Developmental Issues: Why Your First Grader Probably Doesn't Have ADD or ADHD

One of my pet peeves is the tremendous pressure that schools have been putting on our young children to "perform". Over the past several years, schools have been ratcheting up their demands for the performance of academic tasks on younger and younger children. But the developmental realities of young children don't change just because No Child Left Behind wants "results". Young children aren't yet capable, cognitively or psychologically, to tackle heavy-duty academic work -- without paying a price. And I worry about those children, like Linda's daughter below, who may be unfairly flagged as having "problems with focus", or even labeled ADD/ADHD, at such a young age.

Read on for Linda's question, and my answer below:

Hi Dr Heather,

My six-year-old daughter is in first grade. Her teacher says she has "focus" issues, and is worried. While this is a small class in a private school, she is there for about 10 hours every day. That's a long day. I think she just gets tired in the afternoon…at that age the best thing would be for her to be at the house at 3p I think. However we both work full time so it's not an option.

I asked the principal about holding her back. However because she is so smart, there is a chance she would be bored and the principal says in her experience (30 years) holding back children due to focus issues rarely solves the issue at hand. She was tested at age three with a district program that checks for ADD and other issues, and the assessor saw no warning flags.

I think she is just a kinesthetic learner who is dreamy and in her head..and should probably be in school for a shorter day. Am I missing something? Can you really say "ADD" for sure at age six? I am worried that this could just be normal range of behavior for this age, and the requirements of schools these days are just the stress trigger, making her hard to work with.



Hi Linda,

In general, I do agree with you that our educators are expecting WAY too much of our children these days, when it comes to "performance" at an early age.

First grade is an interesting age. Teachers will tell you that they typically witness a huge change in children as the year progresses. Most kids will make the transition from what I see as more of a "preschool" sort of mentality, to more of a "grade school kid" sort of mentality. It's a big step that's made sometime during the year, and many issues of the kind you describe are sorted out in the process. That's why standardized tests are viewed (at least by testing specialists) as being NOT super-valid until SECOND grade. There are too many variables up through the first grade. That's also why we typically don't diagnose a child with ADD/ADHD until at least age 7.

Our own daughter was "flagged" in first grade for variable performance on standardized tests that year. It made me crazy that they made the first graders sit for standardized tests at all -- they're worthless at that age! By the time they had a specialist test her (at the END of the year), all the issues they were concerned about had "vanished". She is now doing beautifully in third grade.

Now of course I can't directly evaluate your daughter, but I do think the questions you are asking are valid, developmentally. Asking a 6-year-old to focus for 10 hours a day, 5 days a week, is pretty unrealistic. But of course you want to make sure to take any legitimate concerns seriously.

You might consider asking the teacher to reinforce "on task" behavior, instead of simply worry about "off-task" behavior. You and she can collaboratively set up a plan whereby your daughter is rewarded (with something simple, like stickers or checkmarks, to trade in for small prizes) on a chart for demonstrating a few minutes at a time of "on-task" behavior. You want to set it up so that the goals are ACHIEVABLE -- not something diffuse like "having a good day". You will get much farther with rewarding her for focusing, than by making a federal case out of her being "off-task". You also want to avoid giving her undue attention for NEGATIVE behavior, especially at this age. Kids have a way of absorbing the negative attention directed at them, and can internalize the idea that they "have a problem". You're much better off by reinforcing -- and praising her -- for doing what you'd like her to do more of. You can also tie her performance at school to things you want her to do at home -- listen, complete chores, etc. If reinforcement and praise are coordinated between home and school, you have a better chance of improving things in both places.

See where this gets you, and let us know how it goes.

Aloha, Dr. Heather The BabyShrink