Dear ADDitude: When Is It Time for Medication?
A parent wondering when it’s time to start trying ADHD medication for her young child gets advice from an ADHD expert and real parents.
“My first grader is ‘holding his own’ academically, but he’d be doing much better if he could focus. Socially, he has poor body and impulse control; he’s also very emotional and cries immediately when something doesn’t go his way. How do I know when it’s time for medication? I want to try everything else first.”
Children as young as 4 can be diagnosed with ADHD, according to the American Academy of Pediatrics (AAP). The AAP recommends behavior parent training as the first-line treatment for preschool-aged children (children younger than 6) with ADHD. Clinicians, the AAP adds, may consider prescribing methylphenidate to a preschool-aged child with ADHD if symptoms do not improve under behavior therapy “and there is moderate-to-severe continued disturbance in the 4- through 5-year-old child’s functioning.” For children 6 and older, the AAP recommends ADHD medication along with behavior parent training.
Experts agree that parents should consider ADHD medications when symptoms interfere with their child’s social, emotional, or academic life.
Read on for more answers and insights from parents raising children with ADHD.
ADDitude Answers
This journey will be easier and shorter if you first accept that you cannot “fix” ADHD. I wasted about 2 years when my son was first diagnosed obsessing about how to “fix it.” Once I finally realized that question has no answer, I began to be effective for my son, because I began to search for tools and strategies that help, instead of just looking to “fix it.”
When my son was finally diagnosed at age 6, he was in first grade — but we had been struggling since the first day of kindergarten. We and the teacher both had been trying behavior modification but with little improvement, so the doctor advised medication.
We were scared, not knowing enough about it, but we wanted to try it because we wanted to help our son so badly. He was down and cried all the time. He often called himself “stupid” and “bad” and didn’t feel like he could do anything right, no matter how hard he tried.
While medication has been a tough road for us (my son also has autism, although we didn’t know at the time, but that makes him super-sensitive to medications), it turned out to be a life-saver. My son wasn’t crying all the time and began to see that he could succeed sometimes.
My advice is to learn all the facts you can about ADHD medication. They work differently for every individual. Adderall and Vyvanse made my son aggressive and quick-tempered and he couldn’t tolerate them, but I know many, many who take those medications very effectively. And my son does well with Concerta or Quillivant, but I know many who cannot tolerate those medications.
Pills don’t teach skills though, so the American Academy of Pediatrics (AAP) recommends a combination of medication and therapy.
Posted by Penny
ADDitude community moderator, author on ADHD parenting, mom to teen boy with ADHD, LDs, and autism
A Reader Answers
Sounds like he has combined-type. You are describing hyperactivity and impulse control as well as distractibility. Medication will likely give your son the ability to focus and control himself.
[Read: Is There Any “Right” Age to Medicate?]
It worked for my son. It was like flipping a switch for him, and he said “my brain isn’t wiggly now.” That was when he was 6. He is now 10, and still medicated. For him it is a lifesaver.
Also include behavior therapies with the meds and you will get your son on the right track and avoid months or years of frustrations. I would also get him on an IEP at school so there is a record of the accommodations each teacher must follow.
Give your son every tool possible to succeed, you will be glad you did. Good luck!
Posted by Pdxlaura
A Reader Answers
For ADHD brains, medication isn’t a glamorous party drug. The right medication is a support system that takes the swirling, half-baked, forgetful mess that we battle every day… and calms it, organizes it, and transforms it into something very closely resembling what might be a normal brain. At least, this is how I feel.
I’ve been unmedicated, over medicated, and incorrectly medicated. I have tried everything to corral my ADHD and bend it to my will. Some days I can (we celebrate those days), and some days I can’t.
The choice to medicate is absolutely yours, but please don’t go into the discussion already believing the worst gossip you’ve ever heard about it. If you choose to [have your son] take medication, you absolutely have to start with a neutral mindset so that you can clearly evaluate whether or not it helps.
If you start medication believing the worst, all you’ll be able to see is the worst.
Posted by MyADHDandMe
A Reader Answers
Medication only works in combination with other things like a good night’s sleep (10+ hours), plenty of protein in each meal, exercise (at least an hour a day), and lots of behavioral modifications/accommodations, so you can definitely start there and if everyone finds it’s really not working, then hopefully everyone will be on board for medication knowing you’ve tried everything.
This is what we did for my son. He was diagnosed in grade four and didn’t start medication until grade 6 when he hit middle school and wasn’t able to cope with just accommodations anymore.
Posted by Rai0414
A Reader Answers
We waited, and researched, for 5 years before finally trying medication for my daughter. I was very worried from what I had heard from friends and on the internet.
Turns out it was a great decision! It’s not a miracle pill but she’s not a zombie at all but sharper and more present, calmer and available. She’s happier. She’s doing better in school. We have a better relationship.
I wish we had done it sooner for her.
The decision to go on the medication doesn’t mean you’ve committed forever. It starts working in about 30 minutes. You will know in a few days if it’s working or not. If not, you keep going back to the doctor until you get the right dose and type of medication. It’s not like other medications that need to build up for months before you know if it’s working or not. At the same time, you can stop it if you feel it’s just not working well. (Doesn’t have to be weaned off). Knowing that helped us to give it a try.
Good luck!
Posted by SnapSprite
A Reader Answers
If you feel that medication is not right for your child, and both [parents] do not want to continue down that path, listen to your gut instinct. Have you considered the naturopathic route? There have been studies on the effectiveness of fish oil, zinc, rhodiola. A good naturopathic doctor and changes to her diet may help.
Posted by momoftwoboys
How to Treat ADHD in Children: Next Questions
- What ADHD medications are used to treat children?
- Is ADHD medication right for my child?
- What are the long-term effects of ADHD medication use?
- What is the ‘right’ age to start ADHD medication?
- Will my child become a zombie and/or build up a tolerance?
- Will ADHD medication suppress my child’s appetite and/or stunt their growth?
- Does stimulant use lead to substance abuse?
- Do kids need to take ADHD medication forever?
- What are common side effects associated with ADHD medication?
- What natural treatments help kids with ADHD?
- How can I find an ADHD specialist near me?
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