I have a 6 year old nephew that is INCREDIBLY hyperactive, to the point where he can not pay attention, or listen to instructions given by his parents or other family members.

How do you know when a child has ADD or ADHD, vs. just being "hyperactive" and a normal kid. He has more energy then other children his same age (and MUCH more energy then his family members!)

I've just "heard" that drugs for kids, like Ritalin, are over-prescribed. What other remedies are there for his over-exaggerated energy and lack of attention (or, is this common in 6 year olds?). And, not to gender stereotype, but is it worse in boys?