ADHD treatment for Toddlers

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Good evening,

Does anyone have any experience of having a confirmed diagnosis of ADD/ADHD for a child under School age??

If so, what treatment is available? It appears that medication is only prescribed from age 6 so what happens until a child reaches that age? My DS has been exhibiting ADHD behaviours since 9 months old and was subject to both cannabis and cocaine use in utero. We are waiting for various assessments but I’m wondering what treatment options are available even if a diagnosis was made....

Thank you

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How do you know it’s adhd? If bm was doing drugs whilst pregnant, is it probable that she was also drinking?

Additionally, if she was doing drugs/alcohol, what were the underlying reasons? Genetic history, psychiatric history, etc.

You won’t get a toddler diagnosed with adhd. Too many variables at that age. If a diagnosis is made at 6, then medication is an option but it’s highly likely that there’s other stuff in the mix. I’m not sure tbh what adhd symptoms would look like at 9 months. I have a son with adhd but I certainly wouldn’t have known that when he was very little.

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It's great you are getting some assessments for him. I wonder what support you are getting for yourselves? Parenting a very active preschooler with a limited attention span (which is what I guess you are doing from your post) is exhausting. If you haven't got any therapy lined up for him, it would be great to get some in place. I wonder if you have access to a support group or people who just get it?

Our LO is a couple of years older, and allegedly at an age where things can be diagnosed. However, as with many other children who have experienced developmental trauma, it would be hard to find an exact label for him. Certainly a mix of in utero stuff, traumatic experiences, and some genetic inheritance going on. I worry less about labels now, and more about getting the right people around him (and us) to support him, with a really good understanding of developmental trauma. Have you looked at the resources from Beacon House? I suspect "treatment options" may relate more to how you parent him, and how other key people in his life support him.

We may look to medication at some point too.

All the best on your journey.


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Hi Donatella,

ADHD has been mentioned as a possibility by three separate paediatricians during AS’s time in foster care.

The behaviours causing concern for the foster carers remain a concern for us and despite my boy being in the middle of the ‘terrible twos’, my mummy radar is heightened!

I don’t know that he has ADHD. His behaviour could be caused by a number of issues but for three ‘experts’ to reference it in their reports is enough for me to ask the question.

I understand that children can be diagnosed as early as three in some cases so my original question remains; what treatment/therapy is available for a 3 year old with ADHD.

We have to make a decision about schooling very soon, our local school is great for DD but would not be suitable for DS if his behaviour continues to escalate.

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Your original question? None as far as I’m aware. My son was assessed at 5 and dx and medicated at 6. I don’t know of any other children who were dx pre 6. Bear in mind also that adhd is often comorbid with other conditions. In my sons case, he has Asd too.

Schooling - tricky. My son was permanently excluded from mainstream at 6. Thankfully as it turns out. So I would look for a school with experience of LAC, of SEN, who are attachment aware or at the very least willing to listen and learn.

And in the meantime keep a diary.

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Hi Squeak,

Thank you for your post. Yes parenting our son is exhausting, frustrating and incredibly lonely. Our support network has dried up and unfortunately we have very little time for ourselves (that’s a whole other story!)

Our DS is hyper active, destructive, incredibly impulsive (to the point of being dangerous), aggressive and defiant.

Im not a fan of labels either, I just want to access the treatment and support he needs. Sometimes the only way to be taken seriously is with a formal diagnosis...sadly Sad

I will certainly look at the resource you have mentioned. I’ll try anything. Good luck with your LO.

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I have come across a 5 y o on dexamphetamine for ADHD BUT having witnessed home life on a couple of visits I suspect that there were other factors in play.

Id be more inclined like Donatella to look down the foetal alcohol route if signs and symptoms have been around from toddlerhood.

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Paediatricians will assess and diagnose within their area of expertise and so may fix on adhd as a result. They may not understand developmental trauma, attachment etc. So I wouldn't take what they say as being that compelling tbh.

Imo the best thing you can do right now is get some sensory integration therapy. Google it. There are lots of books on the subject. A good one is 'the out of synch child '. If you went to somewhere like Family Futures this is the first thing they do. You may have to pay privately for it but I think the ASF can fund it.

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I have one child with severe adhd- diagnosed and medicated at 7

Another child with less severe adhd- he is 6 and the community paediatrician won’t diagnose him until he is nearer 7.

The nice guidelines are however being changed - in March- and I think this allows an earlier diagnosis and medication. But I think it will be 6.

I think doctors generally will have to comply with the guidelines unless in very extreme circumstances.

Certainly with my ad, she was quite a severe case, and at 5 1/2 I took her to see a very senior child psychiatrist, but he was unwilling to diagnose and told me to come back in 18 months.

To be fair also, my son was a very active toddler, but unlike my ad he has calmed down an awful lot, particularly since starting school. He has really thrived there - the structure and positive role models have helped him. He probably does have adhd but it is a lot milder than what I anticipated it would be at 2. Some days I even think he has add rather than adhd. So I do agree with the professionals that you need to give kids time to mature as they can and do change.

Things I did with my ad before diagnosis;

- sensory integration therapy - this really helped to calm and regulate her. This can now be funded via ASF

- neurofeedback - this seemed to help - but the benefits didn’t last unfortunately

- find a very inclusive preschool who are very experienced with Sen children - often these are the nurseries in the more diverse areas...

- we didn’t try it, but possibly theraplay funded by asf

- lots of activity- swimming, trampolining, soft play, parks - I had to be alongside her for all these activities as I couldn’t trust her- so I did a lot of crawling through tunnels etc!! She really needed me close all the time to help co regulate as she could lash out at other children- something which now she would ever do ( she’s matured a lot and is very gentle now)

- self care for you! I had a baby sitter to come to my house to play with my ad to give me a break!

It is exhausting, but will get easier I promise! xx

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ds2 was dx at 4 and on meds age just 5. He had a good team around him and his pyshio and OT and paediatrician all on board.they had know him since he was 4 months old. I cant remember all the facts but I know his paediatrician had to speak to other professionals to prescribe meds for him .

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My grandson was diagnosed with ADHD at 5 - he didn't get medication till 6 even though he ran across a very busy main road backwards and forwards 4 times - so was very much putting himself at risk - he has mild ADHD. My daughter with severe ADHD wasn't diagnosed till 19. it's very variable. The general first line treatment given is a parenting course. The Christopher Green books mentioned in another thread - Understanding ADHD i think and Toddler Taming (or something similar) are very helpful - there's a lot of information out there. The NICE guidelines are very informative. I agree with lots of outdoor activities and also calming activities - which can include swimming. If he has seen several paediatricians what do they say as strategies / treatment to help? Meantime keep a diary / notes and research as much as possible

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If it really is ADHD (which you won't know for sure till he's older) then the only thing on offer would be parenting strategies. There's lots written about how to manage ADHD so I suggest you Google / get a book on it, if you haven't already, and see if anything strikes you as useful.

It's may sound a trivial thing but I particularly remember reading (Christopher Green I think) that the reason everyone else's child appeared to be able to behave in shops was because all the parents with tricky children didn't take them shopping. Made me laugh at the time but it's a good point with many implications. If your child can't manage certain situations or activities, then don't keep trying to make them do them - look for other possibilities that would work better. Or adapt what you do to suit what the child can manage.

Certainly for my dd sitting still and playing quietly was a rarity (until she discovered computers Wink ). But active play and anything where she had to move were great for her. Pushing and riding on wheeled toys (or supermarket trolleys) were great favourites. She also loved to play with sand or water or on a swing. We went out everyday rain or shine. She wasn't good at hand holding (and reins were totally out of fashion when she was a toddler) so pulling her along on a trike or toy tractor was far easier than expecting her to walk nicely. Shops were always problematic as she got over stimulated and if not in a buggy or trolley seat, would grab things off the shelves. So I kept it short or made sure she was securely fastened in a seat and kept her well aware from the goods.

BTW I didn't know she had ADHD as a toddler but I knew there was something not right. With my second dd I knew when we met her aged 2 that she didn't have ADHD. I think you can tell it might be ADHD if you know what you're looking for BUT a lot of behaviours can be down to other causes or developmental. With adopted children there are so many factors involved it wouldn't be clear for quite a while, if ever. All I know is medication helps my dd.

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Another thing I didn't know at the time which I believe helps with concentration is to give a verbal commentary on what the child is doing. Don't know how well it works as I haven't tried but I've read it helps.

My AD who has severe ADHD which wasn't diagnosed till 19 came at 2 years old and although I didn't know anything about it at the time as soon as I read about it I knew - and it was obvious from the age we first knew her. She wasn't diagnosed as she had an acquired brain injury and so everything was put down to this and I thought the doctor knew best! I read as much as I could and treated her as if she had ADHD. At school they did the same and several staff at her secondary school which was a special school - the art therapist and the deputy head and a teacher - told her she had ADHD when asked - though it hadn't been diagnosed and no-one thought to discuss it with me. I like Milly's quote from Christopher Green - I remember reading that if your other children behave well (don't know if this applies to you) and this one doesn't then that is a good indicator - it is the gap that is significant.

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Thank you to everyone that has replied, much appreciated.

The paediatricians have previously recommended reading ‘toddler taming’, structure, routine and a ‘wait and see’ approach. We’ve done all of those.

We’ve also tried fish oil, vitamin b 12, Bowen therapy and a Montessori approach to our play space.

We do not attend toddler groups, soft play, parties or play dates. All of those things exacerbate his behaviour and he disregulates very quickly.

We take long walks (with him strapped into a pushchair) and go swimming. These activities are the only two things that keep him calm and give me time to recharge.

I feel that he is missing out on so much compared to the activities we could do with DD at this age. In addition he struggles with the everyday things such as drinking from an open cup and feeding himself as he can’t concentrate long enough/too impulsive to do these things. He remains strapped into a highchair at meal times despite being physically capable to sit on a big chair.

All of our doors have locks on to prevent him damaging everything/himself when we are not with him.

He has to wear Houdini pyjamas at bedtime as he strips off and removes his nappy. Similarly, even on the coldest of days he will always remove his shoes and socks. We have also considered sensory processing issues.

He attends nursery, they have referred him to SALT and SEND and we have an appointment with the community paediatrician next week.

We adopted his older biological sister 4 years ago and have yet to experience any major issues with her, both children were removed at birth.

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It's ALL about the 'unpicking' for our kids. And professionals really can't see what's what until they're 7+.

Our Little Man started school with nothing but a 'Global Developmental Delay' diagnosis (tho this was enough - then at least- for a full Statement).

Now aged 9 1/2 he has a whole range of diagnoses including off the charts severe ADHD (with ODD/Conduct Disorder markers)/ASD/Attachment Difficulties/Learning Disability/Clinical Anxiety/OCD. Each of these diagnoses took a lot of scrabbling around, bouncing back between different assessments, and different professionals with different opinions. We got there in the end. Largely because of our wonderful post adoption team getting people to actually talk to each other! He's now in a special school. Wish we'd moved him years ago, but really we were waiting for his ASD diagnosis (which came last, they wanted to treat his ADHD first) for the right school.

We could've put money on him having ADHD the very first day we met him (aged 2yrs 9 months) it was SO obvious.

I'd LOVE to say it's got easier. It hasn't. It's got a lot harder as he's grown, and got stronger, and harder to medicate.

Do get whatever support you can as early as you can.

All the best


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Best is to let him walk himself if he can while holding hands, build this up until he's able to walk an hoour or longer. Sitting in a buggy might be nice for him but he'll rest and have extra energy when time is over. Concider autisme as well, hyperactivity os often een symptome in young asd children.

If he does not want to hold hands (probably a red flag if this is the case) use a strap on his wrist or a small backpack with a strap.

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You don't mention getting OT / sensory integration therapy. This is crucial. If he can't drink from a cup or sit in a chair he needs this urgently. You are assuming adhd but sensory problems can look really similar. Have you heard of the 'far' senses - proprioception and vestibular function? These are what are possibly needing some attention.

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I agree with flosskirk- sensory integration therapy really helped my two children with ADHD particularly my ad who is the more severe of the two. I was very cynical about it when we first started, but to my amazement saw significant improvements within weeks.

My ad is now 10 and we too have a wide range of different diagnoses - ADHD, anxiety, learning difficulties, dyspraxia. And we are in specialist education. But with the diagnoses we have found understanding and the right school, which has been key. And for us it has been a journey but it has definitely got easier. I found the toddler years and starting mainstream school, when things really went pear shaped, really challenging. And I really needed extra support then. We are in a much better place now. So things can get better for some of our kids - I’d agree get as much support as you can as early as possiblexx

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We first met my son when he was 4.5 and he moved in at 5. He was clearly hyperactive but gaining an assessment and then going through the 6 month assessment process meant he was 6.5 before he started on medication. The medication took about 3 months to have a noticeable effect but what a difference it made.

Prior to diagnosis, we quickly realised that allowing any deviation from what we considered acceptable behaviour to continue beyond the first signs of a trigger would quickly disintegrate into a full hyperactive episode. This would include and inability to sit still for more than 30 seconds. Destruction of whatever was within his grasp, violence against us and his sister, no sense of road safety, stranger danger or not wandering off shops etc. One of the key episodes which seemed to speed up the diagnostic process was when he gradually demolished the consulting room during his initial assessment and the assessor had to abandon the "Don't intervene" procedure as he had piled up a stack of chairs on a couch, climbed to the top and announced he was superman and was about to launch himself off. This was the result of a task where he was supposed to sit at a table and draw a picture of me.

We used distraction, picking up and carrying, asking a difficult to answer question, playing the "Yes/No" game, lots of Paw Patrol, cartoons with explosions, anything distracting and attention sapping. Loads of exercise, football, running, swimming, cycling, scootering, trampoline and dancing. Whenever we found a board game or a card game which would hold his attention we would exploit it as long as it lasted. We had DVD screens installed in both our cars with cordless headsets to distract him on car rides, which without them became impossible.

I found that when his head was on the same level as mine he would be calmer so I carried him around for the best part of a year, long after it looked natural. I did however have to get indestructible glasses made. Picking him up not only contained him but the closeness seemed to help him regulate. Hyperactivity certainly burns up the calories, before medication he would eat about 50% more than the recommended calorie intake for his age and height and remained stubbornly under weight. We found though that eating was one of the things that distracted him so I always carried a calorific snack for him much to the annoyance of the dentist but we gradually brought him back to target weight. On meds, weight gain and stunted growth can be side effects so he is now monitored every three months.

It was clear that my son had problems from a very early age, but there seemed to be a reluctance from SW's to submit him for testing, sighting the "No diagnosis under 7" guidelines. I can't help wondering though that if he was placed for adoption with a confirmed diagnosis of ADHD would the impression that he would have been less adoptable colour their thought process?

We also have subsequently had a diagnosis of FASD however with the ADHD under control that seems to be only affecting the higher learning functions and not driving behaviours.

Having been through the diagnostic process, I can understand why it may be impossible to use the process on a pre-verbal or pre-school child. A portion of it relies on a comparative questionnaire, filled in by parent and teacher separately. Looking at the differing behaviours in the home and school settings can rule out some of the behaviours relating to attachment and bonding which can disguise ADHD. A portion of the diagnostic process involves an observed, task based, assessment initially usually with a psychiatric nurse, including an interview with the child. Then two visits to the paediatrician for final review and if necessary, a trial of medication.

It would be hard to imagine being able to use that process on a very young child as their responses and deviation for the norm frame the diagnostic process.

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Hi Bunny face, I do know of one child who was diagnosed at 3 years old which at the time surprised me as I also thought that you had to wait until 6 years old. The factors that possibly lead to an early diagnosis were that both parents had ADHD. Theyou were offered a parenting course 123 Magic.

I would definitely look into getting an assessment for sensory processing difficulties, I was on a course recently run by occupational therapists, they said that children are getting diagnosed with ADHD when in fact they have sensory processing difficulties (you can have both). I got an assessment through PAS funded by the ASF.

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