4 Year Old ADHD???

Dido what Riley said.
She always gives great answers for ADHD questions.
Like her , myself and my daughter are both ADHD.

I personally would not trust an ADHD diagnosis for a 4 yr old.

Yes, our son was treated for ADHD symptoms at age four. We started at three (although Kaiser wouldn't officially diagnose until he was five), just before he was kicked out of preschool. My first advice mirrors that below, in that you need a diagnosis from a specialist, not a regular pediatrician. Seek out a psychiatrist, developmental pediatrician or neuropsychologist. You want to be certain this is the condition you're dealing with.

Medication is not a short-term solution but rather a long-term one. It is typically used in conjunction with behavioral therapy and any other forms of therapy a child might need to manage the condition. We tried behavioral therapy alone before medication, but medication is what made all of the difference in the world for our son when he was four. At seven, he's on a long acting form of the same medication (Concerta, long-acting Ritalin) and he's focused, thriving in school and at home, and happy. His personality is totally intact. I can't say enough positive things about medication in treating this condition.

Be very, very careful of the supposed alternatives out there. You'll hear claims about things like diet, vitamins and special cleaning products and can waste a lot of time and money on things that don't have anything to do with treating a genetic brain disorder. Trust the medical professionals who deal with ADHD day in and day out. Go to the websites for ADDitude magazine and CHADD as you begin to learn more about the condition.

Best of luck to you! Hopefully it's not ADHD. It's not a fun path to go down, especially with all of the naysayers out there who don't have a clue about this medical condition. The good news is that there are great treatment options if you listen to the medical professionals.

ETA: To the person wondering how it's caught at such an early age, I can tell you. This is so far beyond a regular preschooler (I have one without ADHD). It's a child who is the Energizer Bunny morning until night. Nothing slows them down at all, unlike normal kids who get tired after busy activities. Can't sit for meals, runs across the furniture repeatedly despite any attempts to stop it, can't sit for circle time (in fact, is usually climbing up something, throwing something, etc. instead), literally tries to climb the walls, doesn't respond to praise or punishment, hits/spits/claws/kicks at parents, teachers, kids and others ... so off the charts you can't even imagine how awful it is. No parenting strategies work. Consistent discipline doesn't work. Treatment with medication isn't "drugging," it's treatment in the same way parents with kids with epilepsy or heart conditions treat them.

You need something more than a pediatrician. You need a developmental pediatrician. It is great that your pediatrician recognizes his issues and is not blowing them off, but for a full evaluation and a comprehensive treatment plan, you need a full evaluation from the very best kind of doctor for his problem, and hands down, that is a Developmental Pediatrican.

You should not be talking about any treatment until you have an evaluation that includes speech, OT, PT, nuerolglogical, ENT, Audiological, neruopsychological, and what ever else he may need to give you a full picture and a comoplete medical diagnosis.

Schools and ECI run public programs that can be very helpful, but they are for the expressed purpose of making children functional in the school envoronment, and are all funded through IDEA, at a 40% rate, which means that they are woefully inadequate to mee the full needs of most children with these kinds of issues. You want more than functional for your child, you want to maximize his potential, and your son will make the fastest progress he will ever make in his life in the next few years. Get the full evaluation, a good diagnosis, and a comprehensive treatment program while he is still young. Time is the only thing you will have that is free, so don't waste any of it.

Get him into private speech, Ot, and find a behavioral or play therapist to help you until he gets a full evaluation.

You should not be worrying about what text book typical is, you should be worrying about the clock ticking away right now. Write to your school district you live in now, and get him into their program. Always supplement his public services with private therapies so that he gets the full program your Developmental Pediatrican recomends.

Medication is a tool that will help children who need it to be more functional, and make more progress in therapy. You will grow to appreciate this when you are paying for his therapy. Nothing about this experience will be short term or easy. Medication is but one part of a comprehensive treatment plan, that only works because of extreemly hard work from his doctors, his therapists, his teachers, you, and him. It will not be short term, it goes on and does not go away, they don't just have the treatment and are cured, it goes on, and their issues just change.

I would be very concerned, if I were you. Texas was my old stomping ground, and have very poor services, and for the most part, they would not admit a child to a ppcd program if they only suspected ADHD. It is not imposible, but highly unusual. I would call a Developmental Pediatricain in the morning, and get an appointment and put myself on the waiting list for cancelations. I don't mean to be an alarmist, but I see a lot of kids as an educational advocate, and I saw a lot of them in Texas, and you really need to be concerned and get him a comprehensive treament plan based on a diagnosis after a full evaluation from the very best professional for this type of thing. That professional is a Developmental Pediatricain.

M.

K.,
Please know, this is not a DIY project. You need some professional help with this, and your son really needs it as soon as you can get it. I see so many kids, and there is just not one of them that has had long term success with diet, unless they had a food allergy instead of a developmental issue. I know a lot of parents who have tried diets, detox, natural supplements, and even nuttier things than this based on a few anecdotal stories of terrifiic success or a cure, but they come back to standard care much poorer, and with so much less time left for thier kids. If you want to explore some of these, do it only if you are fully engaged in a standard, medicalally based, comprehensive treatment program administered by a physical case manager, and only if you have enough money to pay for that plan, and enough left over to try these other things. You will need every penny you have to help him, and you cannot get one second back if you waste it.
MR

First thing I would do (if I were you), is take him to a behavioral specialist. While your pediatrician, is probably wonderful Dr., he really shouldn't be the one to diagnose your child with ADHD. I always feel second opinions are necessary and crucial, when diagnosing young ones with a disorder, that is life long. I'm not saying, there is no way your child has ADHD, or that your Dr. is wrong. What I am saying, is a second opinion (from a TRULY qualified specialist) can confirm this, or send you in a different direction. Most Doctor's send children to specialist, rather then diagnose the child. Pediatricians are not specially trained in behavior disorders and should always refer you , to someone who is.

I stopped reading the other responses after awhile becuase some of them really irritated me. I would NOT refer to giving a child antibiotics for a diagnosed condition drugging them. My son has ADHD, I can certainly feel for you, especially with the sleeping issue. We have had to use melatonin with him since the age of 4 becuase he just would not sleep. Those wheels in his brain are continuosly turning, and would not slow down without the help of melatonin. I would be trying to get him to sleep till 2 in the morning some nights. I know dr's like to typically wait until the age of 6 or so to diagnose, but I was able to get my son diagnosed at age 4. In addition to his pediatrician, we saw a behavioral therapist and a psychiatrist, who all came to thesame diagnosis, so I am pretty confident in the diagnosis. There are diet changes and behavioral therapies that can help to a point, and we tried to treat him through these until he hit kindergarten (he is now in 2nd grade). Once in kindergarten, he needed a low dose medication to help him stay on task. During the summer months I wien him off of the meds. However, Idon't think medication is a short-term thing at all. Most likely, if you start your son on meds, he will need them long-term. If you have any further questions, i am more than happy to message you privately, I know some "mom's" responses can be upsetting, especially if they haven't been where you are at. Good luck! :)

How can a doctor call a 4 year old ADHD with such certainty? Isn't lack of attention one of the properties of 4 year olds?

I just heard or read something that said that many diagnoses of ADHD in young children are actually due to immaturity. Why not wait at least till he's in kinder or first to see if drugging him is necessary.

Does it really matter that much if they are inattentive in preschool? What the heck are they doing in preschool these days anyway?

Like the first responder, I'm not saying it's not possible he has ADHD, I just don't know why it's necessary to treat it with drugs right now. If I remember my kids' preschool days properly, many of the kids were in their own little worlds most of the time.

i'm sure this is obvious but i'd make sure i cut out all corn syrup and sugar and caffiene/chocolate and see if it makes ANY difference first.

There are some great responses and I have worked with kids with ADHD and other disabilities for 20 years. If it were my child I would do a change in diet- I am not saying to do it instead of finding the right people to work with your child or instead of medication, but diet is something you can do today while you are setting up appointments and doing the other things that need to get done. I have seen many kids with ADHD take their medications but their lunch consisted of so many bad things. Good luck and keep reaching out for help and support there are so many groups that can give you helpful support.

2 thoughts in reading your post. Please watch " the medicated child" as it applies to your situation, but probably not as severely. also have you looked into his diet as a possible culprit to behavior? Not easy to figure out but many have found great relief in finding food triggers to behavior. Good luck !

I think there are many well-meaning pediatricians out there, that despite all their awesome medical knowledge, don't have a great grasp on this issue and default to ADHD because its become a catch-all diagnosis any time kids are hyperactive, impulsive, etc. There is a lot of research out there to suggest it is over-diagnosed. Many Pediatricians seem to have a genuine lack of awareness (to any depth that is useful in understanding child behavior) of things like food additives/allergies, SPD (sensory processing disorder), sleep apnea in kids and how all these are linked to hyperactivity. In fairness, there is alot of new research coming out on this all the time. As wonderful as it would be to have a pediatrician that can be a "one stop shop" for you on all things related to your child, I think you may need to compartmentalize a bit - seek a specialist in child behavior (child psychologist is a good starting point.) Make clear that you want to explore all possible causations of the behavior before trying medications (if that is what you want - thats sound.) A good psychologist will be able to evaluate the behavior then refer you to sleep studies, OTs, allergists, and provide therapies long before ADHD drugs need to be given.
And another thing- There is alot of overlap between kids that have "right-brain" preferences/learning styles and what are ADHD traits. These are kids that are geared for a new world - they have amazing visual-spatial skills that in the long run make them very good at computers, higher level math, etc - but unfortunately can make the early childhood years difficult because we still live in a "left-brain" hemisphere leaning world - especially schools. I don't want to overload you on that topic but my point is, a good psychologist can detect this with IQ or other testing measures.
Please don't get frustrated - ADHD is just a very popular diagnosis these days. Good for you for reaching out to look for other options and sources.
Good Luck!
-A
ps - my oldest looked ADHD on the surface - had private school administrators telling me he was ADHD, get him on drugs, etc - but we dug deeper and found he had/has: SPD, gifted IQ with extremely high visual-spatial skills, sensitivities to artificial anything in food, and sleep apnea (which was fixed with surgery).

I could see my 4 yr old with a similar dx, but what we have found is it looks like 2 possible things, Sensory Processing Dysfunction or allergy to artificial colors and maybe other foods. We see a HUGE change in our daughter if she gets artificial colors versus being off of them for awhile. It's night and day and within an hour of having it she is violent, angry, disrespectful and energy out the wazoo. She so much more cooperative and sweet when she doesn't have any fake colors. We are looking into the Feingold diet. I would suggest just trying it. It can't hurt him or anyone and it's a lot cheaper and healthier than medication. If medication is needed, then you can try that...but please try something that's natural first. I think that so many kids are messed up because of all of the chemicals that they are exposed to nonstop now. They even just came out with a study that the pesticides lead to ADHD in some kids. Just try removing artificial colors and even flavors for 1 week and see if there is a change. Remember to check toothpaste, paint, anything that touches his skin and can rub off that can all go into him. Don't let a school rule you yet. No child is required to go to preschool and some are just not ready...we are not sending our daughter.

I know this post is old but I just wanted to tell you that my son's doctors would not even think about giving him medication for attentional issues when he was only 4. In their opinion, his brain is still developing and you never know how the medications will impact the development of his brain. There are ways of addressing hyperactivity and attention deficit disorder that do not have side effects. Behavior therapy is one. Diet modification and supplements are another. A good book to read about healing ADHD naturally is The Autism & ADHD Diet by Barrie Silberberg.

Hope this helps.

I have a degree in special education and i have worked with many children with add adhd. it is way too soon to diagnose adhd. "typical" four year olds exhibit many adhd behaviors. i would not use any adhd medications on a child that age. best of luck with your little guy.

I would do dietary changes first. Look into the Feingold program - I found it to be very helpful for some of our issues (we have more than ADHD going on now.)

Have you seen a neurologist and ruled out physical issues? I would do that in conjunction with a sleep study. We use melatonin too. I have recently learned that melatonin deficit can be an issue with autoimmune disease and Lyme. We have a current diagnosis of PANDAS (strep-related autoimmune disease) but I am looking into Lyme as well. Being from the south myself (we were in NC until my daughter was 5), this is a real possibility and can affect all sorts of things neurologically, so I want to make sure I'm not missing that piece of the puzzle, you know? Just throwing that out there in case it could be an issue for you too (esp being from TX.)

Do you have any other issues like tics, OCD, rages? Do the symptoms ebb and flow or seem to come in conjunction with any physical symptoms at all (like fever for no apparent reason?) I ask because those are all part of our diagnosis, though the hyperactivity and just feeling like she was "off" for her age were the first things to be really apparent and then age 4 was really rough. We ended up not getting any diagnoses until MUCH later.

I can recommend neurologist, sleep doctors, pediatric neuro-psychologist, etc. for you if you are in the area. (We are in Wheaton, but just moved from Elgin.)

But food and tests are the first things I would do. Medication is scary, and especially at that age you want to be sure you aren't introducing more toxins that could make things WORSE instead of better. I would say hold off until you do a few months on the Feingold and get the tests you want run, run.

If you do have to "resort" to medication, it CAN make things worse too (we finally did meds for my daughter and she ended up with really severe full body tics/Tourette's and was literally writhing on the floor!!) There is a whole range of side effects unfortunately to all of those meds. One thing I would say is to make sure you go to a compounding pharmacy so they can give you the PLAIN medicine (without the artificial flavors and colors) so it is "pure" and will be less of a neuro-toxin.

If I can help in any way, please let me know.

I have a food blog where I share some of our journey, and blog about our diet changes through her various diagnoses too:
www.chickiepea.wordpress.com

You can contact me there or through here via private message anytime you want.

Hugs,
M.