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"Overactive" Three-Year-Old

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q: My son will be three in a few days. My husband and I send him to a pre-nursery school five days per week for three hours per day. We recently conferenced with his teachers, and we were both left feeling very anxious at the end of the conference. My son has always been a very happy and active child; however, his teachers told us that he is "overactive" and that he puts himself in danger at school as well as injuring his classmates. He likes to play "shooter" and sword with all of the toys. (At home there are no toys of this nature.) We had no idea that this was happening.

Our son is very bright, but according to his teachers he lacks that inner mechanism that a three-year-old should have that helps to control his behavior. They believe that there is something wrong with him, and hinted that he should be evaluated. We do agree that he is active, but when he is with us he is tractable. They also thought that it is pertinent to mention that he still puts objects into his mouth, and that at his age this was inappropriate. What should we do? This is supposed to be the best day school in our community; yet we feel that the teachers' view of our son is not right. How should we handle this? We would hate to have him given a negative label at such a young age.

A: It is important to understand a little bit about child development in order for you and your husband to sort through all of this. All two year olds lack an inner mechanism to control their behavior, and this extends through age three for many children. One of the great struggles of this age is learning how to attain some self control, and it happens for each child at different ages. One must also take into account different temperaments; some children are a bit more high strung than others. Certainly no one should label a three year old as "hyperactive"--it's the nature of the beast at that age! There are many children who are extremely active at age two and a half to four, who settle down nicely by four to five.

Also, it is not at all unusual for children to still put things in their mouth at age three. However, you also don't want to totally reject the information that the teachers are giving you. Presumably they are educated and experienced people, and are spending up to 15 hours a week with your son--they probably have some useful insights. I would use their concerns as an indication that your son may need some help from you to achieve better self control. He may need more consistent and firm limit setting, appropriate use of time outs for unacceptable behavior (e.g. safety issues), and a certain amount of structure and consistency in his day. You should talk with your pediatrician to make sure there are no specific medical concerns based on his history. I would then recommend setting up a plan with the teachers for handling the problem behaviors so that there is consistency between home and school. If you work together you will likely be able to alter the behaviors that your child is exhibiting, without giving him any negative labels.

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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.

Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

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