Q: If a child is a little shy and at times aloof, can he or she be diagnosed as Attention Deficit & Hyperactive disorder. My child is less than 4 years - lacks concentration and takes time to mix with others. She knows counting from 1 to 20 and is good at language uptake. Is it too early to announce a judgment (ADHD). Would she improve with time? Could she be detected as ADHD child. Should any drugs be given at this early age ? She completed all her milestones very well - weight is 17 Kg & height is 120 cm. She is very inquisitive and sensitive. It takes some effort to put her to sleep at night. She has problem with sleep at an early age with a habit to bang her head on the bed. Please advise and, if possible, give some tips to improve child behaviour.

A:Your child sounds like a bright and normal child to me. It is not only too early to refer to Attention Deficit as a possible condition, but also entirely unnecessary, in my view. Once we use such labels, they tend to get stuck to the child. The only problem that seems to emerge in your description is that the child does not go to sleep easily. This could be handled by reducing the stimulation and excitement as her bedtime approaches, and let her fall asleep. Do not let her watch a lot of TV. Most of it is unfit even for older children. One of her parents should be with her at sleep time, telling her a simple story or singing a lullaby. This will soothe her and she feel fall asleep in a relaxed way. At this age, all children go from one thing to another, with only a short attention span. There are of course, differences among children on all aspects of their development, including the way they go to sleep and the way they wake up. It is necessary for the parents and other caregivers to reassure her of their warmth and concern. Talking to the child, listening to the child and being playful are all important for a child's self confidence to develop. Good picture books which the parents or grandparents can read out to the child and letting the child handle the books, will take care of a number of problems. The child must feel valued as a person, and not valued only for being clever or reciting or reeling off the numbers. In any case, no drugs, please! Make sure also that the Nursery School or Play school to which you may be sending her is not putting too many demands on her or making her feel insecure. Your close observation of the child is good, but excessive anxiety may have a negative effect. Treat her as a special person and a friend and you will find that the pleasures of parenthood will increase.