I want to echo the comments from FIDO on this thread. Some of yall may remember some of the threads I posted on here asking for advise on my son.
My youngest son has been on ADHD meds (Focalin and Vyvance) since he was 4 (he's 5.5 now). I was against giving meds to him initially, but it really became a safety issue that required us to look into it. He's a July birthday, so we also held him back to give him time to mature.
He was asked to leave his Preschool because he just would not pay attention to his teacher and was constantly moving. Moved him to a second school and again, just not able to sit still. This new school has been amazing and worked hard with him. By the end of the first year, he was "managing", but it was clear it was going to be a struggle. He was also incredibly impulsive to the point where if you weren't holding his hands, he might take off running for no reason or pull fire alarms, etc.
We went to our pediatrician who recommended several things.
First, we did occupational therapy which did help. He needed to work on being comfortable in his body and had some mild sensory issues we were able to work through. Additionally we did theraplay to help with things like focusing and being comfortable in situations.
We capped that with the ADHD medicines and those have been a game changer. When he's on the meds, he's actually able to sit still for things like meals or church. When he's not on them, he's constantly moving, rolling, etc. We try to keep the dose as low as possible so he's not a zombie, but just enough that he can sit still when necessary.
I absolutely want him to be a normal boy and run wild, and when it's not 105 out, he's typically outside in the dirt...but we could also see the frustration in his own face when he just couldn't stop moving or stay focused on things.
The biggest downside is that it kills his appetite, which has left him underweight. We cram him full of food in the morning and evening and then he's off the meds on the weekend to really help him gain weight.
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And just as a contrast, my oldest is a typical boy. Wild and full of energy, but he can focus when necessary and listens to his teachers. Could we probably get him on meds if we wanted? Probably, but he can focus and do well in school/sports so I see no reason to start with him.