Q. When should I have my child evaluated for ADHD?

A. Cindy Goldrich, a Melville-based licensed ADHD coach, says she sees four ages when parents may want to have a child evaluated for attention deficit hyperactivity disorder.

Many children younger than 4 run around and act impulsively. But by 4, they should be able to regulate themselves and focus on tasks. ADHD is often noted in preschool, she says. Here are some red flags:

  • Trouble listening and following directions
  • Difficulty staying seated
  • Constant fidgeting
  • Tendency to blurt things out or interrupt
  • Very easily distracted

“It’s as if they have an internal engine that won’t shut off, sort of like Tigger, who is bouncing all over the place,” Goldrich says.

The second “breaking point” when ADHD may become apparent is second or third grade, she says, when kids must sit still for extended periods to learn.

The third point is at the transition to middle school. Before that, the elementary school teacher has acted as “the CEO of their brain,” Goldrich says, directing them in the classroom. In middle school, they don’t have that person to guide them step-by-step through the school day.

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And the fourth point when kids with ADHD might “hit their wall,” Goldrich says, is in high school. “What happens is the demands become more than they can handle.” ADHD is not a problem of intelligence, she says. Kids may have been able to manage until then because they are smart enough to meet expectations without having to, for instance, study for hours or juggle multiple time-management expectations. But by high school, their ADHD becomes harder to overcome, Goldrich says, and they may need help.

Parents should talk to their pediatrician or an ADHD parent coach for more information, Goldrich says.