If you started your ADHD child on meds at an early age (5 - 6 yo)...

[Anonymous]

How has it worked out? Do you have any regrets? Our son is only in K but was diagnosed in preschool. His teacher is fantastic and has done a great job getting his behavior/impulsivity reasonably under control using behavior contracts and other interventions (although we still struggle with this at home). But his ability to attend to the task at hand, particularly when unstructured and if it involves writing, is virtually non-existent. If he does manage to complete a task, he rushes through it and does extremely sloppy, careless work. He does a lot of roaming around, going to the bathroom, dropping his pencil on the floor multiple times, looking around at what other kids are doing, watching birds outside the window, well, you get the picture. His teacher feels that he is being significantly impacted (academically and perhaps also socially) as a result, and she recognizes that he is otherwise a very bright, charismatic kid with a lot of potential. We've had him in behavioral therapy and OT (he supposedly also has some sensory issues -- proprioceptive mostly) over the past year, and I think they have helped a little. But we've come to a point where his psychologist and even his OTR have suggested that we might want to try meds. We are conflicted about starting meds at such a young age, but we also feel like he could potentially benefit greatly in many ways. Has anyone started on meds at a young age, and do you feel it was the right decision?

[Anonymous]

DS started slightly later (but immediately) just short of 6.5 years when he was DX'd. Not until this year did we find a medication that worked well for him at school (we weren't frantically switching medications either but could see there were issues). The medication has helped hugely with behavior but less with producing work/writing etc. with your DS. Our DS has had an IEP and likely has several learning disabilities (going for more testing in the next couple of months). Things like inability to work independently relate to executive function and is a common ADHD-related issue. Medication can help with academic issues (better focus on schoolwork) but, if there are underlying issues like learning disabilities or executive function/working memory etc issues, then those need to be addressed (as best as possible) on their own through appropriate academic supports/interventions. Good luck, OP!

[Anonymous]

We weren't able to start meds until second grade due to other medical problems. But, knowing what I know now, if I could have started earlier, I would have. Here's why. By third grade, kids are reading to learn and writing is a huge part of their school life. These two areas were significantly impacted by my son's ADHD. Fortunately, he was able to catch up in reading, but for writing assignments, he requires significant extra time. This is built into his IEP, so we have no problem when it comes to grades or testing. Now, all well and good while he is at school and the medication is in effect (we don't do evening boosters), but come evening homework time, it's really difficult for him to attend for any period of time and then on top, he takes double the amount of time to complete any assignment due to the fact that his writing speed hasn't yet caught up. It's terribly hard on him.

There are also the self esteem issues. My son's took a huge hit because he was always in trouble. It's not that anyone yelled at him or made him feel bad. But he knew he was being talked to, prompted, moved, redirected and whatnot constantly throughout the day and other kids didn't need this. This bothered him tremendously. And, yes, behavior charts and programs helped control his behavior, but it didn't change the fact that he knew he couldn't control his behavior.

As far as the social thing, ADHD hasn't impacted my son at all, so I can't speak to that.

[Anonymous]

Our DS was diagnosed just shy of 6.5 yrs, but we should have thought about it months earlier than that! It was a huge relief for us to just know what was driving all of the behavior issues. He is currently diagnosed with the hyper/impulsive subtype, but everyone thinks he'll be diagnosed with the combined type this year. We started medication about 6 weeks after the diagnosis, and it made a huge improvement academically, and some decent strides socially. We've been fortunate in that we see hardly any sleep or dietary side effects. If anything, he's actually sleeping better and eating more. Going into 1st grade, he was below where he should have been for reading and writing skills. Within 3 months, he had caught up with both. I do notice a huge difference in his ability to read and write when on the medication vs. off. If we leave homework until after medication has warn off, the handwriting is atrocious and it's almost impossible to get him to focus on reading a page. His behavior in the class room was next to impossible to redirect, even with behavior modification, before we started medicating. I know he's not a perfect little angel in class now, but we hear absolutely no complaints from the teaching staff. When we check in with them, they say that he's doing just great. We do still struggle with his behavior at home when medication has warn off. Good luck OP. Hope some of this background helps.

[Anonymous]

Op here. So would you say, then, that it would be helpful to find out earlier rather than later what issues medication will help vs. not help? We don't have an IEP yet, but we have our second EMT meeting soon and are meeting with a developmental ped. shortly after that. What things to you have in your IEP to help with executive function issues? That's definitely an issue for him, although I don't believe he has any learning disabilities.

[Anonymous]

Anonymous wrote:Op here. So would you say, then, that it would be helpful to find out earlier rather than later what issues medication will help vs. not help? We don't have an IEP yet, but we have our second EMT meeting soon and are meeting with a developmental ped. shortly after that. What things to you have in your IEP to help with executive function issues? That's definitely an issue for him, although I don't believe he has any learning disabilities.

If you get testing done through school or privately, you'll have a sense of the issues. At the same time, your son is still young. I'm one of the PP's whose DS was DX'd at 6.5 years. He got the IEP based on the ADHD diagnosis. Some things become clearer over time -- our son is still below grade level in reading, writing and math. He has made great strides in reading but math this year (3rd grade) has really shown that there are probably bigger issues. Services and general help at his school have been great. Schools tend to hesitate to diagnose specific issues young (some of this is understandable). As I said in a previous post, we'll be doing some private testing in a couple of months and third grade is a good time to do it. Kids have greater maturity, the emphasis in school shifts (from learning to read to reading to learn), and some things just become clearer.

Roughly 2/3s of kids with ADHD have various combos of issues. Large percentages have ADHD and anxiety and/or learning disabilities. It is not easy to untangle one issue from another at a young age in many cases. At this point, for our DS, we think additional testing will yield additional insights. We know at this point that medication is helpful for behavior and has some benefit for certain types of work at school. However, our DS still has difficulty working independently and thus, we expect that there are other underlying issues that are making things hard for him.

We, too, pretty much medicate for the school day (but he takes medication every day, no breaks) and yes, homework is hard, both in terms of focus, neatness, and amount of time. We've tried a booster of medication with very mixed success. Yet there are days that he is very cooperative and does a great job on homework.

Good luck! I liken this journey to a roller coaster rides - lots of ups and downs. We've tried to be level-headed, not rush from one thing to the next, and give various meds/interventions time to work. Good luck to all!

[Anonymous]

Our son started on meds just after he turned 6 and just before his 1st grade year. I was SUPER hesitant to use meds and prior to getting any education about adhd and the medication options was adamant about using them only as a last resort. However, we learned about how much easier it usually is to use behavioral techniques once they can actually hear and pay attention after getting medication and we also learned about how much the medications have improved in recent years. Our doctor told us the medication works immediately so by the same token if you don't like the effect it has you can also stop giving it immediately and see the effects removed. This was a great comfort to us because we were very hesitant. We gave it a try and it has been the best thing we've ever done for him. He says he is so much happier now that he has his adhd medicine. He loves that he can pay attention and no longer gets in trouble all the time (both at home and at school). It just makes my heart so full to see him so much happier now. We do notice decreased appetite but our son was already a bit too much of an eater prior to meds and was borderline overweight. Now his appetite seems more appropriate for a 6yo. He initially had trouble falling asleep (side effect of the meds) but our dr said to try a very small dose of melatonin at night and this seems to work very well for him.

[Anonymous]

Reading along interestedly.

My five year old (not quite 5.5) was diagnosed last month and our meeting to discuss meds with our pediatrician isn't for a few more weeks. I'm very interested to hear folks' replies.

As a side note, my almost eight year old was diagnosed at the same time (both boys are in the NIH study). In talking with the NIH team, they told us that the 8 yo's ADHD is likely presenting as less severe than it probably is because the school already has in place so many ADHD-type supports to help him (he is severly dyslexic, which causes some anxiety and emotional outbursts when he gets frustrated). My take away from that is that, while ADHD meds might have helped him in K or 1st grade, that the school accomodations were a not insignificant aid to him performing well as well.

[Anonymous]

I was reading an article recently on how the dosage that improves cognitive processes is lower than the dosage that improves behavior. In increasing dosage to address the behavior you lose the positive effects on cognition. The thresholds are different making it very difficult to find a medication and dosage that is effective for both cognition and behavior. Just an interesting tidbit to consider when trying to figure out if the dosage is working...depends on what you are targeting.

[Anonymous]

Anonymous wrote:I was reading an article recently on how the dosage that improves cognitive processes is lower than the dosage that improves behavior. In increasing dosage to address the behavior you lose the positive effects on cognition. The thresholds are different making it very difficult to find a medication and dosage that is effective for both cognition and behavior. Just an interesting tidbit to consider when trying to figure out if the dosage is working...depends on what you are targeting.

That's very interesting to hear. DS is on the lowest dose of his current medication and the behavior has ceased being an issue, but there are still cognition issues. Obviously, each kid is different in how meds work.

[Anonymous]

And I would think the type of medication (stimulants vs. non) would make a difference. Did the article focus on just stimulants?

[Anonymous]

13:08 here, I will see if I can find the reference. Yes, I believe it was just stimulants they were looking at.

[Anonymous]

Great thread. Thanks so much for the info, everyone.

[Anonymous]

My oldest was diagnosed with ADHD (primarily inattentive) in K (about 5.5 yo) but didn't start medication until the middle of 1st grade. It was an incredibly difficult decision - excruciating, in fact. But, three years into it, I have no regrets. It's taken us a while to find a medication (stimulants did not work well) and while we don't see the amazing difference some people talk about, the medication does allow DS to slow down and have better emotional regulation. These are incredible barriers to his education appear to be on top of learning disabilities.

We, too, participate in the NIH study and have seen the benefits of good structure and supportive teachers. We've always had excellent structure at home and we've not seen many differences at home when DS is on/off the medication. But, since he's primarily inattentive, I don't expect to see that much of a difference since sustained mental effort usually isn't required during the summer. Every year, he's taken a medication break at the end of the school year and we don't usually re-start it until after a month or so into the new term so the teachers can get a baseline on him. It's our way of determining whether the medication is effect and if he should continue with it.

Our youngest DS in in K and has develpmental delays. He's not yet been evaluated for ADHD because we don't think, because of the delays, that testing would be accurate now and because he doesn't have behavioral issues. He went into K with an IEP and an ADHD diagnosis would not change what anyone is doing. Making a medication decision for him will be much easier than for our first because of the experience and knowledge we've gained. It's sort of like having a baby for the first time. You can learn about it all you want but it's not until you actually experience it that you REALLY understand it all. Good luck.

[Anonymous]

We started our DD at 6 (she's primarily inattentive, and she was just not hearing anything the teacher said to her). Honestly, one of the things that surprised me the most is how much her handwriting improved--it is night and day compared to what it was.