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ADHD Guidelines Change: NOW OKAY – Diagnosing 4 Year Olds

Children as young as 4 can be diagnosed and treated for attention deficit hyperactivity disorder ADHD

Sign: You must be this tall to ride: age 12 (crossed out), age 8 (crossed out), age 6 (crossed out), AGE 4 [ADHD playground]

Caption: Children as young as 4 can be diagnosed ADHD

ADHD Guidelines Change: NOW OKAY – Diagnosing 4 Year Olds

Attention Deficit Hyperactivity Disorder/ADHD guidelines changed to include diagnosing children as young as  4 years old.  The latest change addresses “children ages 4-18 because there is additional research on that age range,” says Mark Wolraich, chairman of the committee that prepared the report, released Sunday at the American Academy of Pediatrics National Conference in Boston.

The American Academy of Pediatrics (AAP), to my understanding, set the standards for ADHD and created new guidelines for diagnosing and treating ADHD in kids as young as 4 (FOUR YEARS OLD). Previously, their guidelines focused on 6- to 12-year olds.  I do understand the need for early intervention, but at FOUR?  “We know that early intervention makes a difference — the sooner ADHD is identified and treated, the better for the child,” says Ruth Hughes, chief executive officer of Children and Adults with Attention-Deficit/Hyperactivity Disorder, a.k.a. CHADD.

Historically, proper diagnosing of mental health disorders can begin between 5 to 10 years for the diagnosis and treatment to work…but FOUR???  At that age, behavior is mostly an outer extension of the parent or environment.  I would think the intervention for misbehaving toddlers would be the naughty chair and psychotherapy. Still, there will be children whom will truly fit the requirements for this extremist age diagnosis.  That is left up to the doctor to determine by examining the four year old and talking to him one-on-one to dig deep into his psyche with 1000 different probing questions to get a complete work up before the “diagnosis” is given, right???  I mean that is what they did with me 8 years ago for my work up… That was then proven to be the wrong diagnosis… To-date, my “official” diagnosis is Bipolar 2 with PTSD.

I, personally, UNDERSTAND the destructive power of LABELING a child at an early age with a “creditable” diagnosis. I worry that some parents will use this new age restriction of being between 4 and 18 as a way to circumvent parenting skills to behavioral drugs such as prescribing Ritalin (Methylphenidate).

P.S. : Methylphenidate can be habit-forming with some nasty side-effects.

Chairman of the committee Conference in Boston Dr. Mark Wolraich says:

“Treating children at a young age is important, because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school.”

“The first line of treatment for preschool children who have ADHD lies with parents. Through behavior therapy, parents need to learn to be consistent in giving positive reinforcement for appropriate behaviors and ignoring or punishing inappropriate ones.”

“If the young children do not show significant improvements with these behavior techniques and they have moderate to severe ADHD symptoms, physicians can consider prescribing Ritalin, but doctors should start with low doses and go slowly.”

Yes, reading over that, I have to agree with Dr. Mark Wolraich.  I worry that we are now going to see an even higher SPIKE in misdiagnosing and drugging children because, as any parent will tell you,  their kids at 4 years old were and are over-stimulated, active and unruly at that age.

The long-term effects remain to be seen. What do you think about the new ADHD age limit??

Read more about this:  see David McCracken, MA, LPC Managing News Editor article that was reviewed by Psych Central’s John M. Grohol, Psy.D. on October 17, 2011 ADHD Diagnosis Now Possible for Kids As Young As 4


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ADHD Guidelines Change: NOW OKAY – Diagnosing 4 Year Olds

Chato Stewart

Chato Stewart has a mission, to draw and use humor as a positive tool to live, to cope with the debilitating effects symptoms of mental illness. Chato Stewart is a Mental Health Hero and Advocate. Recovery Peer Specialist board-certified in Florida. Chato is the artist behind the cartoons series Mental Health Humor, Over-Medicated, and The Family Stew - seen here in his blog posts. The cartoons are drawn from his personal experience of living with bipolar disorder (and other labels). [email protected]

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APA Reference
Stewart, C. (2011). ADHD Guidelines Change: NOW OKAY – Diagnosing 4 Year Olds. Psych Central. Retrieved on August 11, 2020, from


Last updated: 30 Nov 2011
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