Experience with putting a 4 yo on Ritalin?

[Anonymous]

You don’t want to hear it, OP and PP, and I get it, but if your kid is delayed and very hyper, the only thing that is actually going to help is time. By all means, try meds. It’s just going to take years to get it right and your kid won’t know wtf is going on. If your kid isn’t delayed, it’s different. But for a child that’s already only about three developmentally, I’m not sure what you’re expecting meds to do. Doctors will let you do it, sure. They have short half lives.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For some perspective, this board is very pro-meds and is always quick to encourage a parent to choose ADHD meds as a first step. Any other choices are discouraged and disparaged.

But OP is posting about a 4 year old. She hasn't posted any specific reasons for medicating her 4 year old, only general ones. Maybe there are also other reasons, but without knowing them, she's not getting support for medicating her 4 year old.

Yes this board is quick to offer meds as a first step because that is the clinical recommendation of the AAP. Yet everyone seems to be dropping that it is also the AAP recommendation to consider meds for preschool children in moderate to severe situations when behavioral therapy hasn't worked. Being kicked out of multiple schools falls squarely there. "op hasn't provided enough info" is an excuse. So it's ok for us to say she is doing the wrong thing and pile on to make her feel bad for following multiple medical professionals because she hasn't listed out every symptom in a post? OP has shared that her child was kicked out of two preschools and is struggling in a third. Any special needs parent can understand what that means, you do not need more info than that.

The AAP isn't always right.

Of course, but acting like the op is ridiculous but someone who puts their kids on meds at 6 would get major support is.. weird.

They would not. That’s also very young. It’s also different for a child with delays. It’s also different if, as I suspect, OP’s child is the one with epilepsy and a low iq. Meds are only going to do so much. If your kid is this complicated at 4, you need intense behavioral therapy, you should try meds, but know they may not help much, and you should expect progress to be slow.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What factors made the doctors make this recommendation?

Op here. The ADHD diagnosis for one. Problems in school. Problems with attention. Problems with regulation. Problems with gaining new skills due to the severity of inattention and large amount of time spent in a state of disregulation. Problems at home with behavior.

Fwiw, none of those (except problems at school - he's 4?) are reasons to medicate that young. Time will help. Give him time.

I do tend to agree with this as a parent of three children and someone who has and is medicated for ADHD. Emotional regulation is difficult for most 4 year olds as is behavior and inattention. My four year old daughter doesn't want to practice writing her letters or counting numbers and other kids do, but she's 4...Not all children mature at the same pace.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Man this thread is terrible. I'm one of the pps with a 5 year old also starting meds. To all the posters - yes we have tried diet changes (and had alternative docs check allll the things, and levels - nothing), we've tried neurofeedback, we reduced school day length and # of days to GREATLY reduce amount of time in preschool (one of us adjusting our work schedule in a major way and the other reducing to part time to be able to do this). We have done all the parent training. Oh and our child goes to a tiny outdoor preschool that truly cannot be beat in terms of being an amazing environment from an OT, therapeutic environment for a kid with ADHD. It is what everyone on dcum would recommend you send a kid like mine to. Two therapists have visited the school and observed and reported the school to be wonderful, responsive, etc.

I am sharing all this to say - sometimes you can do all of these things and your kid still struggles. The op has tried THREE preschools! And everyone is still posting that is the issue. The posters who are parents with a child with ADHD, it is surprising to me that you don't have empathy that others situation could be different. Your child may have been helped by a small church preschool, or diet changes, or were able to wait because it was just causing disruption and not a safety issue. Instead of looking down on another parent, have a little empathy and gratefulness that you aren't in their shoes. It is a rare parent that jumps to meds, for most of us it is a pained decision at this age and done after exhausting options.

No professional we've talked with, child psychiatrist, multiple psychologists has expressed any concerns at considering this as a next step. They have encouraged it. In fact, keeping medication from your child when they are struggling can be harmful as well, according to multiple people we've talked with. I've worked in this field and most parents honestly wait too long to medicate, not the other way around. you have to also consider your child's sense of self that is developing every single day that they struggle.

It is really unfortunate that a forum like this would be so unsupportive of parents following the next step recommended by professionals. I'm sorry you experienced this op.

No, you’re projecting and getting upset that those of us who were in the same situations haven’t told you it worked. We started at 4. It did not work for us. It’s very hard for the child to tell you how they feel especially if they are delayed, and to get the meds right at that age. Others may have had done success. But don’t go into it expecting a miracle. Meds are their own issue. Look, you’ve got a kid like this, especially if they have a low iq, you don’t have many tools and meds are an important one. You need to do them in combo with therapy. But and it’s a big but. You’ve got a complicated kid with enough issues to need meds at 4, more is going on, and it’s going to be a rough road. I have no doubt you need them, I just doubt that they will be the solution you’re hoping for. They’ll be a part of it, but maybe not an effective one, at some point:

I'm sorry it has been so hard. There were incredibly few people saying "We tried it at 4 and it didn't work for us" - the vast majority of comments were folks just saying "I wouldn't do it" and assuming op hasn't tried enough other things. That is what my post is responding to. The hard thing about dcum is there is so much we don't know about each other and so many assumptions made. I probably assumed a wrong tone to some of the posts because I, as I think anyone can imagine, hate being in the position to make this call. It all sucks and I do think people could approach things on this board with more empathy since theoretically we understand how hard it is. I 100% was defensive because I'm in the thick of it right now and I felt bad for op who has likely tried a lot too before coming here with that question.

to the point of 'we know little and are making assumptions about each other', myself included - we don't personally have the IQ and developmental delays, and that sounds very hard as well, and I don't have my head in the sand as you might think - we've actually already tried one med that wasn't a good fit so believe me I'm well aware we have a long road ahead. There are usually very few magic bullets, but in my experience in the field sometimes you can find the right thing to take the edge off that then makes therapy more effective.

Considering meds is not ridiculous which is the tenor here. Most are just questioning op saying she didn't give enough info to "make her case". I think that isn't cool, personally.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Man this thread is terrible. I'm one of the pps with a 5 year old also starting meds. To all the posters - yes we have tried diet changes (and had alternative docs check allll the things, and levels - nothing), we've tried neurofeedback, we reduced school day length and # of days to GREATLY reduce amount of time in preschool (one of us adjusting our work schedule in a major way and the other reducing to part time to be able to do this). We have done all the parent training. Oh and our child goes to a tiny outdoor preschool that truly cannot be beat in terms of being an amazing environment from an OT, therapeutic environment for a kid with ADHD. It is what everyone on dcum would recommend you send a kid like mine to. Two therapists have visited the school and observed and reported the school to be wonderful, responsive, etc.

I am sharing all this to say - sometimes you can do all of these things and your kid still struggles. The op has tried THREE preschools! And everyone is still posting that is the issue. The posters who are parents with a child with ADHD, it is surprising to me that you don't have empathy that others situation could be different. Your child may have been helped by a small church preschool, or diet changes, or were able to wait because it was just causing disruption and not a safety issue. Instead of looking down on another parent, have a little empathy and gratefulness that you aren't in their shoes. It is a rare parent that jumps to meds, for most of us it is a pained decision at this age and done after exhausting options.

No professional we've talked with, child psychiatrist, multiple psychologists has expressed any concerns at considering this as a next step. They have encouraged it. In fact, keeping medication from your child when they are struggling can be harmful as well, according to multiple people we've talked with. I've worked in this field and most parents honestly wait too long to medicate, not the other way around. you have to also consider your child's sense of self that is developing every single day that they struggle.

It is really unfortunate that a forum like this would be so unsupportive of parents following the next step recommended by professionals. I'm sorry you experienced this op.

No, you’re projecting and getting upset that those of us who were in the same situations haven’t told you it worked. We started at 4. It did not work for us. It’s very hard for the child to tell you how they feel especially if they are delayed, and to get the meds right at that age. Others may have had done success. But don’t go into it expecting a miracle. Meds are their own issue. Look, you’ve got a kid like this, especially if they have a low iq, you don’t have many tools and meds are an important one. You need to do them in combo with therapy. But and it’s a big but. You’ve got a complicated kid with enough issues to need meds at 4, more is going on, and it’s going to be a rough road. I have no doubt you need them, I just doubt that they will be the solution you’re hoping for. They’ll be a part of it, but maybe not an effective one, at some point:

I'm sorry it has been so hard. There were incredibly few people saying "We tried it at 4 and it didn't work for us" - the vast majority of comments were folks just saying "I wouldn't do it" and assuming op hasn't tried enough other things. That is what my post is responding to. The hard thing about dcum is there is so much we don't know about each other and so many assumptions made. I probably assumed a wrong tone to some of the posts because I, as I think anyone can imagine, hate being in the position to make this call. It all sucks and I do think people could approach things on this board with more empathy since theoretically we understand how hard it is. I 100% was defensive because I'm in the thick of it right now and I felt bad for op who has likely tried a lot too before coming here with that question.

to the point of 'we know little and are making assumptions about each other', myself included - we don't personally have the IQ and developmental delays, and that sounds very hard as well, and I don't have my head in the sand as you might think - we've actually already tried one med that wasn't a good fit so believe me I'm well aware we have a long road ahead. There are usually very few magic bullets, but in my experience in the field sometimes you can find the right thing to take the edge off that then makes therapy more effective.

Considering meds is not ridiculous which is the tenor here. Most are just questioning op saying she didn't give enough info to "make her case". I think that isn't cool, personally.

You’ve got to stop taking all this so personally. You’ve made a medical decision for your child, and it’s a controversial one. We made the same one. Accept that not everyone is going to agree with you. It doesn’t matter. It is not their child. Quit seeking validation.
Stand by it and get a thicker skin.

[Anonymous]

Anonymous wrote:You don’t want to hear it, OP and PP, and I get it, but if your kid is delayed and very hyper, the only thing that is actually going to help is time. By all means, try meds. It’s just going to take years to get it right and your kid won’t know wtf is going on. If your kid isn’t delayed, it’s different. But for a child that’s already only about three developmentally, I’m not sure what you’re expecting meds to do. Doctors will let you do it, sure. They have short half lives.

I'm not sure where the delayed assumptions are coming in. I don't have the epilepsy background for why that assumption is being made the op is another poster so no idea there. In my case, child is not delayed at all, quite the opposite. And I'm not looking for a magic bullet, we have a LOT of good tools in our toolbox and a great team, but I do think he may need medication to take the edge off some of the impulse control/aggression so that he and others can be safe. It sounds like we're both projecting a bit here - you are assuming your situation is mine, and I'm assuming mine is ops and all may not be true! I totally hear your very valid thoughts and believe me, I am very aware that this is something we'll be managing for a long time. And i'm going to use every tool in the toolbox to support it.

[Anonymous]

I wish we could have started our now 6 year old on ADHD medicine at 4, but we had to wait. We saw an immediate change for the good the day she started Focalin, even though it was a small dose. As a result of her inability to focus and sit still, she is behind her peers in terms of basic schoolwork. She has time to catch up, but I'm frustrated that we're in a position to need to catch up. Also, there is a lot of bad behavior to unlearn now. If I were in your shoes I would do it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You don’t want to hear it, OP and PP, and I get it, but if your kid is delayed and very hyper, the only thing that is actually going to help is time. By all means, try meds. It’s just going to take years to get it right and your kid won’t know wtf is going on. If your kid isn’t delayed, it’s different. But for a child that’s already only about three developmentally, I’m not sure what you’re expecting meds to do. Doctors will let you do it, sure. They have short half lives.

I'm not sure where the delayed assumptions are coming in. I don't have the epilepsy background for why that assumption is being made the op is another poster so no idea there. In my case, child is not delayed at all, quite the opposite. And I'm not looking for a magic bullet, we have a LOT of good tools in our toolbox and a great team, but I do think he may need medication to take the edge off some of the impulse control/aggression so that he and others can be safe. It sounds like we're both projecting a bit here - you are assuming your situation is mine, and I'm assuming mine is ops and all may not be true! I totally hear your very valid thoughts and believe me, I am very aware that this is something we'll be managing for a long time. And i'm going to use every tool in the toolbox to support it.

DP. Kids with ADHD are delayed in maturity about 3 years - that's not the same as a developmental delay but it is important for a parent to remember.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You don’t want to hear it, OP and PP, and I get it, but if your kid is delayed and very hyper, the only thing that is actually going to help is time. By all means, try meds. It’s just going to take years to get it right and your kid won’t know wtf is going on. If your kid isn’t delayed, it’s different. But for a child that’s already only about three developmentally, I’m not sure what you’re expecting meds to do. Doctors will let you do it, sure. They have short half lives.

I'm not sure where the delayed assumptions are coming in. I don't have the epilepsy background for why that assumption is being made the op is another poster so no idea there. In my case, child is not delayed at all, quite the opposite. And I'm not looking for a magic bullet, we have a LOT of good tools in our toolbox and a great team, but I do think he may need medication to take the edge off some of the impulse control/aggression so that he and others can be safe. It sounds like we're both projecting a bit here - you are assuming your situation is mine, and I'm assuming mine is ops and all may not be true! I totally hear your very valid thoughts and believe me, I am very aware that this is something we'll be managing for a long time. And i'm going to use every tool in the toolbox to support it.

DP. Kids with ADHD are delayed in maturity about 3 years - that's not the same as a developmental delay but it is important for a parent to remember.

Oh of course, I certainly agree with that. pp had been talking about IQ earlier. My posting is not helping the op and creating a weird back and forth so I will stop. Good luck op!

[Anonymous]

Anonymous wrote:

Anonymous wrote:You don’t want to hear it, OP and PP, and I get it, but if your kid is delayed and very hyper, the only thing that is actually going to help is time. By all means, try meds. It’s just going to take years to get it right and your kid won’t know wtf is going on. If your kid isn’t delayed, it’s different. But for a child that’s already only about three developmentally, I’m not sure what you’re expecting meds to do. Doctors will let you do it, sure. They have short half lives.

I'm not sure where the delayed assumptions are coming in. I don't have the epilepsy background for why that assumption is being made the op is another poster so no idea there. In my case, child is not delayed at all, quite the opposite. And I'm not looking for a magic bullet, we have a LOT of good tools in our toolbox and a great team, but I do think he may need medication to take the edge off some of the impulse control/aggression so that he and others can be safe. It sounds like we're both projecting a bit here - you are assuming your situation is mine, and I'm assuming mine is ops and all may not be true! I totally hear your very valid thoughts and believe me, I am very aware that this is something we'll be managing for a long time. And i'm going to use every tool in the toolbox to support it.

You need to calm wayyyyy down. Seriously.

[Anonymous]

Anonymous wrote:I wish we could have started our now 6 year old on ADHD medicine at 4, but we had to wait. We saw an immediate change for the good the day she started Focalin, even though it was a small dose. As a result of her inability to focus and sit still, she is behind her peers in terms of basic schoolwork. She has time to catch up, but I'm frustrated that we're in a position to need to catch up. Also, there is a lot of bad behavior to unlearn now. If I were in your shoes I would do it.

That’s a big assumption as to why she is behind. Being behind at 6, when the expectations are so low, is usually not due to attention issues.

[Anonymous]

I am not the op or the other pp. Some of you have a lot of nerve as if ADHD is nothing more than a stereotype of hyperactivity or inattention. For children with severe ADHD the situation goes beyond that and severely impacts their lives making them miserable and unable to cope throughout the day. It also impacts the children around them. Do you think the op went to four different doctors who recommended medication because her child is "very hyper?" Do you think a child is getting kicked out of three different preschools for inattention or hyperactivity? Give me a break. The medication is likely for help with emotional regulation. That child is likely hitting, kicking, and ashing out at other children and doing the same, if not more, to caregivers who attempt to transition him away from a preferred activity. She didn't provide significant details as her child's situation because she wasn't asking for advice on whether to medicate. She was asking for others experiences. No one needs to be on this thread pontificating whether she should medicate and presuming to know more than four separate doctors.

[Anonymous]

Anonymous wrote:I am not the op or the other pp. Some of you have a lot of nerve as if ADHD is nothing more than a stereotype of hyperactivity or inattention. For children with severe ADHD the situation goes beyond that and severely impacts their lives making them miserable and unable to cope throughout the day. It also impacts the children around them. Do you think the op went to four different doctors who recommended medication because her child is "very hyper?" Do you think a child is getting kicked out of three different preschools for inattention or hyperactivity? Give me a break. The medication is likely for help with emotional regulation. That child is likely hitting, kicking, and ashing out at other children and doing the same, if not more, to caregivers who attempt to transition him away from a preferred activity. She didn't provide significant details as her child's situation because she wasn't asking for advice on whether to medicate. She was asking for others experiences. No one needs to be on this thread pontificating whether she should medicate and presuming to know more than four separate doctors.

So ignore those posters and look at the ones who said they tried it. Several responded. Goodness. You can’t police peoples thoughts on this kind of thing. I have a kid who needed meds at 4, and I understood that our experience was so different from others experiences and reality I stopped looking to them for reference. You have an outlying kid like this, I suggest you do the same. Stop hysterically insisting you’re “right”. It doesn’t work that way. What does it matter?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Man this thread is terrible. I'm one of the pps with a 5 year old also starting meds. To all the posters - yes we have tried diet changes (and had alternative docs check allll the things, and levels - nothing), we've tried neurofeedback, we reduced school day length and # of days to GREATLY reduce amount of time in preschool (one of us adjusting our work schedule in a major way and the other reducing to part time to be able to do this). We have done all the parent training. Oh and our child goes to a tiny outdoor preschool that truly cannot be beat in terms of being an amazing environment from an OT, therapeutic environment for a kid with ADHD. It is what everyone on dcum would recommend you send a kid like mine to. Two therapists have visited the school and observed and reported the school to be wonderful, responsive, etc.

I am sharing all this to say - sometimes you can do all of these things and your kid still struggles. The op has tried THREE preschools! And everyone is still posting that is the issue. The posters who are parents with a child with ADHD, it is surprising to me that you don't have empathy that others situation could be different. Your child may have been helped by a small church preschool, or diet changes, or were able to wait because it was just causing disruption and not a safety issue. Instead of looking down on another parent, have a little empathy and gratefulness that you aren't in their shoes. It is a rare parent that jumps to meds, for most of us it is a pained decision at this age and done after exhausting options.

No professional we've talked with, child psychiatrist, multiple psychologists has expressed any concerns at considering this as a next step. They have encouraged it. In fact, keeping medication from your child when they are struggling can be harmful as well, according to multiple people we've talked with. I've worked in this field and most parents honestly wait too long to medicate, not the other way around. you have to also consider your child's sense of self that is developing every single day that they struggle.

It is really unfortunate that a forum like this would be so unsupportive of parents following the next step recommended by professionals. I'm sorry you experienced this op.

No, you’re projecting and getting upset that those of us who were in the same situations haven’t told you it worked. We started at 4. It did not work for us. It’s very hard for the child to tell you how they feel especially if they are delayed, and to get the meds right at that age. Others may have had done success. But don’t go into it expecting a miracle. Meds are their own issue. Look, you’ve got a kid like this, especially if they have a low iq, you don’t have many tools and meds are an important one. You need to do them in combo with therapy. But and it’s a big but. You’ve got a complicated kid with enough issues to need meds at 4, more is going on, and it’s going to be a rough road. I have no doubt you need them, I just doubt that they will be the solution you’re hoping for. They’ll be a part of it, but maybe not an effective one, at some point:

I'm sorry it has been so hard. There were incredibly few people saying "We tried it at 4 and it didn't work for us" - the vast majority of comments were folks just saying "I wouldn't do it" and assuming op hasn't tried enough other things. That is what my post is responding to. The hard thing about dcum is there is so much we don't know about each other and so many assumptions made. I probably assumed a wrong tone to some of the posts because I, as I think anyone can imagine, hate being in the position to make this call. It all sucks and I do think people could approach things on this board with more empathy since theoretically we understand how hard it is. I 100% was defensive because I'm in the thick of it right now and I felt bad for op who has likely tried a lot too before coming here with that question.

to the point of 'we know little and are making assumptions about each other', myself included - we don't personally have the IQ and developmental delays, and that sounds very hard as well, and I don't have my head in the sand as you might think - we've actually already tried one med that wasn't a good fit so believe me I'm well aware we have a long road ahead. There are usually very few magic bullets, but in my experience in the field sometimes you can find the right thing to take the edge off that then makes therapy more effective.

Considering meds is not ridiculous which is the tenor here. Most are just questioning op saying she didn't give enough info to "make her case". I think that isn't cool, personally.

I agree with you that a poster does not owe additional explanation or reasons - and often it just provides more ammo for people to tell them they are wrong.

What you are going through is hard and frustrating so I get it. But I think many of us live in a weird space with doctors and meds. Yes we trust our doctors to give us the best recommendation but we also live with the knowledge that people and systems are flawed and our knowledge of what works is incomplete. Parents are put in an exhausting place of having to assume responsibility for a lot of research and questioning. It sucks.

I am very very loathe to medicate for the simple reason that I think it often distracts from looking for root cause and using the right therapies. But actually I believe meds can work in harmony with other approaches. As other PPs have said there’s got to be more going on when a 4 yo is like this and that’s more why I am reluctant. It is not the meds themselves. Op may very well be investigating everything else.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm sorry that your child is having so many struggles at such a young age. I don't think I would medicate a child that age unless they were really violent and were a threat to themselves and others. Everything else--as hard as it is--I would just accept and try every other non-med approach and hope that some of it goes away with maturity. There's so little known about the long-term effects of meds on kids. Sure they may help get them through Kindergarten, but what about the rest of their life?

The op did not ask for your opinion on whether you would medicate. It's impossible for you to ponder that since you haven't been in a situation where you've had to consider it. The op was asking for folks who have actually been in their shoes.

And to your question of what about the rest of their life? That is exactly what is on my mind as I make this decision for my own 5 year old. A child's sense of self is being formed in these early years. It has a HUGE impact on later life. The schemas we develop about ourselves at a young age are incredibly difficult to alter later in life. It is completely reasonable to consider medicating your child at this age in certain situations and it aligns with the AAP guidelines. The AAP has considered all of these questions and determined that in moderate to severe cases when behavior therapy has not provided relief, the harm of not medicating can often be more than potential side effects of medicating. There isn't some magical switch at 6 that makes meds not harmful and they are poisoning your kid at 5.5, or even 4. They are most effective and with the least amount of side effects at 6 and up, which is why behavioral therapy is the first line of treatment, but there is plenty of research that it is still worth it for some kids under 6.

No one seems to be considering the impact on kids and their brains from being kicked out of two preschools and unable to function in situations with their peers. Given the ops child has been kicked out of multiple they are very likely grappling with aggression. Asking your child to use coping skills that they can't access because their brain is so wired is not some moral high ground.

I disagree that medication should be based on a tenuous belief like the child’s “schemas” will be bad in the future. There’s little evidence for that. The choice to medicate needs to be based on the child’s current challenges, not based on scaring parents about something that may or may not happen in the future.