ADHD Medication for Preschoolers? - FamilyEducation

Expert Advice

ADHD Medication for Preschoolers?

Pediatrics Expert Advice from Henry Bernstein, M.D.

My 3-year-old daughter was diagnosed with ADHD at 20 months. How old does she have to be before she begins her medication for ADHD?
ADHD can be a difficult and frustrating condition to deal with for parents, teachers, and, most of all, for the kids who have it. There are many ways to approach the treatment of a child with ADHD, and medicine alone will not do it. In short, most experts agree that medication should not be the first choice of therapy for preschool-aged children. Although stimulant medications are the most common and effectively used drugs to treat children with ADHD, the American Academy of Pediatrics (AAP) takes the position that these medications should not be used with preschool-aged children until parents have received appropriate counseling on behavior management techniques. It is believed that preschool-aged children with ADHD generally respond nicely with behavioral interventions.

The AAP does, however, note that medication can be used in this age group if it "becomes evident that the child's behavior cannot be managed by experienced teachers in a preschool or nursery setting." Therefore, it is important that you and your family meet with both your child's physician and the specialists in your child's school system to determine whether drug treatment is prudent at this time. It is possible that there are behavioral management strategies that have yet to be tried, or that your daughter could be placed in a more specialized educational environment. If all of the behavioral strategies have been maximized, medication might then be an option for your daughter. Whatever the final decision on whether to start medication or not, it should be a decision that everyone makes together in the best interests of your daughter.

Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

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