Is 5 Years Old Too Young to Medicate? Long Story...

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On Thursday I had one of those meetings I dread with the principal and deputy principal. Despite my daughter's medication she still has anxiety issues and unfortunately occasionally results in a serious transgression.

She stabbed her integration aide's hand with a pencil (apparently without provocation) and the deputy principal asked me to explore a placement in an Autism school. Fortunately the principal came to my support saying the issue is one of behavioral management and the school will be willing to support her entry into year one (primary) in 2013. However the continuation and possible upgrade of medication was a prerequisite.

Both her teacher and principal are in a conundrum because she is classified as too high functioning (academically) to be in a special school but her behavior has of recent been hard to predict due to noise sensitivity issues and over-stimulation.

Despite the medication (Ritalin 20mg/day) she avoids rooms that over-stimulate her (currently music room and art room) and this generates conflict with her aide over compliance. The conflict leads occasionally to tearing a book, hitting/punching the aide or physical contact with another child.

The principal wants to be progressive about developing my daughter's academic talents but in return wants us as parents to bump up her medication and look at introducing anti-anxiety drugs. This is a type of negotiated settlement is typical of the landscape for HFA and ADHD kids in mainstream school's in Australia.

I am sorry to hear that. Controlling her environment better - which they could do, if they really wanted to - seems to me like it would meet everyone's needs better.

Honestly, I'm not that appalled by small amounts of physically aggressive behavior in young children. They lack the tools for expressing themselves anyway else, that is why they do it, and proactive adults are perfectly capable of making sure these small young children do not do any serious harm. Find and mitigate triggers, and teach the child to do the same for themselves, that is what works. I realize that if the child can't develop the required mitigation, control and self-advocacy skills by the time they are 10 or so, their physical size will change the equation, but to not do everything you can that is NOT medication before they get to that age and size seems to me like a set up for more problems later.

Agreed, somebody on this forum expressed regret their parents didn't medicate them when they were children, despite the risks. I can't see any way around it. Having school principals discuss medication may not be appropriate but we have no choice.

It's a fine balance, dependency as well as neurological developmental changes leading to changes in dosage and is something we have to also consider.

I have no trouble medicating a child so that they can focus and learn without falling monstrously behind, when all natural attempts have resulted in nothing but frustration to the child. But that is different than being asked to increase medication because someone is concerned about a teacher's well being as opposed to the child's.

Definitely a fine balance.

I almost never question a parent's final decision on the question, because it IS such a fine balance, involving dozens of considerations we, as readers on a forum, can never get the full picture of. But I do think there is too much outside pressure on this decision, from schools and doctors and therapists choosing convenience and expedience instead of trying to figure out what the child really needs, and that is the pressure I feel a strong need to push against.

5 years old is not too young to medicate, in my opinion. I think that the most important thing is that the child is old enough to be properly assessed and for the doctor to figure out a proper dose.

Both of my kids started meds at just under age 4, and are doing great (25 mg/day Prozac for anxiety for day and .1 mg Clonidine at night for sleep and anxiety). Just be sure to thoroughly check out the meds and closely monitor the child for side effects and signs of overmedication. Also, I would personally use a pediatric neurologist or child psychiatrist if you go this route, if one is available.

Of note, my older son did experience some initial hyperactivity when he started the Prozac (an SSRI antidepressant that also helps with anxiety). However, that went away after a few weeks. His meds have been changed and increased/decreased several times to meet his needs.

Child and Adolescent Clinical Psychopharmacology Made Simple (available off of Amazon.com) is a book that I like. I also have one article on meds on the "autism links" page of my free website, www.freevideosforautistickids.com.

--Good luck!

I would never medicate a child. When I was in grade school they wanted to put me on meds because I asked the teacher too many questions and she did not want to deal with me. Luckily my parents never allowed them to dope me up. They wanted to medicate me for ADHD but when I got evaluated for Aspergers when I was 40 they found no signs of ADHD.