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According to the U.S. Centers for Disease Control and Prevention, 1 in 11 school-aged children are diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) and new research suggests that the warning signs often appear even before the demands of school begin. As many as 40 percent of children have significant problems with attention by age four, and ADHD is now the most common mental health disorder diagnosed in the preschool years.

Mark Mahone, director of the Department of Neuropsychology at the Kennedy Krieger Institute in Baltimore, encourages parents to be especially observant of their young child's behavior.

"Research shows that children with ADHD have abnormal brain development, meaning that ADHD has a biological basis that often makes it a lifelong condition," Mahone said. "We want to catch ADHD early because it has such a profound effect on learning and academic development. Children whose symptoms begin in early childhood are at the highest risk for academic failure and grade repetition."

Mahone and his colleagues at Kennedy Krieger are among the first to use neuroimaging to study the brains of preschool children with symptoms of ADHD. They recently discovered that children with ADHD have a smaller caudate nucleus-a small structure in the brain that is associated with cognitive and motor control-than their typical peers. By identifying the biological markers of ADHD, they hope that intervention can begin earlier to facilitate better educational outcomes.

In preschool-aged children (3-4 years), Mahone recommends that parents look for the following signs that are associated with an ADHD diagnosis when children reach school age:

1. Dislikes or avoids activities that require paying attention for more than one or two minutes
2. Loses interest and starts doing something else after engaging in an activity for a few moments
3. Talks a lot more and makes more noise than other children of the same age
4. Climbs on things when instructed not to do so
5. Cannot hop on one foot by age 4
6. Nearly always restless - wants to constantly kick or jiggle feet or twist around in his/her seat. Insists that he/she "must" get up after being seated for more than a few minutes
7. Gets into dangerous situations because of fearlessness
8. Warms up too quickly to strangers
9. Frequently aggressive with playmates; has been removed from preschool/daycare for aggression
10. Has been injured (e.g., received stitches) because of moving too fast or running when instructed not to do so

"If parents observe these symptoms and have concerns about their child's development, they should consult with their pediatrician or another developmental expert," Mahone said. "There are safe and effective treatments that can help manage symptoms, increase coping skills and change negative behaviors to improve academic and social success."