Little Billy is rambunctious, active and full of life. At 7 years old, Billy often is out of his seat in his second-grade classroom, is reminded by his teacher to focus on his work and fidgets with his classmates disrupting their work. At recess Billy struggles. Kids tell the teacher Billy pushed during foursquare, ran between their jump-rope game and stole their ball. Billy spends most recesses sitting on the bench frustrated and confused. When asked why he can't control himself and follow school rules, Billy shrugs and sadly answers, "I don't know."

At home Billy is active. He jumps off the porch with a towel tied around his neck imitating superman, chases his dog around the yard until the dog is too tired to run and pesters his little sister until she cries. When asked by his mother to come in and wash for dinner, Billy screams "no," runs to the corner of the yard and cries while screaming, "I don't want to come in, I want to play!" Frustrated, Billy's mom wonders if he might have Attention-Deficit, Hyperactivity Disorder (ADHD).

ADHD is a childhood psychological disorder displaying at least one of three key symptoms: extreme inattention, hyperactivity and impulsivity. These symptoms must be consistent in all domains of the child's life; at school, home, sports, grandparent's house, church, etc. If a child is overly active only at school or only at home, ADHD is probably not the culprit. When a kid displays ADHD behavior only at home or school, the result is likely due to inconsistent boundaries, too strict or too lax discipline or boredom.

According to the National Institute of Mental Health, four percent of children display at least one key ADHD symptom: extreme inattention, hyperactivity and impulsivity, while a Gallup survey shows 10 percent of 13-17-year-old boys are medicated for ADHD. Many children display impulsivity, hyperactivity and inattentiveness but not to the extreme required for a diagnosis. The children I work with who have the disorder are extremely impulsive, cannot sit still for more than a few minutes and find it difficult to follow a conversation without interrupting or becoming distracted. These children have little control of their bodies and are unaware of the reason behind their negative behavior.

Having a diagnosis of ADHD is neither important nor necessary to support an active child. Instead of searching for a diagnosis, I suggest looking at the whole child. Every child is different and acts and reacts differently depending on innumerable variables.

Is ADHD normal high energy or a genuine disorder? I believe most kids diagnosed with ADHD are healthy schoolchildren who, in a more natural outdoor environment, would seem perfectly normal. The required limitations and rigidity of many elementary school classrooms are difficult for an active child, resulting in acting-out behavior. When a child acts out in the classroom, he gains negative attention from teachers and administration, often resulting in a more restrictive environment. Limiting an active child's ability to release energy increases acting out behavior, negating the purpose for the restriction.

How does a parent, teacher, grandparent or coach work with an active child to reach their full potential while not squelching their spirit? I offer the following behavioral techniques in hope of supporting the child while empowering the adult to discover hope.

• Do not feed the chaos. Placing an active child in places and situations where he tends to fail and expecting him to succeed breeds aggravation. The goal is to limit places where an active child fails and place him more often in places he succeeds. We can then slowly reintroduce the child to places where he struggles and teach strategies to be successful.

• Offer a small, hard toy with nubby points to hold and manipulate during class work.

• When the child needs to concentrate, have him sit on an exercise ball, creating an off balance seating position.

• Create a time when the child can be the center of attention in a positive, creative way - show and tell, tell a joke, read a story.

• Active children often have a negative reputation due to their acting out behavior, which creates a feeling of helplessness. The child might think, "Why should I behave, people only notice when I make a mistake." Offer the child lots of love and positive attention by all adults in the child's life. These adults should make a point to check in with him and have an honest conversation about choices, behavior and his attitude every day. Overwhelm the child with honest nurturing.

• Decide which fights you want to fight. Safety rules are nonnegotiable (no hitting, don't run out into the street) but if the child rolls his eyes at you, you might let it go.

• Offer required homework and chores as necessary. Cut homework assignments and chores in half and offer active children small, incremental steps in the work required. An active child will see a whole page of work, a whole flowerbed to weed or the entire kitchen to clean and find it overwhelming and become distracted, then distract others.

• Follow through with what you say 100 percent of the time every time. If an adult gives in once with a decision or punishment, the child will believe the adult will eventually give in if the child complains, cries, yells, fights or begs enough. It should not matter if you are in a store, restaurant, at a family gathering, with a group of friends or in school. If a parent gives-in in a social setting, the child will use the social setting to win their way. If a teacher gives in in the educational setting, a child will use that setting to misbehave.

• No negotiations - if you want something done, tell the child to do it and expect it to be done. No yelling or raising your voice. If the child raises his voice, remain calm and repeat what you want done.

• Inattentive children need to learn to think before acting. Do not allow this child to answer quickly. After asking a question - give him 15-20 seconds to think before he speaks. We need to slow down his impulsive thoughts and teach him to think before he acts.

• Impulsivity and lack of long-term gratification plagues a child with ADHD - reward good behavior often and repeatedly. The reward should begin at a constant interval (every hour), then spaced out (once a day) then intermittent (the child does not know when the reward will come).

• An active kid often has an excuse for most of his poor choices - the reason is not important and should not be listened to. Simply ask him what happened and help him reason how he is going to make it not happen again.

• Children with ADHD learn ineffective coping skills to deal with their disability. One-on-one counseling or guided peer reflective play teaches children appropriate responses to inappropriate behavior and "unlearns" ineffective skills.

Bill Rutherford is a psychotherapist, public speaker, elementary school counselor, adjunct college psychology instructor and executive chef, and owner of Rutherford Education Group. Please email him at bprutherford@hotmail.com and check out www.foodforthoughtcda.com.