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At the preschool age, it can be hard to tell whether certain behaviorsrepresent a real problem or just "kids being kids." Clinicians compare a childwith others the same age to determine whether the symptoms are inconsistentwith the developmental level. Preschoolers with ADHD are not justrambunctious. They seem unable to wait their turn or think before acting.Despite warnings, they may play with matches or rush into traffic. They arenoisy and constantly interrupt others, and they can sow chaos at home or inday care.
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Stimulant drugs are increasingly prescribed for younger children, althoughthe FDA has not approved them for children under age 6. The first large,controlled trial of methylphenidate(Ritalin and others) in children ages 3 to 5 found the drug was not quite aseffective as it is in school-age children.
The most popular alternative to drug treatment is parent training, whichis based on the belief that parental negligence, intrusiveness, or harshdiscipline might trigger hyperactive behavior in a child with a predispositionto poor impulse control. Parents are shown how to set appropriate limits anduse moderate rewards and punishments. The bottom line, according to theHarvard Mental Health Letter: Be slow to make the diagnosis, and considerparent training and specialized day care before resorting to stimulant drugs.
The Harvard Mental Health Letter is available from Harvard HealthPublications, the publishing division of Harvard Medical School, for $59 peryear. Subscribe at http://www.health.harvard.edu/mental or by calling1-877-649-9457 (toll free).
Media: Contact Christine Junge at [email protected] for acomplimentary copy of the newsletter, or to receive our press releasesdirectly.Also in this issue: -- Endophenotypes: A new way to look at psychiatric disorders -- Ignoring hallucinatory voices -- When both partners are violent -- Muscle relaxation -- Borderline personality disorder -- Children, depression, and the FDA
SOURCE Harvard Mental Health Letter
