Hyperactivity: helping a child with lots of energy

The AAP says it is typical for young children to run in circles, rarely stop to rest, bump into things and ask lots of questions.

What helps at this age

• Lots of outdoor play every day
• Short activities, then a change
• Simple jobs: carrying, fetching, pushing
• Songs and games with movement

The AAP says long stretches of active play are typical, with the occasional impulsive act, especially when excited.

What helps at this age

• A daily dose of real exercise
• Movement breaks between seated tasks
• A sport or activity they choose
• Clear, short rules for indoor play

The AAP notes that in the teen years, very active behaviour often fades or is replaced by a sense of restlessness. Long, lively social time, like dancing, is typical.

What helps at this age

• Sports, gym, dance or skating
• Walking or biking instead of being driven
• Standing or moving while studying
• Protecting sleep

The AAP describes signs that may point to a hyperactivity problem, such as often knocking into people or things, frequent injuries, or being unable to sit for a story or a meal, compared with others the same age.

A 2023 review of 44 studies with 1,757 children and teens with ADHD found that physical exercise can help ease ADHD symptoms and improve executive function skills like planning and focus.

The authors say results should be read with caution because many studies were small or of limited quality. They suggest choosing exercise children enjoy, so they keep doing it.

An expert quoted by the Child Mind Institute calls exercise a “do-no-harm” step, and says physical activity matters for children’s development whether or not they have ADHD.

The Child Mind Institute adds that exercise helps but isn’t a miracle cure, and doesn’t replace other treatment a child may need.

In a U.S. survey of 452 parents of children with ADHD, parents reported fewer symptoms after activities in green outdoor spaces, like parks, than after the same activities indoors or in built-up areas.

Easy ways to add green time

• Do homework breaks in the garden or yard
• Play in the park after school
• Take a weekend nature walk
• Walk the long way, past trees

The CDC says nutritious food, lots of physical activity and enough sleep can help keep ADHD symptoms from getting worse. The NHS suggests making time for activities your child enjoys, because exercise helps focus their energy.

Ideas

• Animal walks: bear crawl, crab walk, frog jumps
• Dance to one song
• Jumping jacks or star jumps
• Race to the end of the garden and back
• Wall push-ups

Many active children settle to homework more easily after a run around. Plan short breaks between chunks of work, instead of one long sitting.

Ideas

• Clap or tap a rhythm and copy each other
• “Simon says” with hands and faces only
• Squeeze and relax hands and feet, one at a time
• Stop for a run-around on long trips

Giving an active child helpful jobs lets them move and feel useful at the same time.

Ideas

• Carrying shopping bags in from the car
• Fetching things for you from another room
• Pushing the shopping trolley
• Setting the table
• Watering the plants

The CDC notes some children with ADHD learn well while moving. Letting your child stand at the counter, sit on a ball or swing their legs while they work may help them focus.

If your child is physically impulsive or accident-prone, the AAP suggests taking time to clear clutter and safety-proof your home.

Ideas

• Anchor bookshelves and dressers to the wall
• Clear a space where active play is allowed
• Move breakables out of reach
• Use soft cushions or a mattress for a “crash pad”

Understood describes heavy work as activity that pushes or pulls against the body, like carrying laundry or swimming. Occupational therapists use it with some children who seek a lot of physical input, and it may help them calm down and feel more settled in their bodies.

Ideas

• Carrying groceries or laundry baskets
• Climbing and hanging on playground bars
• Pushing a vacuum or a box of toys
• Squishing play dough
• Wheelbarrow walking

Ideas

• Balloon keep-up (don’t let it touch the floor)
• Cushion obstacle course
• Dance party with freeze
• Indoor scavenger hunt
• Kids’ exercise or yoga video, then screen off

Ideas

• Biking, scooting or skating
• Climbing frames and trees (with supervision)
• Jumping rope
• Running games like tag
• Swimming

Wrestling and pillow fights can be a great outlet. Understood suggests wrestling only if your child won’t get over-excited.

Simple rules

• Anyone can say “stop”, and everyone stops
• No hitting faces or heads
• Soft surfaces only
• End with a calm activity, not straight to bed

Letting kids take the lead is key, according to the Child Mind Institute. Try a few taster sessions before signing up for a whole season.

An expert quoted by the Child Mind Institute says highly competitive sports may not be the best fit for kids who struggle with directions or coordination. Non-competitive options can work well.

Ideas from the Child Mind Institute

• Biking
• Fencing
• Martial arts
• Swimming
• Track and running

Activities with lots of waiting for a turn can be tough for a very active child. Look for activities where everyone keeps moving, or where waiting time is short.

Ask the coach

• How much of practice is spent waiting?
• Can my child have a job between turns?
• How do you handle kids who find it hard to stand still?

The Child Mind Institute suggests building exercise into home life: family bike rides, walking to school and games like tag.

Try this order

1. Big movement: run, jump, dance (a few minutes).
2. Slower movement: stretching, animal yoga poses, slow marching.
3. Heavy work: carry cushions back, push against a wall.
4. Breathing: a few slow belly breaths.
5. Quiet: a book, drawing or cuddle.

Sesame Workshop suggests breathing games for young children, repeated four or five times each.

Ideas

• Mountain breaths: trace up a finger while breathing in, down while breathing out
• Snake breath: breathe in, then let it out slowly with a long “hiss”
• Stuffed animal ride: lie down with a soft toy on the tummy and watch it rise and fall

Sesame Workshop suggests helping your child set up a small calming space with soft blankets, comforting toys and other soothing things.

What to put there

• A few books
• A soft blanket or beanbag
• A squeeze ball or play dough
• Pictures of calm-down choices

Ideas from Sesame Workshop

• Animal alphabet: name animals from A to Z
• Story of the day: tell your day in order, from waking up

When your child is revved up, getting louder yourself usually adds fuel. Lowering your voice, slowing down and breathing slowly yourself shows their body what calm looks like.

The CDC suggests parents find out whether students get 20 minutes or more of recess a day, and whether the school has a policy that stops teachers taking away recess as a punishment.

The Child Mind Institute suggests talking with teachers about movement beyond gym class.

Ideas to ask about

• Being the class helper: handing out papers, taking messages
• Short movement breaks between lessons
• Standing at the back or using a wiggle cushion
• A quiet fidget that stays in the hand

If your child has ADHD or another condition, movement breaks and other supports can sometimes be written into a 504 plan or IEP.

After a long day of sitting, many active children need to run before they can focus again. A snack and outdoor play first, then homework in short chunks, works for many families.

Ideas

• Burn energy first: a walk or play before you leave
• Explain what will happen and how long it will take
• Agree one or two simple expectations
• Plan a reward for afterwards

What to pack

• A small notebook and crayons
• A squeeze ball or quiet fidget
• Stickers
• A snack and water
• Small figures or a travel game

Ideas

• Go at quieter times
• Sit near the door or by a window
• A short walk outside with one adult while you wait for food
• Praise good moments during the meal

Ideas

• Stop every hour or two for a run-around
• Audio stories or music to sing along to
• Car games like “I spy”
• A map so they can see how far is left

Try to fit the big, energetic play into the afternoon and early evening, and keep the last hour before bed calm and quiet.

Calm evening ideas

• Bath
• Drawing or colouring
• Gentle stretching
• Puzzles
• Reading together

The AAP suggests keeping TVs out of bedrooms and screens off at key times, as part of reducing distractions for children with ADHD.

A simple routine

• Bath or wash
• Pyjamas and teeth
• Story or quiet chat
• Lights out at the same time

• Your child is often getting hurt
• They can’t sit for a story, a meal or a short game, compared with others their age
• Teachers keep raising the same concerns
• Friendships are suffering
• Your child seems unhappy or feels “bad”

Your child’s pediatrician can look at the bigger picture, including sleep and other possible causes, and talk with you about next steps.

The CDC says parent training in behaviour management is the recommended first choice for children under 6 with ADHD. Parents typically attend 8–16 sessions with a therapist.

If your child seems to crave movement, crashing and jumping, an occupational therapist can assess their needs and create a plan of activities that fit.

The National Resource Center on ADHD, a CHADD programme funded by the CDC, runs a helpline at 1-866-200-8098, Monday to Friday, 1–5 pm Eastern Time, with Spanish-speaking staff available.

The National Parent & Youth Helpline offers free emotional support to parents, caregivers and young people, 24/7, by call, text or chat at 1-855-427-2736.

Outside the U.S., Find A Helpline (findahelpline.com) lists free, confidential helplines in more than 175 countries.