Last week, a mother sat across from me, wringing her hands nervously. “Everyone keeps telling me my daughter just needs more discipline,” she said quietly. “But what if it’s something more? How do I know if I should be worried or if I’m overreacting?”

I hear this question almost daily. And I understand the weight of it. You don’t want to pathologize normal childhood energy, but you also don’t want to miss something that could help your child thrive. After years of working with families, I want to help you understand the difference and trust your instincts.

The Line Between Energetic and ADHD

Let me be clear: all young children are energetic. They run instead of walk. They interrupt. They struggle to sit through dinner. This is developmentally normal, especially for children under seven.

But ADHD is different. It’s not about having energy, it’s about how the brain regulates attention, impulses, and activity levels. Think of it like this: an energetic child can focus when they’re interested. A child with ADHD struggles to focus even on things they love.

Here’s what I look for in my practice:

An energetic child might bounce around the house after school, talk nonstop about dinosaurs, and resist bedtime. But they can settle down to watch their favorite show, complete a puzzle they enjoy, or listen when you read their beloved bedtime story.

A child with ADHD can’t seem to regulate their focus, even with things that excite them. They start the puzzle but abandon it within minutes. They love the story but keep interrupting or fidgeting so much they miss the plot. They’re wide awake at bedtime but almost impossible to wake up in the morning.

The Three Types of ADHD (Yes, Three)

Many parents don’t realize ADHD comes in different forms. It’s not always the stereotypical “bouncing off the walls” child.

Hyperactive-Impulsive Type: This is what most people picture constant movement, blurting out answers, difficulty waiting turns, always “on the go.” These children are often identified early because their behavior is hard to miss.

Inattentive Type: These are the daydreamers, often girls, who slip through the cracks. They’re not disruptive, but they’re constantly zoning out, losing things, forgetting instructions, and struggling to finish tasks. Teachers might describe them as “spacey” or “not reaching their potential.”

Combined Type: Shows significant symptoms of both inattention and hyperactivity-impulsivity.

I’ve worked with brilliant children who struggled silently for years because no one recognized their inattentive ADHD. They weren’t “problem children,” so no one thought to evaluate them until their anxiety and self-esteem went down from constantly feeling behind.

Red Flags That It’s Time to Seek Help

Trust me when I say this: you know your child better than anyone. If your gut is telling you something feels off, listen to it. But here are specific signs I tell parents to watch for:

At home:

• Cannot complete simple tasks even with your full attention and support
• Loses or forgets things constantly (homework, jackets, permission slips) despite reminders
• Extremely impulsive decisions that create safety concerns (running into street, climbing dangerously)
• Emotions shift dramatically with little trigger explosive anger or sudden tears
• Cannot engage in quiet activities for even short periods, regardless of interest level

At school:

• Teacher expresses concerns multiple times across different months
• Falling behind academically despite clear intelligence
• Frequent reports of “not listening,” “daydreaming,” or “disruptive behavior”
• Making careless mistakes even on work they know how to do
• Difficulty making or keeping friends due to impulsive or inattentive behavior

The critical question: Are these behaviors affecting multiple areas of life? ADHD isn’t just “sometimes.” If your child focuses perfectly at home but struggles at school, that might be a classroom environment issue, not ADHD. But if you’re seeing challenges at home, school, playdates, sports, and family gatherings across different settings with different people that’s a signal.

Also consider duration. ADHD symptoms persist for at least six months and typically start before age twelve. A child going through a stressful period (new sibling, moving homes, family changes) might show temporary hyperactive or inattentive behavior that resolves as they adjust.

Taking the First Step: Your Pediatrician Visit

When you decide to seek help, start with your pediatrician. I know this feels overwhelming, but preparation makes it easier.

Before the appointment, do this homework:

• Write down specific examples of concerning behaviors with dates
• Ask your child’s teacher to complete a behavior rating scale (your pediatrician can provide this)
• Track when behaviors are worst and best (time of day, activities, settings)
• List any family history of ADHD, learning disabilities, or mental health conditions

During the visit, your pediatrician will likely:

• Review your child’s developmental and medical history
• Ask detailed questions about behaviors at home and school
• Rule out other possibilities (hearing/vision problems, sleep disorders, anxiety, learning disabilities)
• Possibly refer you to a specialist for comprehensive evaluation

Here’s what many parents don’t expect: there’s no single test for ADHD. No blood work, no brain scan. Diagnosis is based on observing patterns of behavior over time across multiple settings. This can feel frustrating if you want a clear answer but comprehensive evaluation is actually more accurate than any single test could be.

The Evaluation Process: What to Expect

If your pediatrician refers you to a psychologist, psychiatrist, or developmental pediatrician, the evaluation typically includes:

Clinical interviews with you and your child, asking detailed questions about development, behaviors, family dynamics, and daily functioning.

Rating scales and questionnaires completed by you, teachers, and sometimes other caregivers. These standardized tools compare your child’s behavior to typical development.

Direct observation of your child during testing or play to see attention, impulsivity, and activity levels firsthand.

Academic and cognitive testing to rule out learning disabilities and understand your child’s strengths and challenges.

The entire process usually takes several weeks. I know waiting is hard, but thorough evaluation prevents misdiagnosis and ensures your child gets the right support.

Treatment Options: It’s Not Just Medication

When I give an ADHD diagnosis, I see fear flash across parents’ faces. They worry it means their child is broken or will need medication forever. Let me ease your mind: ADHD is highly treatable, and there are multiple approaches.

Behavioral interventions form the foundation, especially for younger children. This includes parent training (learning specific strategies to manage behavior), classroom accommodations (preferential seating, movement breaks, modified assignments), and organizational skills coaching.

Medication can be life-changing for some children, helping their brain regulate attention and impulses. But it’s not mandatory, and for children under six, behavioral approaches are tried first. If medication is recommended, start with education: understand options, ask questions, start low and adjust carefully with medical supervision.

Therapy helps children develop coping strategies, build self-esteem, and manage emotions. Many kids with ADHD also benefit from social skills groups.

School support: Your child may qualify for a 504 Plan or IEP, providing formal accommodations and services.

The best outcomes come from a multimodal approach combining several strategies tailored to your child’s unique needs.

You’re Not Alone in This

Whether your child has ADHD or is simply energetic, you’re doing the right thing by seeking information and trusting your instincts. Getting evaluated doesn’t mean you’ve failed, it means you’re being proactive about your child’s wellbeing.

And if your child does have ADHD? That’s not a tragedy. It’s information that unlocks doors to support, understanding, and strategies that help them succeed. I’ve watched countless children flourish once they received the right diagnosis and support.

Your child is still the same wonderful person they were before any label. They’re just getting the tools to show the world their full potential.

Take a deep breath. You’re advocating for your child beautifully. And whatever you discover on this journey, you won’t be walking it alone.