View Full Version : Why do children not take medication, before the age of 4-6?


mildadhd
08-04-17, 01:11 PM
Hi,

This thread is meant to discuss, why do children not take medication before the age of 4-6?












M

Lunacie
08-04-17, 02:21 PM
There seem to be at least a couple of reasons.

One: symptoms of impairment should be seen in more than one setting. Many
children are mainly at home until they begin school at age 5 or so.

Two: the FDA has not approved the medications for children under the age of 6.
Why? Because the effects are less predictable in younger children who are still
going through a period of tremendous growth (both body and brain).

Emre22
08-04-17, 03:18 PM
Hi,

This thread is meant to discuss, why do children not take medication before the age of 4-6?












M


I think it is better in this way

It can also be a reason

ADHD mostly causes problems with integration of daily life, basic responsibilities etc.

A child who is under 6, i guess they arent responsible for anything, they are under protection of their parents.They dont need to organise anything, they dont need to study etc.
They only play with toys, have fun etc. , i guess hyperactivity can be tolerated until some age like 6

So why would a child use ADHD medication? There is no proper or concrete reason for it. You need really strong evidence which shows it is important to take medication for children. Otherwise side effects and negative impact on growth risk are not worth to take.

When u start medication , you need to estimate what are benefits what are losses. When u estimate it for children who are under 6 , they cant benefit more than they lose

Emre22
08-04-17, 03:38 PM
Also i want to clarify toleration of hyperactivity

When i was child(before school) i remember that i was real troublemaker
I was doing really dangerous things, i was climbing on anything i found. My parents realized i have hyperactivity disorder but they were scared of medication . So they chosed a different way , they didnt prohibit anything , but they put me under watch all the time.

I remember that when i went to playground my mother was watching me all the time.Instead of prohibiting , having strict rules, they chosed that way. Once they didnt watch me while riding bicycle , i remember that i jumped from a height with my bicycle which is about 1m :D thankfully i didnt hurt myself
when we were at holidays , my poor father was watching me all the time when i was in aquapark under the sun :D It was hard for them . when i was a child , it was really hard to find good psychologist in Turkey , so i couldnt have any kind of theraphy.
My parents chosed to sacrifice their time in order to keep away me from hurting myself.

When i started primary school, i started to become inattentive and hyperactivity part was decreasing . My grades were good until 5th class, after 5th class lessons required cumulative knowledge and self-studying. My parents chosed to buy special lessons,additional school, rented teachers etc. somehow i passed High school entrance exams with good grades.

I only think that if parents sacrifice enough for their children it is possible to tolerate ADHD for children by my experiences. ( btw i am only child, it can be more difficult for parents who have children more than 1 , if two of them have ADHD at least)

I think medication is last option for children.

Fuzzy12
08-04-17, 03:44 PM
I think meds might also be problematic for very young kids because they might find it more difficult go description (or understand) side effects. I remember when I started meds the side effects were quite disturbing e.gm heightened anxiety. Not everyone has side effects but if they do it must be quite hard on kids. Also it might be more difficult to adjust or titrated dosages.

I also found that meds alone were not enough ajd I had to use vwry specific behavioural strategies along with meds to get any benefit from them. I can imagine that figuring this out and finding specific tools might be quite difficult for a child.

Anyway as with everything it's a risk benefit analysis. I'm sure some kids do need meds and will do a lot better on them (and be much safer and happier )

aeon
08-04-17, 03:49 PM
It would be difficult to do a double-blind, placebo-controlled, randomized study to get clinical results about this, but I do wonder about the neuroplasticity and neuroremodeling that occurs with dextroamphetamine, and if use with children at that age could potentially prevent/cure ADHD because intervention would occur during the time of explosive neuronal growth.


Cheers,
Ian

mildadhd
08-04-17, 08:05 PM
Nobody is born with mature self-regulation.

Implicit and explicit self-regulation mature after birth.

It is normal for everyone to exhibit immature hyperactive, impulsive and inattentive behavior, before the age of 4-6.

Behaviors associated with emergence of AD(H)D are not generally considered abnormal, until after the explosive neural rate of implicit development declines, about the age of 4-6*.



M

Lunacie
08-04-17, 09:16 PM
Nobody is born with mature self-regulation.

Implicit and explicit self-regulation mature after birth.

It is normal for everyone to exhibit immature hyperactive, impulsive and inattentive behavior, before the age of 4-6.

Behaviors associated with emergence of AD(H)D are not generally considered abnormal, until after the explosive neural rate of implicit development declines, about the age of 4-6*.



M

But kids develop at pretty much the same rate ... unless there is a disorder
that impairs that development and slows it. Most moms have a sense of how
their child compares with similar aged children at library story hour, or the
play park, or in child care situations.

Some kids are much more immature, hyperactive, impulsive or inattentive,
more often, compared to their peers. Without using the term "abnormal"
there is clearly something different going on with their development.

Google webMD for "adhd in toddlers and preschool kids."

sarahsweets
08-05-17, 07:42 AM
My son was diagnosed at age 3.5 but didnt start meds until age 4. At that time meds were not recommended before age 6 so because there really wasnt much internet to speak of, or that I had access to, I had to go to the library and research it. Imagine having to constantly be at the reference desk asking for help, I love the internet for this reason. I was a recently graduated college student so thank God I still had access to the university library because the one available to me at home was pretty dinky.

I think the choice to medicate is a huge one, and very often parents are demonized or at least questioned when they start meds, as if they want to medicate their kids or that its easy or a good "baby sitter" to use medication. Any parent that loves their kid will do real research. Not the Dr google/webmd kind, but real pub med, cited research. I had taken my son to 4 different psychiatrists/neurologists and subjected myself to poor research and judgment. There was no way I was going to start my young son on medication without proper research. And there was no way I was going to let a doctor bully me into any decision.

Its so hard to study children in the long term. To find that many kids, that you can study over years consistently, and then compile data is a huge hurdle. Plus you would need enough kids to do a blind double controlled study and I just dont know if there are enough people out there willing to follow through with it. Sometimes you have to go with your gut as I did. I will never say it wasnt worth it and I will always say it saved his life.

He made the choice to stop meds when he was 16, i guess his body changed. What was I to do? I cant force a 16 year old to take meds, He was a gifted student and has an unbelievable IQ so maybe he just learned enough coping skills. He said he didnt like the way they made them feel after a break in the summer. I wished he would have stayed on them because now that he is 21 I see him struggle with some of the adulting he does.
He is in college and lives with us (he's a millenial so I dont see his financial situation changing anytime soon) and I see the adhd in full force everytime I see coffee cups in the bathroom, or he starts discussing politics with me while I am on the toilet. He is forgetful and distractible and still has ants in his pants, but he is a man now and I did my best.

Maybe he will tell me how I failed him when he reaches 30. Maybe I did, maybe I didnt push hard enough or I pushed too much. Maybe I missed something or maybe my alcoholism late in his teen years broke him, but I cant change the past. I can only help guide him now and make up for whatever I didnt do enough of.
I adore him and I have let go of regret.
I did my best and will never say otherwise.

mildadhd
08-05-17, 11:01 AM
I think children do not take medication, before the age of 4-6, because their brain's are not developed enough to be diagnosed.

It is normal for everyone's implicit self-regulation to be developing after birth and the first few years of life.



M

Lunacie
08-05-17, 11:55 AM
I think children do not take medication, before the age of 4-6, because their brain's are not developed enough to be diagnosed.

It is normal for everyone's implicit self-regulation to be developing after birth and the first few years of life.



M

Autism can be diagnosed as early as 18 months, and the child benefits greatly
from early intervention. I think the same is true of some kids with adhd, that
the difference can be seen in toddlers and early intervention would be helpful.

Early intervention doesn't have to be medication, but like Aeon, I wonder if
the meds were given early they would boost development in the brain so the
child isn't as delayed.

mildadhd
08-05-17, 12:38 PM
Autism can be diagnosed as early as 18 months, and the child benefits greatly
from early intervention. I think the same is true of some kids with adhd, that
the difference can be seen in toddlers and early intervention would be helpful.

Early intervention doesn't have to be medication, but like Aeon, I wonder if
the meds were given early they would boost development in the brain so the
child isn't as delayed.

You know I am all for learning ways of promoting healthy early development of self-regulation, especially for children born with more sensitive temperaments, that may negatively influence development, before the age of 4.

Parenting figures may certainly notice differences, (more sensitive temperament) and parenting figures could make accommodations for any hypersensitivities that may help reduce negative impact on their development.

But how would you know if the child has ADHD for sure, in the first place, before the age of 4, when implicit self-regulation is normally immature?



M

Lunacie
08-05-17, 12:57 PM
You know I am all for learning ways of promoting healthy early development of self-regulation, especially for children born with more sensitive temperaments, that may negatively influence development, before the age of 4.

Parenting figures may certainly notice differences, (more sensitive temperament) and parenting figures could make accommodations for any hypersensitivities that may help reduce negative impact on their development.

But how would you know if the child has ADHD for sure, in the first place, before the age of 4, when implicit self-regulation is normally immature?



M

You would know by comparing the self regulation of the child to the typical
regulation of other children of the same age.

You don't expect the child to have the development of a 4 year old at the age
of 2, but you compare him or her to other 2 year old children.

As I said in the post you responded to, you look for the differences.

mildadhd
08-05-17, 01:20 PM
You would know by comparing the self regulation of the child to the typical
regulation of other children of the same age.

You don't expect the child to have the development of a 4 year old at the age
of 2, but you compare him or her to other 2 year old children.

As I said in the post you responded to, you look for the differences.

What would be the differences at those ages?

How do rule out possible development between 2 and 4?

How do you rule out other conditions like BP, etc.

Why do doctors recommend behaviour therapy before the age of 4-6?

I think it is great that you are focusing on the early period of development in regards to early intervention, some of the many benefits of supervised play therapy in regards to noticing differences.

But the facts are doctors do not prescribe medication until age of 4, why not?





M

Lunacie
08-05-17, 02:00 PM
Being overly fidgety and squirmy, moreso than other kids in their age group.

Having an inability to sit still for calm activities like eating and having books read to them.

Talking and making noise excessively.

Running from toy to toy, or constantly being in motion.

My granddaughter was age 5 when I commented to a friend that I had
noticed these things before she started pre-school, and they had not
improved over time.

When I took her to story time at the library, the leader would guide the kids
through an activity like "The wheels on the bus" and then they would sit down
while she read them a story.

My granddaughter could not sit quietly. She would wriggle around, from butt
to knees and back and even lying down. She would interrupt the story teller
to share an event that the story reminded her about, or to ask a question.
The other children sat and listened quietly before the next activity, even kids
who were younger than she was.

Same thing at the dinner table, from sitting on her butt, to kneeling, to
standing in the seat, to getting down to get something or do something.

Often interrupting other people, saying "Mom" over and over before mom
could even ask "What?" And when she was asked what she wanted she didn't
remember. That got really old.


As far as the meds, most of the research was done on kids between the ages
of 6 and 18, so there are no studies to reference in treating children younger
than 6, although there is nothing to rule it out either.

mildadhd
08-05-17, 09:53 PM
Being overly fidgety and squirmy, moreso than other kids in their age group.

Having an inability to sit still for calm activities like eating and having books read to them.

Talking and making noise excessively.

Running from toy to toy, or constantly being in motion.

My granddaughter was age 5 when I commented to a friend that I had
noticed these things before she started pre-school, and they had not
improved over time.

When I took her to story time at the library, the leader would guide the kids
through an activity like "The wheels on the bus" and then they would sit down
while she read them a story.

My granddaughter could not sit quietly. She would wriggle around, from butt
to knees and back and even lying down. She would interrupt the story teller
to share an event that the story reminded her about, or to ask a question.
The other children sat and listened quietly before the next activity, even kids
who were younger than she was.

Same thing at the dinner table, from sitting on her butt, to kneeling, to
standing in the seat, to getting down to get something or do something.

Often interrupting other people, saying "Mom" over and over before mom
could even ask "What?" And when she was asked what she wanted she didn't
remember...



I love when you and other members describe things I can relate to.




M

Lunacie
08-05-17, 11:38 PM
I love when you and other members describe things I can relate to.




M

Have you browsed the thread in the children's sub-forum called something like
"You know your child has ADHD when ..." There are lots of stories like these.

Caco3girl
08-07-17, 09:07 AM
My daughter was diagnosed at age 7. Prior to that time I warred with myself if she was being a kid or if there was an issue. ALL kids have the inability to regulate self control, all kids have issues focusing, all kids have hyperactive outbursts....so how do you know it's ADHD or if they are being a normal kid? I didn't really come to the decision to take her to talk to a psychiatrist until second grade, when the school called with several ADHD issues. That is why MY kids wasn't medicated until age 7.

Lunacie
08-07-17, 11:39 AM
My daughter was diagnosed at age 7. Prior to that time I warred with myself if she was being a kid or if there was an issue. ALL kids have the inability to regulate self control, all kids have issues focusing, all kids have hyperactive outbursts....so how do you know it's ADHD or if they are being a normal kid? I didn't really come to the decision to take her to talk to a psychiatrist until second grade, when the school called with several ADHD issues. That is why MY kids wasn't medicated until age 7.

I think it was harder for my daughter, mom of my adhd granddaughter, to
realize the behaviors were not so typical. She was an only child who didn't do
any babysitting or childcare, having no interest in babies or toddlers.

I grew up in a family of 5 kids and as a teen I babysat a lot of kids, so I had
more experience in the typical range of "normal" or neurotypical children.
I was noticing traits in my granddaughter by the age of 3 that were different,
but she was 5 before I got a hint of what direction to look.

Everything I read about adhd was undoubtedly what she and I were both
living with. I had been searching for the answer to my own oddities for many
years but nothing had ever quite fit. Until I read about adhd, and then nearly
everything fit. We just have a few extra pieces in our puzzles.

aeon
08-07-17, 12:26 PM
When I was a tot my mum brought me to many a specialist because she sensed something was not quite right with me.

That said, me, the inveterate people pleaser, would always win the favor of whatever specialist, and do my very best on the cognitive tests given, such that they would conclude not only was there nothing wrong with me, but indeed, I was a specially-gifted child.

And then there was the question of what would a woman know about neurodevelopment in a child, even her own child, anyway? Surely the idle imaginings of a well-meaning, albeit unschooled, mum could easily be dismissed by those with multiple degrees and certifications, either by right of knowing better, or by coddling the “hysterics” of a new mum.

38 years later, I got my ADHD diagnosis at age 41.

What could have been had I been medicated from the start, when my disability was so clearly evident to those with open eyes and open minds?


Cheers,
Ian

mildadhd
08-07-17, 01:36 PM
I was noticing traits in my granddaughter by the age of 3 that were different,
but she was 5 before I got a hint of what direction to look.





Makes sense that parenting figures may notice differences when comparing temperaments, before birth and the age of 4.

But hyperactive, inattentive and impulsive behaviors are very normal behaviors before the age of 4.

Children have different ways of learning.

There is no way of knowing for sure if the hypersensitive temperament has emerged into a AD(H)D temperament before at least the age of 4.

The critical developmental period of implicit self-regulation is before 4.

Some people are born with more reactive temperaments.

But nobody is born with full control of their self-regulation.





M

Lunacie
08-07-17, 03:35 PM
Makes sense that parenting figures may notice differences when comparing temperaments, before birth and the age of 4.

But hyperactive, inattentive and impulsive behaviors are very normal behaviors before the age of 4.

Children have different ways of learning.

There is no way of knowing for sure if the hypersensitive temperament has emerged into a AD(H)D temperament before at least the age of 4.

The critical developmental period of implicit self-regulation is before 4.

Some people are born with more reactive temperaments.

But nobody is born with full control of their self-regulation.





M

I have read that there is one critical period of development of self regulation
in infancy, and another period that happens between age 4 and 7. But no one
has full control of self regulation at the age of 7 either.


In fact, there is no way of knowing for sure if a person has adhd at any age
since there is no definitive test to prove it.


Here's what one research professor wrote about age of onset:

Age of onset criteria

In DSM-IV, the age of onset criteria was "some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years." This reflected the view that ADHD emerged relatively early in development and interfered with a child's functioning at a relatively young age.

http://www.helpforadd.com/2013/june.htm

As you say, these symptoms may be difficult to differentiate from normal
childhood traits, and the DSM-IV now says they should be noticed by the age
of 12. That doesn't mean it cannot be diagnosed before the age of 12.

aeon
08-07-17, 04:07 PM
Not that this proves anything, but in kindergarten, my teacher did the test with us young’ins where the child is to sit at a table, on which is a cookie. The rules are that the child can have the cookie now, or if the child can wait 5 minutes, they can have 5 cookies.

I was the only child who was able to wait the 5 minutes, and then when I got my 5 cookies I gave them away.

I may have been a child, but I knew how to control myself in all manner of situations. It was, after all, a survival skill...and in my case, I learned to never, ever, show what I wanted or desired, because it would be used against me.

No 4-year-old is born with self-control, but some learn it because they are left with no other choice, neurodevelopmental deficits be damned.


Cheers,
Ian

mildadhd
08-07-17, 05:21 PM
I have read that there is one critical period of development of self regulation
in infancy, and another period that happens between age 4 and 7. But no one
has full control of self regulation at the age of 7 either.


In fact, there is no way of knowing for sure if a person has adhd at any age
since there is no definitive test to prove it.


Here's what one research professor wrote about age of onset:


http://www.helpforadd.com/2013/june.htm

As you say, these symptoms may be difficult to differentiate from normal
childhood traits, and the DSM-IV now says they should be noticed by the age
of 12. That doesn't mean it cannot be diagnosed before the age of 12.



I would love to discuss these topics in a different thread about the critical period of explicit development, occurring after the age of 4.

This thread is focusing on why we do not take medication during the critical period of implicit development, before the age of 4.





M

Luvmybully
10-10-17, 09:07 PM
There is absolutely a degree of hyperactivity and impulsiveness that can be recognized before age 4.

My 2 year old granddaughter has NO impulse control. None. She does not sit still, some part of her body is constantly in motion. As Lunacie has said repeatedly, every age has typical behavior, typical development. Some kids are very far outside of that norm.

I can't say about medication in one so young, it is honestly not something I have thought about in over 20 years. I feel that the child's ability to communicate what's happening in their body is very important.