Hey parents, are you ready to scream: “UNCLE!’’

The challenges of parenting continue to evolve. You’ve mastered the art of juggling multiple school apps, attended countless virtual parent-teacher meetings and prepared more peanut butter and jelly sandwiches than you can count.

You’ve experienced the chaos of leaving your little ones alone for just a few minutes, only to return to a living room transformed into a disaster zone. And your daily workout? It often involves rescuing your 6-year-old from the kitchen countertops as they hunt for snacks.

While the pandemic may have sparked these new roles, the reality is that children still face limited in-person social interactions and families often find themselves navigating a whirlwind of activity at home.

Rachel Slick, a behavioral health therapist with UCHealth Internal Medicine and Primary Care in Greeley, said that it’s important to normalize that these behaviors are common amongst children, especially when they’re at home and engaging with screens for extended periods. “That doesn’t mean they are disordered behaviors or that they require medication intervention.’’

Even as life returns to a semblance of normalcy, you might still wonder when to be concerned about a hyperactive child at home.

“With or without a formal diagnosis, there are basic behavioral management strategies that parents and caregivers can implement to provide more structure and manage inattention and hyperactivity,” Slick said. “This is not a new struggle for caregivers.”

Hyperactivity in children, characterized by constant activity and occasional disruptions, is to be expected. For parents at their wit’s end, Slick offers insights and tips to help manage these behaviors.

What is hyperactivity?

Hyperactivity is characterized by being constantly active and occasionally disruptive.

How is that different from ADHD/ADD?

ADHD is attention deficit and hyperactivity disorder. ADD is attention deficit disorder (without hyperactivity). The state of being ‘hyperactive’ does not necessarily indicate a diagnosis of ADHD, Slick said.

ADHD is diagnosed when symptoms impair functioning in more than one area of life: understanding and communicating, social and interpersonal functioning, academic or occupational functioning, or participating in family, social and community activities.

“Most people experience hyperactivity at some time during their lives without it interfering with their functioning,” she said.

These diagnoses require components of inattention as well. These traits look like difficulty focusing long enough to complete tasks or play activities, trouble listening when spoken to directly, difficulty following instructions, failure to finish schoolwork or chores, difficulty organizing tasks, delaying or procrastinating tasks that require focus, losing things that are necessary for tasks, distractibility, and forgetfulness in daily activities.

Isn’t hyperactivity a normal characteristic of children?

“Yes, some level of hyperactivity is considered developmentally normative in children,” Slick said.

When should I be concerned? What are the characteristics of hyperactivity that aren’t normal or healthy?

Certain children, compared to similar-aged peers, are more active.

“As a parent or caregiver, the time to take action is when the hyperactive behaviors cause interference with schoolwork or making friends,” she said. “This may be indicated by constant punishment at school, difficulty connecting with other children, trouble completing tasks like homework or chores, or being the victim of bullying at school.”

Other signs of a hyperactive child include:

• Fidgeting or tapping hands or feet
• Squirming in their seat
• Leaving their seat when they are expected to remain still
• Running around or climbing in situations where it is not appropriate
• Unable to play or take part in leisure activities quietly
• On the go or acting like they are driven by a motor
• Talking excessively
• Blurting out an answer before the question has been completed
• Difficulty waiting their turn
• Interrupting or intruding on others

Slick stresses that it is important for parents and caregivers to note that these traits are common in children as they develop and begin to learn social norms. They are only “clinically significant” if they cause impairment in functioning at school or home.

Can you have attention deficit without hyperactivity?

Yes. ADD is attention deficit disorder, without hyperactivity. Just like ADHD, it is considered diagnosable when six or more of the symptoms are present and have persisted for at least six months, and cause impaired functioning. The symptoms are:

• Failing to give close attention to details or making careless mistakes in schoolwork, at work, or during other activities
• Having difficulty sustaining attention in tasks or play activities
• Seeming to not listen when spoken to directly
• Not following through on instructions and failing to finish schoolwork, chores
• Having difficulty organizing tasks and activities
• Avoiding or being reluctant to engage in tasks that require sustained mental effort
• Losing things that are necessary for tasks or activities
• Being easily distracted by noise or activity
• Being forgetful in daily activities

Who can diagnose ADHD/ADD? Is there a hyperactivity diagnosis or is it something, as a parent or caregiver, I’ll see and need to address?

Medical providers and mental health professionals can assess and diagnose ADHD/ADD. The diagnosis is not as clear-cut as a blood test or throat swab, Slick explained. It requires an evaluation of the child’s behavior in multiple settings and is overall quite subjective. And anecdotal observations from home and school help clarify symptoms and work towards a more conclusive diagnosis.

“As a parent or caregiver, you may notice these behaviors and their impact on the child’s overall functioning,” she said. “If you think that the behaviors are interfering with the child’s academic or social success, it may be time to bring your concerns to a professional.”

With or without a formal diagnosis, there are basic behavioral management strategies that parents and caregivers can implement to provide more structure and manage inattention and hyperactivity. What are these behavioral management strategies?

• All humans, regardless of age or diagnosis, benefit from routine. Consistent bedtimes, wake times, and meal times will help, as well as a schedule that is somewhat predictable day-to-day.
• Designate a specific space for the child to work on schoolwork – creating associations in the child’s mind between that space and focusing
• Schedule specific movement time for the child to provide an outlet for their energy and hyperactivity
• Offer specific praise to your child when you see them exhibiting positive behavior. This will increase the likelihood that this positive behavior will continue. Example: “I like how you cleared your plate off the table after dinner.”
• Consider introducing a token economy. For example: A child receives a sticker each time he completes a school assignment on time. Once he earns 10 stickers, his parents will let him have an extra 30 minutes of game time on the tablet.
• Decide together with your child, ahead of time, which behaviors are acceptable and which behaviors are not. This helps the parent stay consistent – punishing a behavior one day and allowing it the next day is confusing to a child.
• Children with inattention and/or hyperactivity often struggle to transition from one task to another. Offer warnings to ease this transition. Let them know that in 10 minutes we will switch to math, 5 minutes, 2.5 minutes.
• Break up large tasks into manageable steps. For example, “get ready for school” is a broad task. Work with the child to define what smaller steps go into that task: brushing teeth, getting dressed, preparing backpack, etc. Consider creating a checklist together and placing it where the child can see it regularly (on the mirror in the bathroom, on the fridge, etc.)
• Consider setting a timer for the child to work on a task for 5-15 minutes, depending on their age, followed by a timed 5-minute break. Use this break wisely: movement will help manage hyperactivity, for example. Avoid screens during this break. To refocus the child after the timed 5-minute break, consider using a grounding exercise like this one:

5 Senses Grounding Technique involves asking your child to name:

5 things you can see

4 things you can hear

3 things you can feel (touch: textures around you, a blanket, lotion, your shirt, glasses on your face)

2 things you can smell

1 thing you can taste

If this strategy and grounding technique is implemented consistently, the child will begin to associate the grounding technique with ‘focus time’ and will find it easier to refocus on the tasks at hand.