Is it Just a Phase? How to Tell Common Childhood Phases from More Serious Problems
By Susan Anderson Swedo, M.D., Henrietta L. Leonard, M.D.
The most frequent question parents ask us is "My son is always so 'hyper.' Do you think he's hyperactive?" When we ask them to define hyper, they say, "He's constantly on the move," "He's always on the go," or "He can't settle down." Sometimes, the parents just say, "You know, 'hyper'!," as the term has been used so often that it now has an implicit meaning. That meaning often depends upon the person's perspective, however, and
"hyper" is used to refer to everything from a normal three-year-old' exuberant activity to the frenetic activity levels seen in children with hyperactivity disorders. The word "hyper" is actually an abbreviation of hyperactivity, which is part of a medical diagnosis: attention deficit hyperactivity disorder. ADHD is common and affects about 5 to 10 percent of children in the United States, but even so, most hyper children don't have true hyperactivity or ADHD. Their activity level is in the normal range-for their age.
"My four-year-old wears me out! Is he always going to be this hyper." Activity levels vary by age along a spectrum that is highest in young children and lowest in the elderly. Most of the change in activity levels occurs in the preschool years. If you think about a child of two to three years of age, he is constantly on the move-running from room to room, climbing up and down from chairs, and covering the entire room with toys as he plays. When he's outside, he runs everywhere-even on the hottest days, he won't slow down for more than the second or two it takes to get a drink and give you a sweaty hug. That same child looks quite different when he's seven to eight years old. By then, he can play quietly with games or toys for long periods of time and is able to stay seated throughout a family dinner (with only occasional forays to the bathroom). His activity level can be adjusted to fit the situation-if he's at soccer practice, he can run as hard and long as a three-year-old, but if he's in school, he can sit quietly in his seat and do his schoolwork.
The decrease in energy levels happens at different times for different children. Sometimes, it seems that your child will never "settle down," especially when you've spent the day running after him and are totally exhausted. If you're not sure whether your child's activity level is normal for boys his age, compare his behavior with other children's: how much do they move, how often do they change activities, and how long can they sit still? If the children are younger than five years of age, they probably run more than they walk and fidget more than they sit still. By the time they reach first grade, most girls can sit still for long periods of time and most boys for at least brief periods. Their behavior is more appropriate to the circumstances, although they might still have hyper periods in certain situations, such as when they're excited about a birthday party or overstimulated by holiday excitement. As the children grow and develop, their nervous systems mature and their activity levels modulate-this happens more quickly for girls than it does for boys. No one knows yet why girls' nervous systems develop faster than boys', nor why their overall activity level is ultimately lower, but the differences are striking, particularly in the early grade school years.
"My son is so much more hyper than his sister was at this age." If you watch a typical boy at age six, he appears younger and more active than a girl of the same age. He prefers rough play and outdoor activities to playing quietly or doing craft projects. If he's seated, he's likely to be tipping his chair back and forth at the dinner table, and, like Zachary, he still runs in the house and climbs on the furniture, especially when he's bored, tired, or needs to blow off steam. His ability to modulate his activity levels to fit the situation is less mature than a six-year-old girl's would be and his activity seems hyper and immature in comparison with hers.
These gender differences can worry parents, especially when they have children of both sexes and their son is second-born. The parents build a set of expectations through experiences with their daughter's behavioral development, and then their son doesn't fit those expectations. In comparison with his older sister, he appears to be hyperactive, but chances are he's not. Comparison with other boys his age will help his parents decide if the activity level is really hyper, or if it's merely a function of his age and gender.
"My son never sits still-especially when we're in church or eating at a nice restaurant." Zachary may have been jumping on the couch and running about the family room because he was bored. After all, he'd already spent four days in the house and it was time for him to get out and do something fun! All children get bored at times, and when they're bored, they look for something interesting to do. Large muscle activities, like running, jumping, and wrestling, are an ideal response to boredom because they are so stimulating. However, there are many situations in which such physical activity is inappropriate, like church, school, or a dinner party. If the child can't escape his seat, he begins to move anyway, by squirming and fidgeting in his chair.
If boredom is the cause for your child's increased activity levels, then he should be hyper only in situations in which he isn't sufficiently stimulated, such as watching a boring program on TV, waiting at the dentist's office, or visiting Aunt Tillie in the retirement home.