Family Therapy UK

Excitable, Overactive and Difficult to Calm Children



This information is aimed at very young children up to the age of about five or six.  Excitable, overactive and difficult to calm children are in the news at the moment.  Everyone seems to know about ADHD (Attention deficit hyperactivity disorder) and very often when a child is over excitable and difficult to settle, parents and teachers wonder whether their child has ADHD.  You can read my information leaflet on ADHD on this site.

ADHD is rarely diagnosed in children under the age of four or five because it is difficult to distinguish normal over-excitable behaviour from ADHD.  There are also concerns about very young children taking ADHD medication such as Ritalin.

It is quite normal for young children to be unsettled, over-excitable and difficult to calm at times. Young children are full of energy.  Children progress from a position of having all their needs met as babies to one where we expect them to be more sensible and independent. This is a difficult shift in a young child's life. It is a time of big changes. Their bodies are growing and they have to face new situations and challenges such as going to nursery school and maybe the arrival of new siblings. They may struggle with these new situations and events. Being so young and inexperienced about life, they have not yet fully developed the sophisticated coping skills of older children.

Facing new situations can lead to anxious feelings. Many of these anxieties are around separation and dealing with the demands of a more independent existence. At this age, children's feelings are very powerful. They have not yet mastered social skills and can become easily over-excited or moody. Experiencing the emotional development of our children can be a wonderful and satisfying experience, but at times, their bursts of energy and excitability can be exhausting. This is can be magnified if you are isolated, tired, exhausted or depressed.

It takes a long time to build up social skills in your children. Teaching them these skills will help them develop better self-control and social abilities in their later life.  Being a parent is hard work at times, but do look around at other parents with young children. They will experience similar difficulties at times too.  It is easy to fall into the trap that only you have such difficulties and that you are a bad parent.

Children's temperaments vary enormously.  It is not uncommon for parents to have one child who is very easy going and calm and another who is much more challenging.  Some characteristics of our temperament are genetic, some are learnt.  Children with a lively temperament will need greater help in controlling it and will present a bigger challenge to parents.  In some situations, a lively temperament will be a positive asset to a child.  They may be more outward going, may enjoy sports and physical activities and have lots of friends.  In other situations they can become a nuisance and may develop difficulties in nursery or school with other children.

If your child has difficulties at nursery or school discuss this with the class teacher. If your child is at school you can contact the school nurse or doctor for advice and help. School doctors are called community paediatricians in the UK.  Children who have mild hearing difficulties often become loud (for obvious reasons) but sometimes they become withdrawn.  This is because they cannot hear and follow instructions as well as other children.  They can become quite frustrated and start feeling stupid and fall behind the rest of the class.  Because their hearing difficulty is slight, it can be missed by teachers.  In my work with children who have difficulties in primary school, it is surprising how many children have had mild, but significant, hearing difficulties such as "glue ear".

Children who have speech and language difficulties can also become over excitable and upset.  The school or your doctor can refer you to a speech and language therapist for help.  Speech and language therapists will properly assess you child and provide treatment if it is required to help them communicate better.

Very often, children who have difficulties at school hold their feelings in until they get home.  When they get home, into a safer environment, it all comes pouring out in "acting out" behaviour.  Acting out behaviour is a term used to describe acting out feelings through behaviour.  Because young children are not good at explaining things, they can show their feelings through the way they behave.  It can be useful to think of difficult behaviour in your child as a message that they are distressed or frustrated in some way.

If children have a long term illness or are taking medication, this can upset their normal behaviour.  With some medications there are side effects.  Always ask your doctor about possible side effects from medication.

Family Issues

If your child has a difficult temperament or has started being more challenging than normal, think about how you manage their behaviour.  There are some other information leaflets in this series which may help you listed at the bottom of this leaflet.

Think about your own psychological health and whether it may be playing a part in your ability to manage your child.  Are you unhappy or depressed?  Maybe you have had to face a major illness, deal with a bereavement, have financial or relationship difficulties.  Maybe you are just feeling a little low or fed-up with life.  These types of situations and events make it harder to cope with demanding children.  If you have a partner, talk to them about this.  Try to get a break from the children from time to time and keep up some social activities.  If you have pre-school children, keep yourself focussed on how it will be easier when they start nursery or school.  Try not to become isolated.  If you feel you are not coping, or are becoming depressed, talk to your doctor who will arrange help for you. Many GP practices in the UK have counsellors, health visitors and primary health care workers who can help you with these types of difficulties.

If you are having relationship problems with your partner, this can upset and distress the children too.  Children are sensitive and will pick up on fears and anxieties are around them. This can make them anxious, more demanding and clingy.  Try to keep children out of disputes and arguments.  If you need help as a family, your doctor may be able to refer you to a health visitor, or in more complex situations, to a child and adolescent mental health unit. In the UK you can seek out a Family Therapist or contact organisations such as relate RELATE, or the NSPCC.

It may be useful to adjust your management of the children.  Be clear about rules of behaviour you expect from the children. Try to be consistent in how you deal with the them when they are naughty. Work together and in agreement with your partner.  Try not to pay too much attention to the difficult behaviours in your child. Do praise and encourage good behaviour.  Don't ignore good behaviour, always comment on it and how it makes you feeler warmer and closer towards the child.

With over excitable and restless children, having a routine often helps.  This is true for most children.  Routines around bedtimes or getting ready for school in the morning can help children feel clearer about what they need to do. It gets them into the habit of doing things at a certain time and in a certain way.  Gentle reminders of what they need to do can help too.  Be clear about what you expect from them.  For instance it will be better to say, "Sam, I would like you to go up to your room and put your toys back into the red toy box for mummy" than "Sam go up and tidy your room!"  Remember to praise them when they are doing well.  Praise them even if the improvement is small. Let them know how pleased you are.  Be specific when you praise them.  For instance, "When you play so well Sam, it makes me feel so good and close to you."  This will encourage them to make further improvements.

Young children enjoy doing things with their parents. Getting a child to help you put their toys away is more interesting and rewarding than you telling them to do it on their own. If you have lots of difficult times with a particular child, try taking them out somewhere interesting. This way you can build up your relationship with them away from your normal setting.

If all this fails and your child has persistent difficulties both at school and home, you may want to talk to your doctor for advice. If school have particular concerns they may ask for an educational psychologist, SENCO, speech therapist or school doctor to assess your child.  This could be to check out whether they have ADHD, a specific or more general learning difficulty or speech and language difficulties.  Work closely with other professionals. Expect and ask for clear information from them about what they are doing and why.  Try not to fall out with them.

Here are some further information leaflets in this series that may help you

Dealing with conduct disorder

How to deal with very difficult behaviour in children (up to age 10)

Dealing with tantrum behaviour

Attention Deficit Hyperactivity Disorder

Specific learning difficulties

Getting Extra Help in the UK


Dennis Neill

Family Therapist

Family Therapy UK

7th September 2009

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