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4 year old... Testing? Diagnosis? Medication? Where to start?
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An_242319 posted:
2 seperate PreK teachers have brought up thier concerns with my 4 year old son for over a year now - nothing extreme, but he has a hard time sitting still while others his age do not, and has a tough time transitioning. He is reading and writing, no developmental delays (9 weeks premature), and otherwise well behaved and sweet as can be.

I wanted to initiate some testing to determine if there is an issue, or if it could be he is just 'immature' compared to his peers - and if medication is justified. We are seeing a new pediatrician - and when I brought up my concerns they had me fill out a Cooper questionaire (which he scored as a 22) and promply wrote out a prescription for Metadate, said any further testing would be just a longer questionnaire, and neuropsychiatrists don't know any more than anyone else about ADHD. I asked about diets to control the symptoms and he said if you feed any kid sugar they are going to climb the walls.... uhhh.

???????? Not what I was expecting. At. All.

I refuse to give my son any medication until I have something more than a 10 question form to fill out. Not that I am against medication - but it seems as though he has been completely rushed to a diagnosis! Am I wrong? I've been looking into diets and supplements - thinking first to try to see if there is any improvement with those before medicating.

What sort of testing should I expect/ask for? Is 4 years old too young for a diagnosis - much less medication? Has anyone had success with the diets? I am on info overload and I feel like I'm feeling around in the dark here.

If there are other threads that address this same issue, can someone point me to them? I hate to ask the same questions that others have asked before, but I don't have much time to sort through the board.

Any advice appreciated!
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Shaetae22 responded:
My daughter, who is now 8 and medicated, also showed some symptoms at an early age. I refused to medicate her until she was in school and her pediatrician agreed. Most ADHD (including Concerta, which my daughter is on right now, do not recommend use before 6 years of age. After my daughter turned 6, I had a formal ADHD meeting with her pediatrician and he gave me two forms, one for me and one for her teacher, to fill out and they were pretty extensive. I would recommend definately waiting until he is a little older and is in school. Also, I have heard that the red dye can cause hyper-activity, etc. I use behavioral correction, as well as keep the stuff with red dye to a minimum and it does seem to help. ADHD is extremely over-diagnosed and I agree that there should be a lot more than a 10 question form to fill out, especially being so young!
 
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Gina Pera responded:
I can see why you are alarmed. If I didn't know as much as I do about ADHD, I would be absolutely aghast at the idea of giving a four-year-old medication after such a simplistic exam.

But I'm really of two minds on this.

1. I've seen how children whose parents delay medication as long as possible lag behind in developmental milestones and often develop long-running problems (and "emotional baggage") because of it.

The brain is "programmed" to learn certain things at certain ages; if those things aren't learned then, there often isn't a "catchup" period. It's just missed entirely.

So, in my 12 years of studying this topic and talking to thousands of people on every point of the lifespan, I have to say I'm leaning more towards medication at a younger age for those who are really missing out on key developmental milestones.

2. All that said, I am also sad that four-years-olds don't have more free time and less structure these days. While certainly these types of attentional demands can help to identify ADHD earlier (a good thing, in my opinion), they also just create more stress for kids, which can intensify any ADHD issues.

I also see how physicians often have no clue about assessing overall issues as related to brain health, including dietary intake, exercise, environment, exposure to sunlight, etc. For example, most Americans are deficient in so many key minerals/vitamins that it boggles the mind. Yet, many physicians seem to view this area of basic biochemistry as little more than mumbo-jumbo. It's dispiriting.

So.....how would I resolve such a "on one hand and the other dilemma"?

I would read as much as I can about ADHD from solid sources. I might start with Dr. Mark Bertin's book, "The Family ADHD Solution." I know you said you don't have time to sort through board discussions, but you will need to make an investment of time in educating yourself. This is too important to your child's entire future.

I would also scrutinize my child's diet. Is breakfast usually a bowl of cereal and milk? I would cut out first dairy and then wheat, to see if that helps the child. And I would make a breakfast that includes protein.

I would make sure the child is getting enough sleep, is not exposed to the household chemicals that are so omnipresent these days in fragrances, fabric softeners, mastics in furniture, etc. and is getting enough exercise and sunlight.

After I tried these things, I would re-assess and re-consider the ADHD diagnosis and medication. As you say, he's a preemie, and that's a factor. I would also look for the genetic connection to you or the child's co-parent. If one of you has ADHD, that can make parenting more of a challenge. A home life affected by disorganization and ADHD-related stress in an adult can of course affect the child's behavior.

I hope this helps.


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