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ADHD in Children under Six

Tommy began to show impulsive and unfocused behavior at age four when he entered his first year of preschool. I got notes practically every night about how he'd "acted up" during his three-hour preschool class. The inappropriate behavior escalated until his teacher suggested that we have him evaluated for ADHD. We took him to his pediatrician, who used a written test/questionnaire which both the teacher and I filled out. After it was scored, the pediatrician determined that indeed, he did have ADHD. Around the same time, his preschool occupational therapist also diagnosed him with Sensory Integration Disorder.

child-adhdFeeling a bit confused about the two diagnoses, we made an appointment with a respected psychologist who worked with children. His opinion was that one couldn't truly diagnose ADHD until the child was a little older, around at least six. He also said that ADHD and Sensory Integration Disorder often shared the same symptoms. We asked him his opinion of medicating our four-year-old. He cautioned against it.

And yet, we were feeling pressure by the school to medicate. So we did. We put Tommy on an ADHD med--Focalin. Tommy became instantly suspicious of the little granules of medication we put on a peanut butter cracker. (We had to open the capsule and extract half of the med granules because we wanted to give him a smaller dosage.) He wouldn't eat the crackers. That first week, I became very discouraged and called the pediatrician who suggested we try a patch of the same kind of med. The patch was easier for him to "take." But that night, he acted very confused--one of the side effects of ADHD meds. We took him to the Emergency Room, where the ER doctor told us to stay away from meds with a child so young. We stopped the medication process.

Fast forward to his 2nd year of preschool, age five. With a new teacher, we thought things might be better, but they weren't. I began to receive the same negative notes in Tommy's backpack about his impulsiveness and his lack of focus. At the conference with the teacher, I asked her if she believed Tommy had ADHD. She said yes.

The school's solution was to put him on a behavioral plan to modify his impulsiveness. It involved the use of picture cards which he'd present to his teacher when he wanted to change activities. We also decided to try something new. We began to take him to occupational therapy once a week.

We are now waiting to see if these new therapies work. If they don't seem to help, we're probably going to try medication again. We might try Ritalin.

Fast forward six weeks. Recently, we heard from his teacher. She thinks the behavioral plan and the occupational therapy are working to combat the symptoms of ADHD. Thank goodness.

What is the upshot of our ADHD journey?

When a child is experiencing ADHD symptoms at such an early age, it becomes problematic because experts disagree if one can truly diagnose such a young child, and experts also disagree about medicating a young child around three or four. Many people believe that giving the child "time to grow up" is what is needed, not medical intervention.

I personally don't ever want to medicate Tommy. For the moment, he is unmedicated. And he's doing pretty well.

This ADHD road is a long one, especially when it begins at such a young age. But millions of people travel it.

About the Author
Managing Partner and Editor-in-Chief at one of the best social networking and lifestyle sites for moms, EverythingMom.com. Trying to balance life at home with my 3 kids (all under 8), while building my business, working at EverythingMom.com and developing my writing. Oh and throw a load of laundry in and a dinner that isn't burnt. Wasn't working from home suppose to be easier?
Posted by Carrie Anne in health on January 28, 2010
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Comments  

 
0 # cpn 2010-02-02 19:21
Thank you Laura for writing about your journey thus far. I look forward to more! We also are travelling this road with one of our sons and I find it distressing how non-clinicians are so quick to provide a 'diagnosis' and recommend the drug route. After several years of this, we now understand that this is a very complex situation, and that ADHD is sometimes more of a wastebasket diagnosis. What I mean by this is that there isn't a way to physically confirm that they don't suffer from a whole host of other conditions...from problems with vision or hearing or processing or even whether they are showing signs of boredom due to giftedness. I believe there is a place for medication, but only once a myriad of other possibilities are explored and ruled out. It's a tough road but it's worth the hard work! Thanks again for your insights! Christine
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0 # Scatteredmom 2010-02-02 19:25
When my son was in grade 2, his teacher suggested that we check out Ritalin as well. Jake was 6 years old. We had him assessed privately by a psychologist , and it turned out that he didn't have ADHD at all.

It took 5 more years until Jake was finally diagnosed with Developmental Coordination Disorder (Dyspraxia), which comes with sensory integration issues. In the meantime we went through years of teachers and and various schools demanding that Jake had ADHD and be medicated, even though the assessments said otherwise. The next disorder the school thought he had was autism, and they were wrong there as well.

We later found out that Ritalin doesn't work well with kids who have anxiety (as Jake does), because it increases the anxiety and can make them suicidal.

Parents need to know that teachers are not qualified to diagnose children nor recommend medication. Many disorders can appear similar to ADHD, and often times the average educator only knows small pieces about them. They are NOT doctors.

Elementary school was a long, hard road for Jake but now at 14, he's doing really well. Personally, I credit Children's Hospital for giving us the right diagnosis because it's made the world of difference.

(I'm not saying that your child's diagnosis was wrong, just pointing out our own experience)
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+1 # Jenaferlm125 2010-02-03 16:11
Thanks for sharing your story. My son had similar issues but instead of the medication route, we eliminated artificial food coloring and flavorings. It showed an AMAZING result.

You might want to give it a try-- it is becoming a well documented non medication based treatment. :-)
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0 # marandaHQ 2011-05-18 06:00
I totally agree with eliminating food colouring, as well as foods with naturally occurring salicylates. One of my children is especially sensitive, and it was much worse in the preschool years.

We also use ADHD medication and behaviour therapy, just to point out that it's not a one-or-the-other thing! ;)
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0 # ADDrift No More 2011-05-18 05:42
Thanks for sharing your story. I knew at 3 that my son had ADHD. I had him in to see a psychologist who didn't believe in diets and non-medication making much of a difference and warned he would need medication when he started school, though she agreed that 3 was far too early. We eliminated colouring, preservatives and dairy after many weeks of elimination diets. Within a short amount of time, I saw a significant difference in my son. I encouraged lots of physical activity and outside exploration. I also used the 1-2-3 Magic for discipline (great for ADHD) and started to organize things in the house differently. It all worked pretty well until he turned 11. That's when we started medication in the hopes of helping everything else we were doing already. It's still a work in progress...everyday. I blog too. It helps my frustration to have something positive to do with my frustration and lessons learned. Good luck to you. If you ever need anything, just send me a message. :)
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0 # marandaHQ 2011-05-18 06:02
Part of the diagnostic criteria for ADHD is that the child is at least age 7. I can't believe a Dr would even diagnose such a young child, never mind prescribe meds. I have two ADHD kids, and with the second I was pretty sure he ADHD by age 6 but had to wait until age 7 to bring him in for testing. Our testing process for both boys was about 5 hrs long, not counting all the questionnaires we did beforehand. I can't see getting a preschooler to do 5 hrs of testing?? Also, if your child does NOT actually have ADHD, stimulants will not work for them. It's mind boggling to me that a dr would agree to prescribe drugs for a 4 year old.

Medication has been life changing for my boys, and I would never take them off. Even with meds, they still need a lot of guidance & behaviour therapy, but the medication gives them the capacity to benefit from it. It can take a while to find the right medication(s) at the right dosage, but it's really been worth it for my kids.
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+1 # Pam Nease 2011-05-18 19:16
Is it ADHD or could it be sleep deprivation? Could it be both? Are they linked? I agree - take a look at nutrition and the possibility of a red dye 40 sensitivity. Doctors in both the U.S. and Canada are now also looking at the importance of sleep and how it can affect a child's behaviour and learning abilities. Some believe that many children are been misdiagnosed and given medication when all they need is improved sleep. Here is a link to the Sleep Lab at McGill University led by Dr.Reut Gruber.
http://www.douglas.qc.ca/expert_advices?id=118
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0 # ADDrift No More 2011-05-19 02:15
I agree with Pam! Sleep makes a huge difference. My son is 12 and used to go to bed at 8:30 every night, which we thought was pretty good...until his eye began twitching from exhaustion. Now he goes to bed at 7:30 pm everynight. He's up at 7 am each morning. Most parents don't realize their kids need so much sleep but it affects their moods and their ability to learn. As far as diagnosing kids, I agree you don't know for sure until they're a little older and you shouldn't accept a diagnosis until you've explored all other factors first (like diet, sleep, discipline, etc). Which we had. Having said that, even once they're diagnosed, you still need to see a doctor regularly and I've had my son reassessed every 2 years since (complete with questionaires and 6 hours of assessment time). It's a long process but it ensures you are always on top of the condition and the child's needs as they get older and more independent.
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