An increasing number of children are diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, there is concern among doctors and parents that many children are misdiagnosed. A high activity level may be completely normal and simply an exaggeration of normal childhood temperament. Alternatively, it may have a variety of causes, including emotional disorders or abnormalities of brain function, such as ADHD.

Generally, 2-year-olds are active and seldom stay still. A high activity and noise level is common up until age 4. In these age groups, and in children functioning developmentally in this age range, such behavior is normal. Active behavior can cause conflicts between parents and child and may worry parents. It also can create problems for others who supervise such children, including teachers.

Determining whether a child’s activity level is abnormally high should not simply depend on how tolerant the annoyed person is. However, some children are clearly more active than average. If the high activity level is combined with short attention span and impulsivity, it may be defined as hyperactivity and considered part of ADHD.

Scolding and punishing children for a high activity level usually backfires, increasing the child’s activity level. Avoiding situations in which the child has to sit still for a long time or finding a teacher skilled in coping with such children may help. If simple measures do not help, a medical or psychologic evaluation may be useful to rule out an underlying disorder such as ADHD.