at 6. I suspected far earlier (probably starting around when he turned 3) that he had some fairly serious issues but was assured by everyone that he was just being a kid. If I could go back and do it again (especially after having two later kids and seeing what 'normal' really is), I would have had him evaluated earlier and begun some of the behavior modification we've now been doing for 5 years.
The first step in an evaluation can be done fairly simply with (short) questionnaires that each parent and any teachers or care providers complete. This is important for several reasons, but primarily: a) it gives you an idea of the kinds of situations that can be indicative of ADHD, if you haven't thought about or researched it before; b) since kids' behavior can vary depending on the setting and people in a given interaction, having a number of responses can help present a consensus and also give you an idea of his responses in situations when you're not there. And they can vary widely - my boy's first grade teacher's reports had him well into the autism spectrum, while no one else's even came close.
A pediatrician can use the simple forms to determine if a full evaluation is necessary. A full evaluation should be done by a psychiatrist, preferably specializing in ADHD. We actually had two done, one by the school psychiatrist and one by the Center for ADHD at CHOP. There was a clear consensus.
The next step after getting an evaluation/diagnosis is to determine a treatment plan. If your experience is like mine, the evaluating psychiatrist will likely discuss medicine as an option. It may be worth considering but I'm conservative with (meaning I'm not anti-) medicine and we chose to implement a behavior modification plan along with regular psychologist visits. Even if you medicate now or at some point in the future, both of these steps are very well worth pursuing.
With the psychologist, I believe that my son benefited from speaking about his behavior with someone who was an authority figure but not me or a teacher. I also got a lot out of it in terms of coping strategies - having an ADHD kid can be exhausting and frustrating, and it's worth knowing best techniques for both dealing with the kid and coping with the stresses on yourself. As for behavior modification, the idea is having a system in place to reward good behavior, creating positive associations with goo behavior instead of (just) negative associations with bad behavior. Our kid was old enough that we centered it on school, but you could do a similar thing with day care or home as well. We put together a daily checklist where the teachers would assign points in various categories (did he stay in his seat? Did he get his work done? Did he refrain from blurting out or making noise? Did he follow other instructions?) and if he had enough points on a day, he'd get Pokemon cards or a Hot Wheels or a comic as his interests were, or additional screen/video game time. As he got older the work became more of the focus and we began offering weekly prizes (for a certain number of points in a week) and monthly (for earning weekly prize 4 weeks in a row).
About medicine: About 1 year after diagnosis his behavior wasn't much better; we tried medication and noted a quick boost in his performance that began to lag as early as a week after starting; we went through several different strengths and formulations and while we noted some improvement, my son also lost 10% of his body weight over the 6 months we had him on medication (and he was only ~50 lbs to start with, like a lot of ADHD kids he has never been a big eater). If it had been a magic bullet performance-wise, that might have been an acceptable cost, but with limited benefit like we experienced, all of us (teachers, parents, doctors) decided it wasn't worth it.
Overall I'd encourage you to do some reading on ADHD (*not* internet reading; there are plenty of books on the subject and considering it's your kid's future at stake, it's worth investing the money and time to read them if you really think he may be diagnosable) and consult with both a pediatrician (if you can find one you trust/like) an a psychiatrist, as well as any care providers the kid has.
Good luck! ------- so I'm in a band now: album ---> http://greenwoodburns.bandcamp.com/releases Soundcloud ---> http://soundcloud.com/greenwood-burns
my own stuff -->http://soundcloud.com/lonesomedstringband
avy by buckshot_defunct
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