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Attention Deficit Hyperactivity Disorder

Drug Treatment of Young Children



I feel that 5 years of age is too early to begin drug treatment of ADHD. My grandson has just been diagnosed with ADHD and the child neurologist prescribed Ritalin but did not recommend any behavior modification plan. What would be your suggestion for treatment? Wouldn`t it be prudent to try a behavior mod plan first before resorting to drugs?


It has to be frustrating to see your grandson get medication and not understand what risk-benefit decisions went into prescribing it.

Without knowing your grandson it is difficult to answer your questions. There are not very many five year olds on medication for ADHD but I have had a few patients that age who benefited greatly from stimulant medication such as Ritalin.

Regarding medication versus behavioral modification...in general, most children with ADHD are helped best when both medication and behavioral work are used. I have known a good number of parents who tried very hard to work behaviorally first to medicate their child as late as possible. I think that, in general, that's can be a good philosophy as long as the child is capable of developmentally appropriate activities such as not endangering his/herself or others and is able to play well with other children. However, again, without knowing your grandson I can't say which would be the best approach.

Perhaps when you see your grandson you will understand better and, if not, I encourage you to ask his parents about why the medication was prescribed. Of course, that does not guarantee you'll feel any better about things but it may get you more information than I can give not knowing him.

I wish you, and your grandson, the best.

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati