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ADHD in Children Health Center

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ADHD in Preschool Kids

Behavioral Therapy Comes First

For preschoolers diagnosed with ADHD, behavioral therapy is the first treatment.

This type of treatment involves changes in behavior by parents and teachers. Techniques include praising and rewarding good behavior, ignoring bad behavior, and using time-outs. Structure and routine are important for young kids with ADHD.

The Medication Question

If your child is 4 or older and you’ve tried behavioral therapy for at least 6 months without much change, you can also try low-dose ADHD medication.

"But don't ever give up on behavioral therapy," Perrin says. "Behavioral therapy is important even when a child is on medication."

Not all ADHD medicines are FDA approved for children younger than 6. But many doctors prescribe these drugs for preschoolers with ADHD.

"ADHD medication doesn't work as well for this age group," Perrin says. "It definitely does work, but it works less powerfully and less predictably in younger children than in an older child."

Although there can be side effects, the AAP believes that the benefits outweigh the risks in young children who aren't getting better with behavioral therapy.

A study found that young children are more sensitive than older children to the side effects of methylphenidate, one of the more commonly used medications. Those side effects may include delayed growth, loss of appetite and weight loss, insomnia, and anxiety. The side effects, including delayed growth, reversed once the kids stopped taking the medication, DuPaul says.

There aren't any studies on the long-term effects in children who start ADHD drugs at such a young age. But studies of children in elementary school "have not indicated any long-term side effects of treatment," DuPaul says.

Deciding whether to make medication part of your child’s treatment isn’t easy. It's a decision that’s made after carefully weighing the pros and cons. What’s right for one child (and family) may not be right for yours. Talk to your child's doctor, and together you can decide what’s best for your child.

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Reviewed on May 12, 2015

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