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Expert Q&A

	By Jenny Lewis, M.D. Pediatrician

My son is 3; he will be 4 in April. I know what ADHD is like, and my son shows all of the signs, including not sleeping at night. I would like to know what I should do or who I should talk to about this. Also, I would like to know if there is any other option than prescription drugs. I really don't want to put him on meds. Thank you."

The diagnosis of ADHD at 3 is hard to establish. I would talk with your pediatrician or health care provider. It may be that the sleep difficulties are caused by something other than ADHD. Similarly, without knowing what the signs are, it is difficult to know whether the daytime behavior you are observing suggests ADHD, another problem or any problem at all.

There are ways to evaluate whether a child has ADHD, though there is no one specific test, and these should be discussed with the physician.

I certainly agree that medications in a 3-year-old should only be used after other means, such as behavior therapy and discussion of ways that you, as a parent, can change the structure at home, have been implemented. Regardless of the therapy tried, there should be goals set and an objective assessment of improvement made at three months and six months in order to know whether to continue the therapy.

In short, you need a more thorough evaluation of the behavior before making any treatment decisions."

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