Being active does not equate to ADHD

Dear Doctor,

MY four-year-old son is a very active boy. He can’t sit still for long and is always excited and curious about his surroundings and wants to explore.

I think this is normal but my parents and in-laws say he is hyperactive and that has got me worried.

What’s the difference between a child with attention-deficit/hyperactivity disorder (ADHD) and one that’s just high-spirited?

Worried Mum, Klang

Children cannot be labelled as having ADHD just because they’re active or curious.


Dear Worried Mum,

MOST active children do not have ADHD. There tends to be an over-diagnosis in children with high energy levels.

Being very active, impulsive and curious do not equate to a diagnosis of ADHD.

Some children may have behavioural or disciplinary issues which should be handled differently.

The striking characteristic in a child with ADHD is inattentiveness. They have poor focus on any activity and are usually unable to complete a given task.

It is often difficult for parents to ascertain if their child does indeed have ADHD.

If you are in doubt, get him evaluated by your paediatrician or a child psychologist.


Bed-wetting at 4 is no cause for worry

Dear Doctor,

MY four-year-old still needs to wear a diaper to bed at night. Although she doesn’t wear diapers during the day and can use the toilet by herself, at night she tends to wet the bed.

What can I do to keep her dry at night? Is this normal for children her age?

Justina Peters, KL

Bed-wetting should only be a cause for concern if it goes on beyond the age of five.


Dear Justina,

You will be glad to know you are not alone in this. At the age of four, an estimated 20 per cent of children still wet their beds at night.

Most experts will not consider night bed-wetting to be a problem under the age of five years.

Keeping dry at night involves a more complex mechanism of brain-bladder control and hormone secretion and some children achieve this maturity later than others.

I would not be too concerned about your daughter now given that she is dry by day and uses the toilet independently.

Ensure she is not constipated, not taking fluids 1-2 hours before bedtime and makes a trip to the toilet before you tuck her into bed.

Night-time wetting may be viewed as a normal variation in your child’s development.

If her bed-wetting persists beyond the age of five, it would then be advisable to bring her to see her paediatrician to rule out any other medical conditions.


Answers provided by Dr Kerry Vivienne Jayaprakasam
consultant paediatrician, Pantai Hospital Kuala Lumpur.



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