Medicate My 4-Year-Old?!

Revised guidelines give doctors the go-ahead to diagnose and treat ADHD in younger kids, but are parents comfortable evaluating preschoolers for attention deficit?


Filed Under: ADHD in Preschool|Kindergarten, Diagnosing Children with ADHD, ADHD Medication and Children, Behavior Therapy for ADHD, ADHD Treatment
Medicate my 4-year-old, girl with pill, medication

The new AAP guidelines can prevent a lot of pain and suffering in the lives of individuals who have ADHD.

Patricia Quinn, pediatrician
   
 

How Young Is Too Young for Diagnosis and Treatment?

ADDitude readers on getting their young children diagnosed and treated with medication.

"My son took ADHD medication at six. If a child needs glasses, you get them. If a child needs insulin, you give it to him
- Andi, Illinois

"As a psychologist, I am cautious about diagnosing a child at three or four. Many children at this age have behaviors that mimic the symptoms of ADHD."
- An ADDitude Reader

"My son was diagnosed with ADHD at four years old. He is now 11, and I am grateful for the early diagnosis. We have been through years of family and individual counseling and have tried different medications to help my son thrive."
- Deidra, Utah

"Putting very young children on medication? I'm not so sure. It depends on a lot of things, but, most important, a child should be treated by a doctor who has experience with ADHD. My son started his meds in fourth grade. They helped a little."
- Diane, Virginia

"My son is now eight years old, and he displayed symptoms of ADD at an early age. We have not put him on medication, and he is doing well without it. We will medicate if things change for him."
- F. Chery, Connecticut

"Children who have severe ADHD symptoms may be treated at age four. Why would you wait for a child to fail at school, if you know something can help?"
- Heather, Michigan

"ADHD can be accurately diagnosed at age four, but giving a child medication at that age seems unnecessary, unless the problems are severe."
-Kristen, Connecticut

 
   

Ann Marie Morrison suspected that her son had ADHD when he was three.

"John's temper tantrums were more intense than those of other three-year-olds, and they came out of nowhere," says Morrison, of Absecon, New Jersey. "It took forever to get him out the door. He had to dress in the hallway, where there were no pictures or toys to distract him. He couldn’t sit still, and he tore apart every toy. I carried gift cards in my purse, so that when he destroyed a toy at a friend's house, I could hand the mom a gift card to replace it."

When Morrison discussed John's hyperactivity and impulsive behavior with his doctors, her concerns were dismissed. "He's just an active boy," they said. "One pediatrician said, 'Even if he has ADHD, there's nothing we can do until he's at least five years old,'" recalls Morrison. "That's like saying, 'Your son has a serious illness, but we can't treat it for another two years.' What was I supposed to do in the meantime?" The family moved to another part of the state when John was five years old, and, by chance, their new pediatrician was an expert in ADHD. She had been diagnosed with ADHD herself and had raised a son with the condition.

"At John's checkup, she was taking a medical history and John was, as always, unable to sit still. She stopped and asked, 'Have you had him tested for ADHD?' I started to cry. I thought, 'Oh, thank God. Someone else sees it,'" says Morrison. "After years of being told by relatives that I needed to discipline him more, after years of feeling physically and mentally exhausted, and thinking I was a horrible parent, someone realized what we were dealing with."

A thorough evaluation of John, which included input from John's teachers and family, led to a diagnosis of ADHD. Soon afterward, he was put on medication, which has helped him focus and improved his impulse control. Treatment has changed John’s and his family's life. "If John had been diagnosed earlier, it would have helped a lot," says Morrison. "I don't know if we would have given him medication when he was three or four, but I would have learned techniques for getting him organized, disciplining him, and helping him establish a routine, without having to figure it out by myself. If I had known earlier that he had ADHD, I would have taken better care of myself, too. I wasn't prepared. It's not just the child who's affected by ADHD. It's the whole family."

Today, it's likely that children like John will be diagnosed and helped earlier in life, thanks to new guidelines from the American Academy of Pediatrics (AAP). The findings include recommendations for evaluating and treating preschool children and adolescents ages 4 through 18 years. Earlier guidelines, released in 2001, covered children ages six through 12.

"The AAP committee reviewed the research on ADHD done over the last 10 years, and concluded that there are benefits to diagnosing and treating ADHD in children younger than age six," says Michael Reiff, M.D., professor of pediatrics at the University of Minnesota, who served on the committee that developed the new guidelines.

Next: Understanding the New AAP Guidelines

Why Parents Worry About Early ADHD Diagnosis

Try Behavior Therapy First

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