Should We Medicate 4-Year-Olds With ADHD?

New recommendations from the American Academy of Pediatricians call for doctors to screen children as young as 4 for Attention Deficit Hyperactivity Disorder (ADHD). More controversially, doctors are recommending giving mediations such as Ritalin and Vyvanse to children with ADHD who have moderate to severe problems when behavior therapy does not seem sufficient. The use of such medications for children under 6 years old has not been approved by the Federal Drug Administration; doctors can still prescribe the medications for younger children.

The AAP has also created a revised tip sheet about symptoms of ADHD for parents as well as revised its advice for doctors to diagnose children aged 4 to 18. Guidelines issued about 10 years ago had focused on diagnosing ADHD in children aged 6 – 12 years old.

Currently, nearly 1 out of 10 children are diagnosed with ADHD in the US. With pediatricians now encouraged to diagnose children at a younger age, it’s possible those numbers could go up.

Medication For Children With ADHD

Already, doctors are prescribing more and more stimulant medications for children diagnosed with ADHD, with prescription use growing the most among 13-18-year-olds, rising from 2.3 percent in 1996 to 4.9 percent in 2008. Prescription use for stimulants such as methylphenidate (e.g., Ritalin) and amphetamines (e.g., Adderall) was the highest among 6-12-year-olds (rising from 4.2 percent in 1996 to 5.1 percent in 2008), according to a recent study in the American Journal of Psychiatry.

Stimulant use has so far been very low (0.1 percent from 2004 onward) in preschool-aged children. Again, with the call to diagnose ADHD in younger children, it’s likely that stimulant use will also increase in that age group.

But are we turning too quickly to medication to help children pay attention in school and not “act out” impulsively? Are we in essence “giving up” too quickly? Besides behavior therapy to help someone with ADHD (including adults) pay attention and focus better, changes in the physical environment (such as the  Stand-Up Desk) can help. Having ready access to exercise and even just to get up and walk around can also be helpful.

Adaptions, Accommodation, Acceptance

I’ve written before about my husband having struggled with severe ADHD all of his life. It’s fair to say that not only would he have been diagnosed as a young child; as he himself says, his late mother definitely also had ADHD,. Certainly more than a few students in my college classroom have ADHD and ADD and I’ve tried to adapt my teaching style to accommodate for their needs. For instance, I try to run my Latin and ancient Greek classes at a rapid pace (none of this standing at a lectern and droning on and on) and to repeat myself (and always to post assignments online and to be available via email). I write a lot on the chalkboard, show some video clips and webpages on an overhead projector and walk a lot around the room. I also don’t have the overhead lights at full strength: Something about the glare seems to detract from focusing. I try to be attuned to the fact that just because someone doesn’t seem to be paying attention, it doesn’t mean they are not.

If younger and younger children will be diagnosed with ADHD, we need also to consider teaching strategies and other accommodations that allow different styles of learning. Medication has its uses but there’s more than one way to help a child — to help anyone — pay attention and learn.
Related Care2 Coverage

Will Ritalin Kids Become Ritalin Adults?

ADD: Just An Excuse For Bad Behavior, Perry Suggests

The Stand-Up Desk – A New Way To Learn


Photo by jeffkarpela


Karla B.
K B.3 years ago

Thanks for the article .. please sign my petition .. or just type adhd in the search , link is first one below , I appreciate your support

Ann Fuller
Ann Fuller4 years ago

I agree....lots can be done with out medications. Lavender is another oil for calming, diffuse for 1/2 hour at a time. Cut out additives and preservatives especially RED. Parents spend time with your children, listen and interact with them. See how alternative things go BEFORE you turn to medication.

Karla B.
K B.4 years ago

Please join me on "Discuss ADD" . Everyone's welcome

Karla B.
K B.4 years ago

Can a teacher ignore a student, because of the way s/he is perceived

Bring back hope to special needs

Meris M.
Meris M.4 years ago

The American Academy of Pediatricians (AAP) is being influenced by the pharmaceutical industry. If the AAP condones 2-year-olds being exposed to the wireless components in computers and iPads which emit harmful radiofrequency radiation that can cause hyperactivity, among other health problems, then no wonder kids "require" drugs like Ritalin. Children should not be prescribed such drugs at all, let alone 4-year-olds. Keep them away from wireless technology, including cell phones, and also soda drinks and other foods that contain artificial additives.

Cynthia Kathleen
Cindy Parks4 years ago

When my son was five, I was told he had ADHD and to give him coffee until his meds kick in which would calm him down. Well, my son was climbing the walls!! More doctor visits and more opinions later (including one that said he was autistic) we find out from a specialist it wasn't ADHD after all but an inner ear infection that was blocking his tubes which were causing his problems. Idiot Doctors!!!

Carrie H.
Carrie H.4 years ago

Have the kids do exercises before they have to sit in a class room.

tara lav
Bracha Katz4 years ago

Let kids be kids! Most of the problem with 'ADHD' is because the classes are not stimulating enough, and most kids aren't meant to sit still for 7 hours a day.
These drugs harm children's body & spirit.

Kerry Baker
.4 years ago

The pharmaceutical companies at it again. When people wake up to the fact that there is no financial incentive for pharmaceutical companies to find a cure for anything, then maybe they will realise what's going on here. I strongly doubt that kids have ADHD to the degree that is being diagnosed. I suspect that often it's just kids being kids, and parents who can't cope with inquisitive children. Simple diet changes also help, like not giving red cordial and so on. Time to stop poisoning little bodies with drugs and get back to good diet and realistic expectations of kids behaviour.

Linda C.
Linda C.4 years ago

Another way to help children without using drugs is by helping them learn and devise calming techniques and to look at diet. Reducing excess stimuli and helping children learn techniques of concentration can reduce the tendency to be distracted, as does getting regular physical exercise. Walking at a steady pace, for example, helps to establish basic body rhythms. There are many natural dietary calming agents such as peppermint and almonds; in addition, ridding the diet of as many artificial preservatives and coloring agents as possible is a big help. Children and their parents should experiment to learn if such common irritants as gluten or other foods such as peppers and tomatoes are contributing to the child's agitation. Much can be done without drugs.