Anonymous
Post 03/15/2023 09:32     Subject: Experience with putting a 4 yo on Ritalin?
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.
Anonymous
Post 03/15/2023 09:32     Subject: Re:Experience with putting a 4 yo on Ritalin?
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:
Anonymous
Post 03/15/2023 09:31     Subject: Experience with putting a 4 yo on Ritalin?
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.
Anonymous
Post 03/15/2023 09:30     Subject: Experience with putting a 4 yo on Ritalin?
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.
Anonymous
Post 03/15/2023 09:18     Subject: Experience with putting a 4 yo on Ritalin?
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.


They shared their child is in their 3rd preschool after being kicked out of two, has already had a neurospsych at 4, seen multiple professionals, truly no one can extrapolate that the op is in an incredibly difficult situation? Can you imagine the stress? It's more likely based on this information that op is a caring parent who has agonized over this decision than a parent trying to jump to meds.
Anonymous
Post 03/15/2023 09:15     Subject: Experience with putting a 4 yo on Ritalin?
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.
Anonymous
Post 03/15/2023 09:13     Subject: Experience with putting a 4 yo on Ritalin?
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.
Anonymous
Post 03/15/2023 09:07     Subject: Re:Experience with putting a 4 yo on Ritalin?
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.


+1
Anonymous
Post 03/15/2023 09:07     Subject: Re:Experience with putting a 4 yo on Ritalin?
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.


I mentioned diet. Zero judgment, actually just a parent of a dysregulated 4 yo who has so much better days now with this simple tweak. I think it’s criminal that docs don’t talk about it. I mention it because someone mentioned it to me and it made a huge difference so for me, it’s my version of doing what I’d want someone to do for me. I think it can just as easily be ignored if it’s not relevant but may be helpful.
Anonymous
Post 03/15/2023 08:57     Subject: Experience with putting a 4 yo on Ritalin?
Anonymous wrote:
Anonymous wrote:Have you first tried no additive, dye free, high protein diet with lots of omega 3s, low/no sugar and minimal processed food, plus checked iron, ferritin, zinc, magnesium levels?


Different poster (not OP). It was hard enough to get my seriously emotionally dysregulated kid to sit down and eat anything, let alone a super-restrictive diet. This is just unrealistic! OP, try the meds--ignore the naysayers. These are the same people who dismiss the need for anti-depressants, counseling just muscling it through depression with "clean eating" and willpower. They are delusional and not worth your time.


Interestingly, I am often anti-med on here. Of course it’s hard to tell what is happening, but there are posters who describe medicating for ADHD to just enhance their child’s performance or because they cannot tolerate any divergence from the norm. Even in the face of serious side effects. And then there are the people who push meds as necessary for any ADHD dx by screaming “your child will dieeeee if you don’t medicate!” As for SSRIs - I have taken them myself and know they have real side effects and are very hard to stop taking. So I do not take that lightly either.

But. These meds are appropriate for severely impacted kids, which OP’s child sounds to be. And it sounds like meds are inevitable for this child, so gettinf started now is not a bad idea.
Anonymous
Post 03/15/2023 08:55     Subject: Experience with putting a 4 yo on Ritalin?
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?
Anonymous
Post 03/15/2023 08:55     Subject: Experience with putting a 4 yo on Ritalin?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Have you first tried no additive, dye free, high protein diet with lots of omega 3s, low/no sugar and minimal processed food, plus checked iron, ferritin, zinc, magnesium levels?


Different poster (not OP). It was hard enough to get my seriously emotionally dysregulated kid to sit down and eat anything, let alone a super-restrictive diet. This is just unrealistic! OP, try the meds--ignore the naysayers. These are the same people who dismiss the need for anti-depressants, counseling just muscling it through depression with "clean eating" and willpower. They are delusional and not worth your time.


Or, we have kids with ADHD too. And we have experience and opinions. There's a reason OP hasn't heard from anyone who successfully medicated their 4 year old. It's just too young.


"4 is just too young" What are you basing this on? It sounds like on your feelings and not on the research. And your statements could be really harmful. The recommendations for treating ADHD in children under 6 is actually very clear by the AAP to include medication if behavioral therapy does not provide enough relief. In under 6, the recommendation is therapy first for 10 weeks (most try it for much, much longer) and then:

"Methylphenidate may be considered if these behavioral interventions do not provide significant improvement and there is moderate-to-severe continued disturbance in the 4- through 5-year-old child’s functioning. In areas in which evidence-based behavioral treatments are not available, the clinician needs to weigh the risks of starting medication before the age of 6 years against the harm of delaying treatment. "

Also from the AAP clinical guidelines:

"A number of special circumstances support the recommendation to initiate PTBM as the first treatment of preschool-aged children (age 4 years to the sixth birthday) with ADHD.25,83 Although it was limited to children who had moderate-to-severe dysfunction, the largest multisite study of methylphenidate use in preschool-aged children revealed symptom improvements after PTBM alone.83 The overall evidence for PTBM among preschoolers is strong."


OP - it seems like you are already doing this but do not listen to uninformed parents whose children were not in the same situation as yours and do not actually understand the clinical guidelines. The professionals you are working with actually know the AAP guidelines which specifically note to weight the harm caused in waiting. Good luck!!
Anonymous
Post 03/15/2023 08:53     Subject: Experience with putting a 4 yo on Ritalin?
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.


What are the impacts those problems are having though? The kid is 4.

Personally I would not medicate a 4 yo just to do better in preschool. I do not see the benefit.


My guess is that OP is being very clinical in how she describes the problems here …
Anonymous
Post 03/15/2023 08:46     Subject: Experience with putting a 4 yo on Ritalin?
Anonymous wrote:
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.


What are the impacts those problems are having though? The kid is 4.

Personally I would not medicate a 4 yo just to do better in preschool. I do not see the benefit.


Op here. I think I’m gonna go ahead and follow the advice of our large medical team, but thank you for sharing.

My question was about experiences from people who have done this, not for opinions on whether we should ignore the unanimous consensus of multiple doctors.


Idk, don’t invite discussion about whether medicating 4 yo is effective then. If you are medicating a child then they should be specific goals in mind.
Anonymous
Post 03/15/2023 08:42     Subject: Re:Experience with putting a 4 yo on Ritalin?
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.