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I am concerned that my bright five-year-old daughter may be displaying signs of ADD. Since starting school, she has displayed a high level of achievement in both reading and math. She has been well-supported at home. However, her teacher has commented that although she is very bright, she often day dreams and requires extra time to complete classroom tasks.

She is very quiet and appears anxious when answering questions, speaking in front of the class or meeting new people. We have also noted in the home environment that requests frequently have to be repeated up to four times before she answers. Having a general conversation is difficult because of her fidgeting, slow processing or her being cognitively engaged elsewhere. During homework tasks, she requires ongoing prompting in order to focus.

She becomes very frustrated when she makes mistakes and, out of frustration, becomes defiant. She is popular with her school friends and although shy, manages to make friends in new environments. Also, I am not sure whether this is relevant, but her motor function appears delayed and she has struggled in her attempts to ride a scooter or bike. She is also prone to accidents and falling when running.

I am unsure whether it is too early to seek an assessment or even raise the issue with the school. The general advice from the literature that I have read is that assessment should not be sought until the child is seven due to underdeveloped cerebellum. What is your general opinion on this?

Don’t be so quick to rush to ADHD as the cause. Your descriptions suggest more the possibility that she might have a language disability (difficulty quickly processing what she hears and difficulty organizing her thoughts to respond). Or, she might have a motor disability (Sensory Integration Disorder), resulting in her gross and fine motor difficulties. Although not yet in first grade, she shows early signs of a potential learning disability. The behaviors I least hear you describe would be those associated with ADHD.

I encourage you to request that her school professionals assess her. Waiting until age seven and the end of first grade is to wait until she fails. Act now so that the help she needs is in place during first grade. These studies would include a speech-language evaluation, an occupational therapy evaluation, and an educational assessment (called a psycho-educational evaluation). These test results will clarify her needs and the services she will need. If your school system refuses to test her until she is seven, try to get the studies done privately.

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