QuestionHow young is too young to be prescribed Adderall?
Hopes&Fears answers questions with the help of people who know what they're talking about. Today, we talk to mental health professionals and an intervention specialist about medicating for ADHD.
For parents of children with ADHD (Attention Deficit Hyperactivity Disorder) the road to treatment is a difficult one. People with ADHD can suffer from organizational, behavioral, and concentration issues. In extreme cases, medicating people with ADHD can have a healthy, positive effect on their lives. In fact, 3.5 million Americans (or 6%) under the age of 17 are prescribed medication for the disorder, some starting as young as two years old. Is there an age that's too young to start taking ADHD medication? To answer this question, Hopes & Fears asked the experts.
Associate Professor of Educational Psychology at University of Buffalo
ADHD is simply a term used to say that a child is exhibiting behaviors that are developmentally inappropriate for his/her age, or that cause problems for them, academically or socially. When I think about a child with ADHD, I don’t think about it in black or white. To make a diagnosis, it is up to the physician to figure out if this child has difficulties that need treatment and help—and if so, how do you help them. My first step would definitely not be medication. We have a number of other best practices approaches to follow, like working with the parents or teachers. Medication would be my last resort.
In fact, guidelines from the American Academy for Pediatrics say not to start a child too early on medication. You should use behavioral training first.
year olds are the average age of ADHD diagnosis, but children reported by their parents as having more severe ADHD were diagnosed earlier
Doctor George Sachs
PSyD Child and Adult Psychologist
ADHD can be identified typically around five or six, but as young as three. The first step is an evaluation which determines what is going on, so I don’t think medication is the first step; we must do a careful evaluation first to figure out what is happening in their entire world—their school, their home, and nutrition. ADHD can look like other things like trauma and anxiety, so it is important to first find out what is going on.
Medication is not recommended until much later. Medication is not recommended at any certain age, but it is after you rule out all other things. It can be very effective in some cases.
average age of diagnosis for children
years of age
reported as having mild ADHD
years of age
reported as having moderate ADHD
years of age
reported as having severe ADHD
Steven W. Evans
Professor of Psychology at Ohio University, Editor-in-Chief of School Mental Health, and Co-Director of the Center for Intervention Research in Schools
Identifying ADHD depends on severity. You can identify ADHD in toddlers depending on their severity, but more often than not it is easier to identify around pre-school age.
Something to note is that there is no such disorder as ADD. That has not been a valid diagnosis since 1995. Kids with ADHD do have an inattentiveness, though. In terms of school, students with ADHD suffer in two domains: social behavorial and academics. In the social behavorial domain, it’s about managing their hyperactive and impulsive systems to follow the rules and stay on task. Other kids and teachers often view them as disruptive and annoying.
The other area is academics, where the big problem is attention. It is difficult for them to pay attention to whatever task they are supposed to be doing: listening to somebody or participating in an activity or independent work. The disorganization is difficult too because they are expected to keep track of more materials, assignments, and long-term projects. Disorganized thinking also contributes to difficulties comprehending. Reading or listening to something for long stretches of time make it hard for students with ADHD to understand what they have heard.
The decision of medication ultimately comes down to the same risk of starting someone on any medication on a daily basis versus the risk of not doing it. If a child is three or four years old but is exhibiting a lot of dangerous behavior—running into the street, up trees; getting into fights—in situations like that, the risks of keeping him off medication may be greater than the risks associated with taking him off medication. In those cases, I won’t say recommend, but I would consider medication given the dangers and severity. It is a trade-off as you get older.
1 in 10 (11%)
US SCHOOL-AGED CHILDREN and more had recieved an ADHD diagnosis by a health care provider by 2011, as reported by parents.
children repoted by parents to have ever recieved a health care provider diagnosis of ADHD, including:
→ 1 in 5 high school boys
→ 1 in 11 high school girls
Illustration: Yulia Goldman