What are inattention, impulsivity, and hyperactivity?

Inattention means a child often has trouble focusing, is easily distracted, or has a hard time finishing activities. An example of inattention is when a child can’t pay attention to what the teacher is saying or appears to be daydreaming.

Impulsivity means a child tends to react quickly, before thinking things through. An example of impulsivity is when a child blurts out the answer to a question before someone finishes talking.

Inattention and impulsivity are normal for young children. But by the time they’re in school, most children can pay attention for a longer time and can think and plan before they act. If your school-aged child behaves more like what you would expect from a younger child, this behavior may be a sign of a problem.

Hyperactivity means a child fidgets and moves more than other children the same age. In school, a child with hyperactivity has trouble sitting still and may distract other children and make it difficult for the teacher to keep the classroom in order.

The good news is there are things parents and families can do to help children with inattention, impulsivity, or hyperactivity manage their behavior and succeed at home and school.

How can I help my child at home?

These tips are helpful for all children, but they can be especially helpful for children with inattention, impulsivity, or hyperactivity. Parenting is a busy job, so use your judgment about which tips make the most sense for your family.

Connect with your child

• Set aside one-on-one time every day. Even just 10 minutes each day can make a big difference. Try taking a walk together, playing a card game, or reading a book aloud.
• Ask your child about their life. Make sure your child knows they can come to you if they have any problems, such as being bullied or having trouble making friends at school.
• Praise your child and let them know you appreciate their positive behavior. For example, “I’m proud of you for working so hard on your homework” or “Thank you for putting away the markers when you were done with them!”

Use positive parenting

• Explain rules in a positive way. For example, instead of saying, “Don’t run,” you could say, “Please walk slowly.”
• Reward positive behavior. Praise your child or give small rewards when they behave in a kind, generous, or positive way. Spending time doing fun activities with a parent is a very powerful reward.
• Pay less attention to negative behavior. When your child is misbehaving, try not to pay a lot of attention to them. You can also use a brief time-out as a consequence. Over time, your child will learn that acting out isn’t a good way to get your attention.

Be consistent and provide structure

• Set up family routines. Follow a regular schedule for playtime, mealtime, and bedtime. Knowing what to expect can help your child feel safe and secure.
• Set clear rules, limits, and consequences, and stick to them. Make sure everyone who takes care of your child is on the same page. If you and your family members don’t agree, ask your child’s doctor to help you talk through your differences. Being consistent, not rigid, is important.
• Help your child learn to recognize and manage their own behavior. For example, if your child tends to leave their homework at home, teach your child how to make it part of their bedtime routine to put homework into their backpack.
• Create a quiet work space for activities. A place to do homework or other activities away from noise or other distractions will help your child stay focused and organized.
• Create a visual schedule to help your child learn independence and organization. To create it, take pictures of your child doing the tasks on the schedule (or cut pictures out of magazines). These can help your child complete routine tasks having multiple steps, such as getting ready in the morning or getting ready for bed.

Build healthy habits

• Get active! Encourage your child to be active for at least an hour every day. This activity can include playing outside, joining a sports team or an activity at the YMCA, biking or walking to school, or dancing at home to favorite music.
• Eat healthy. Eat healthy meals every day, including fruits and vegetables, whole grains, and protein foods. Remember to eat breakfast!
• Get plenty of sleep. School-aged children need 9 to 12 hours of sleep every night. Teens need 8 to 10 hours.
• Limit screen time. Try for less than 2 hours a day of entertainment screen time. Avoid scary or violent TV shows, video games, and movies.

How can I help my child at school?

Some children act differently at home than they do at school. It’s important to talk with your child’s teacher regularly so you know what’s going on at school.

If your child is having a hard time at school, ask the teacher what strategies they are using to help your child, and work together to come up with other ideas.

These are some strategies you may want to try.

• Ask the teacher to have your child repeat back instructions to check for understanding.
• Determine whether the teacher can move your child to the front of the room.
• Get your child a homework planner, and ask the teacher to sign it every day.
• Work with the teacher to break down large assignments into smaller parts.

If the teacher has tried various strategies and your child is still having a hard time, ask the school about testing. You can also sign a release form so your child’s doctor and teacher can talk with each other.

Remember, you know your child best.

Whether it’s at school or the doctor’s office, you are your child’s biggest advocate. Don’t hesitate to speak up on behalf of your child.

When do I need to go back to the doctor?

If it’s been a few months and your child’s inattention, impulsivity, or hyperactivity isn’t getting better (or it’s getting worse), it’s a good idea to go back to the doctor. The doctor may ask you and your child’s teacher to fill out a questionnaire about what’s happening. Then, you and the doctor can make a plan to try new approaches or strategies that may help.

The doctor can also help you decide whether visiting a specialist for therapy could help your child.

It’s especially important to talk with the doctor if

• Your child’s behavior is causing problems or keeping your child from doing normal activities at school, at home, or with friends.
• Your child starts to have other behavior problems, such as feeling very sad, worrying a lot, fighting, or acting out.
• You notice a change in your child’s behavior after a stressful event, such as a divorce or death in the family.

Make time to care for yourself too.

Parenting can be stressful. If you’re feeling overwhelmed, don’t be afraid to ask for support from family, close friends, social services, or your faith community. Children pick up on the stress and worries of adults, so getting support for yourself can help your child too.

To learn more about inattention, impulsivity, and hyperactivity and what you can do to help your child, visit these websites.

• American Academy of Pediatrics HealthyChildren.org: www.HealthyChildren.org
• American Academy of Child and Adolescent Psychiatry: www.aacap.org
• American Psychological Association: www.apa.org
• Children and Adults with Attention-Deficit/Hyperactivity Disorder: www.chadd.org
• National Alliance on Mental Illness: www.nami.org
• National Federation of Families for Children’s Mental Health: www.ffcmh.org

More resources about inattention, impulsivity, and hyperactivity

This space is for you to write notes about other helpful resources you have found for your child’s attention.

Disclaimer

The information contained in this resource should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. Original resource included as part of Addressing Mental Health Concerns in Pediatrics: A Practical Resource Toolkit for Clinicians, 2nd Edition.

Inclusion in this resource does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this resource. Website addresses are as current as possible but may change at any time.

The American Academy of Pediatrics (AAP) does not review or endorse any modifications made to this resource and in no event shall the AAP be liable for any such changes.

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