Adhd meds for a 5 year old?

[Anonymous]

My son with HFA has always had trouble learning because he can't attend. He is also hyperactive. We will be doing a neuro-psych eval soon. I have been speaking to a psychiatrist who feels it may be a good idea to try medication, so that he can be accepted to a school where the children are higher functioning. Is it too soon to start medication? What are my options?

[Anonymous]

You can try a behavioral plan and modifications in the classroom. These would be a good idea in any case whether you medicate or not.

[Anonymous]

We've tried a behavioral plan. It helps but is not enough. He's not learning when in a group. He does much better one on one, but schools are always in groups. What accommodations do you recommend? He needs constant redirection.

[Anonymous]

I don't have experience with HFA. My son has ADHD. He started medication when he was 5. It made a big difference for him. Behavioral plans alone were not working. Good luck. Deciding to medicate is not an easy decision.

[Anonymous]

It's worth trying. ADHD is commonly comorbid with HFA.

It's hard to tell however if your child has ADHD. Trouble attending, constantly needing redirection and prompting is a hallmark of ASD without ADHD. My kid with ASD who does not have ADHD according to his neuropsych needs lots more prompting and redirection than his NT classmates and it can be super frustrating for his teachers since DS can easily do the work when he wants to.

The teachers use a behavior sticker chart everyday for each of his work modules. DS is a stickler for getting ALL his stickers and showing off the completed chart everyday to his parents. Providing external motivation and rewards have worked for him.

After so many completed charts, he gets additional rewards like playdates, visit to his favorite park to look for bugs, additional mods into Minecraft, etc.

[Anonymous]

I can't speak for your son .. only mine. My son is 6.5yo and was diagnosed with ADHD at 5.5yo when school was just falling apart for him. We're separately pursuing further evaluation since I also suspect HFA. A big part of the problem we had in Kindie is that he required one-on-one attention and direction to be able to successfully meet school benchmarks and function in a public school environment. It's not that he can't talk about an grasp other things that are far beyond his grade level ... this is just about the things that they evaluate for. And it's not that he's not bright ... he is SO smart ... it's that he's not able to track direction.

I had the opportunity to observe him this last weekend when we went to the MD Renn Faire. We were there for the weekend and I managed to forget his medication so I observed him unmedicated. I saw how differently he behaved than other kids around him. He was unable to do things as simple as hold his place in line. He was too distracted by the activities and new environment. My son is on Strattera and not on stimulants because of his appetite and weight gain (or loss ... I've posted separately) but I've noticed a significant difference between his behavior and his ability to track the world around him on medication vs. not. Now that he's settled into school, I notice a significant difference between this year and last year.

ADHD is a delay in the development of executive function. Executive function is an underlying capability that determines a lot so far as how kids absorb and function (or not) in the school environment. I have a lot of issues with "the school environment" but the fact remains that a delay in executive function can severely impact a child's ability to function in that environment and learn key material that is a basis for further grade levels. So regardless of the fact that my son grasps on some level atoms and molecules and the basic states of matter, the fact that he refuses to read means he is behind. As I said, I can't speak for your child, only mine. With my child, as genius as I see him in science and technology, he does not absorb reading and writing the way other kids do in the school environment. This year medication is allowing him to track, at least somewhat. I know our psychiatrist believes he would function better on stimulants, but we are not medically able to try them yet because of the weight loss issue.

The only other thing I have to say is that it's not a decision you have to make now for all time. Some medications have a time period you have to build up or draw down but for a lot of ADHD medications you should see an impact right away. Your most powerful tool is a journal. With a journal you should be able to see appreciable impact after starting a medication (or not) ... and have something to bring to the psychiatrist if not. If a medication is not helping, you do not need to continue using it. I know I've been conditioned by years of articles about overdiagnosis to mistrust a psychiatrist pushing medication. While those articles may be right, they don't necessarily speak for my son ... and the fact remains that early intervention is the most successful intervention (in a large part because we operate in the forced schooling paradigm .. but that's a separate issue).

[Anonymous]

Thank you. Have you ever had a neuro-psych eval done? I'm pursuing it to find out if something like a LD can be causing his behavior. His behavior worsens when he 's asked questions after the teacher reads a book, for example.

[Anonymous]

Starting your DS on ADHD meds at 5 is medically acceptable. Zenzedi is a newish prescription for children 4-6 years old and Procentra is a liquid medication that children as young as 4 can take, too.

[Anonymous]

Anonymous wrote:I can't speak for your son .. only mine. My son is 6.5yo and was diagnosed with ADHD at 5.5yo when school was just falling apart for him. We're separately pursuing further evaluation since I also suspect HFA. A big part of the problem we had in Kindie is that he required one-on-one attention and direction to be able to successfully meet school benchmarks and function in a public school environment. It's not that he can't talk about an grasp other things that are far beyond his grade level ... this is just about the things that they evaluate for. And it's not that he's not bright ... he is SO smart ... it's that he's not able to track direction.

I had the opportunity to observe him this last weekend when we went to the MD Renn Faire. We were there for the weekend and I managed to forget his medication so I observed him unmedicated. I saw how differently he behaved than other kids around him. He was unable to do things as simple as hold his place in line. He was too distracted by the activities and new environment. My son is on Strattera and not on stimulants because of his appetite and weight gain (or loss ... I've posted separately) but I've noticed a significant difference between his behavior and his ability to track the world around him on medication vs. not. Now that he's settled into school, I notice a significant difference between this year and last year.

ADHD is a delay in the development of executive function. Executive function is an underlying capability that determines a lot so far as how kids absorb and function (or not) in the school environment. I have a lot of issues with "the school environment" but the fact remains that a delay in executive function can severely impact a child's ability to function in that environment and learn key material that is a basis for further grade levels. So regardless of the fact that my son grasps on some level atoms and molecules and the basic states of matter, the fact that he refuses to read means he is behind. As I said, I can't speak for your child, only mine. With my child, as genius as I see him in science and technology, he does not absorb reading and writing the way other kids do in the school environment. This year medication is allowing him to track, at least somewhat. I know our psychiatrist believes he would function better on stimulants, but we are not medically able to try them yet because of the weight loss issue.

The only other thing I have to say is that it's not a decision you have to make now for all time. Some medications have a time period you have to build up or draw down but for a lot of ADHD medications you should see an impact right away. Your most powerful tool is a journal. With a journal you should be able to see appreciable impact after starting a medication (or not) ... and have something to bring to the psychiatrist if not. If a medication is not helping, you do not need to continue using it. I know I've been conditioned by years of articles about overdiagnosis to mistrust a psychiatrist pushing medication. While those articles may be right, they don't necessarily speak for my son ... and the fact remains that early intervention is the most successful intervention (in a large part because we operate in the forced schooling paradigm .. but that's a separate issue).

Not OP but this response was very helpful to me as it resonates with my own son's experience. I am curious as to what other attributes and behaviors you notice that have you suspecting HFA?

[Anonymous]

+1 on PP's suggestion that this does not have to be an all-time decision. With stimulants you'll see the effect immediately and can stop it at any time. It helps dramatically with the ADHD but can aggravate some of the HFA issues like inflexibility or obsessive behavior. A tough balance to strike, and we're currently off medication. But I'm glad we experimented with it and am sure we will again. We think he's actually carried forward some of the abilities the medication helped him find, even though he's not currently on it--as if having the experience of being able to sit still and concentrate taught him that he could do it, and that persists to some extent even with the crutch removed.