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Ask Dr. Yogindra Vasavada Your Own Question
Dr. Yogindra Vasavada
Dr. Yogindra Vasavada, Pediatrician
Category: Pediatrics
Satisfied Customers: 3102
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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I have a 4 year old grandson who seems to be very anxious.

Customer Question

I have a 4 year old grandson who seems to be very anxious. He is very fidgety when engaging in quiet activities and frequently bites his nails and picks his nose. He is easily frustrated by tasks, has temper tantrums and is very loud and boisterous. He was the only child in his family until triplets came along when he was three and then another baby just a year later. He can be very sweet and obedient at times but then his mood change suddenly change. I have seen him deliberately trip or push his younger toddler siblings on a regular basis. I am very concerned and would like to suggest that he be tested for ADHD. I would appreciate any advice you might give.
Submitted: 2 years ago.
Category: Pediatrics
Expert:  Dr. Leah replied 2 years ago.

Hello and thank you for your question. Based on the behavior you have described your grandson exhibiting, I think there is no harm in getting an evaluation from either a Developmental Pediatrician or a Pediatric Neurologist. This way, you know if he actually has ADHD or not.

Having said that, there is a strong possibility that his behaviors are due to sibling rivalry. It sounds like he has had to adjust to lots of changes within the household, and toddlers sometimes feel "replaced" when this happens. I know from first-hand experience how much time and effort from parents and other caregivers need to care for triplets. Your grandson may feel that he needs to do certain things to get the attention of the adults in the family, even if it means doing things that could potentially harm a younger sibling. I think this may also be the reason for his loud outbursts and tantrums, kind of a way to say, "Hey, look at me!"

Obviously, you and his parents cannot always give him undivided attention with 4 other siblings at home. What I would suggest is to have one adult spend 15-20 minutes/day with your grandson doing an activity that is only appropriate for him. This may help him realize that he's "not forgotten," and curb some of his undesirable behaviors.

Expert:  Dr. Leah replied 2 years ago.

One other suggestion about the "nail biting:" you may want to get one of those "anti-stress" squeeze balls. Whenever you see him biting his nails, give him the squeeze ball to hold/squeeze instead. He may not even realize how often he bites his nails, especially if he's distracted by the "quiet activity."

Expert:  Dr. Leah replied 2 years ago.

I see that you not online. If you have further questions when you return, feel free to ask.

Customer: replied 2 years ago.
Thank you for your prompt response. My heart goes out to him because he seems very anxious so much of the time. He can be a very sweet and helpful little guy but his poor behavior is difficult to handle with so many little ones around. I think I will try to find a way to carefully suggest to his parents he be tested for ADHD just in case. We all just assumed it was sibling rivalry but I would like to make sure it's not something more serious. I do have to say though that his grandfather and I had him to our house for several days to shower him with one-on-one attention and he was very well-behaved for the most part. Thanks again; I feel better after chatting with you. All the best.
Customer: replied 2 years ago.
I will also get him an anti-stress ball; I think that could be helpful for him.
Expert:  Dr. Leah replied 2 years ago.

Very glad to help! Best wishes to you and your family!