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I have been dealing with ADD/HD children for many years in both the educational and medical professions. I don't know who diagnosed him, but I would have the following questions and corrections before I started any child on medication.
1). Did the child get a full medical and psychological evaluation by a child psychologist/psychiatrist who specializes in different treatment modalities for children with ADD/HD? or was this "prescriber" a family doctor with no formal training in ADD/HD? Who determined that the child's behaviors are dysfunctional?
2). Is this child (4 yrs old) getting at least 12 hours of sleep each night, every night? Sometimes you have to make children go to bed!! This is easily corrected, but is often the last approach used and should be the first. Some children get more worked up the more tired they get and you just about have to tie them to the bed to keep them there. (I had one of these. When we finally realized how much sleep the child really needed, she got remarkably better.) Sleep needs vary widely between children, but most need at least 12 hours at age four. This is really hard for some parents to understand because long sleep needs can really upset a modern household with multiple children.
3). Is the child exhibiting dysfunctional behavior or just "age" appropriate behavior that is getting on someone's nerves? Many adults do not understand what normal behavior for a energetic 4 year old is like and they do not understand the wide ranges of "normal" for most 4 year old boys.
4). What types of behavior management strategies have been tried consistently by parents, teachers, and others? Children are often strong-willed and very stubborn. Many are misdiagnosed as ADD/HD and medicated when parents or teachers get frustrated and don't know what to do with their strong, stubborn personalities. (I personally have 2 of these stubborn, self-willed, head-strong off-spring--but they do not have ADD/HD. It took all my time and energy just learning to manage their behavior, and sometimes it wasn't pretty!)
Medication should NEVER be used, especially in children under age 10, without all of the above being done and documented over a period of at least 1 year and in all types of situations. Most medications used for ADD/HD DO have growth related side-effects and a parent needs to be fully aware of the advantages and disadvantages before giving them to a small child.
Just some things to think about.
