Ok, well ~ I'm gonna put my .02 in here. Keep in mind, I was PTSD galore after everything with Dylan, and then I had my youngest acting a little, well, hyper and impulsive.
First off, ADHD only children do go to Special Education Preschool/Early Intervention because my youngest, Jared, did. And he is only ADHD. He will always only be ADHD.
I also think, at only not even 5 years old, personally, I wouldn't get too excited yet. easy child could have many things that can be handled with early intervention, therapy, etc, without the medications, that can be "fixed". I also think that there are other ways to teach hyper kiddos how to settle down, and not every kid needs medications.
He's not even in kindergarten yet. I remember when I thought Dylan was ADHD, they wouldn't even THINK about a script until he made it into kindergarten. Now, they're giving drugs to 4 year olds?
Ok, I'm sorry, but that worries me.
I think what you're doing is fine. You tried Strattera, which is NOT like Concerta, and it didn't work. You're gonna try Concerta.
IF the Concerta doesn't work, what to do? I would not, seriously, would NOT assume that means that your child is Bipolar, Intermittent Explosive Disorder (IED), Autistic or anything else. I would just keep on with the early interventions you have, and try to find something else to teach focus/attention for now. Maybe play therapy. Maybe a sport. I put my kids in karate, there are TONS of little toddlers in there, that are doing awesome. It's a thought.
I say this to you, Hangin, in hindsight of everything I have been through with Dylan. I know you've been around a while, but really, I cannot put here all of the "stuff" I have gone through with him, for no real good reason. I started this journey with him when he was 3, 3 years old, and now he just turned 11. And now, 8 years later, all those drug trials and evaluations and everything else for what? Cuz you know, how he was at 3, he is not now. How he was at 5, how he was at 6, heck, how he was at 8, he is not now.
And now, at 11, he is on no medications. None. What kind of effect did all those medications I pumped into him have on him? Seriously. I have no idea. Because once you start on the hunt for the miracle medication, it doesn't end. I tried Tenex. Didn't work. Tried Clonodine. Didn't work. Went down the line of stims, hoping for one to work. "Well", says psychiatrist, "if the stims didn't work, let's try an antipsychotic". Seroquel - nothing. Abilify, nothing. Risperdal - encopresis. Hallucinations. Nothing. On and on, Tegretol. Topomax. Depakote. Trying the things that didn't work before, again. Lithium. Wellbutrin. On and on. Ridiculous. Geodon. Zyprexa.
The Lithium/Abilify mix was, in all honesty, wonderful for 16 months. Why? I have no answer for that. It made him fat as heck. It causes him to pee the bed day after day after day. It messed up his thyroid. Was it worth it? 16 months of peace. Yeah. Now? Nope.
I'm rambling because I have the computer to myself for a minute. Sorry if it's not getting pieced together. I think you know what I'm saying though.
Your child is 4. He is SUPPOSED to be hyper. He is SUPPOSED to be impulsive. He is FOUR!!!!!!!!!!!!!!!!!!!!!! There is a difference between hyper and impulsive and not being able to stay on task and focus. Can he play a board game with you? Chutes and Ladders? Try it. If he can sit through that, one on one with mommy, what does that tell you?
Somewhere along the way, adults forgot that little kids, especially boys, are supposed to be hyper, impulsive and loud. This isn't the June Cleaver days. Kids aren't Beaver.
With regards to my youngest, I waited until he was in the middle of 3rd grade to put him on Concerta. Hated it. It wasn't so much he was hyper, it was because he couldn't pay attention in school. He'd do everything but. And that tiny little 18 mg. took care of it. I actually took him off for a month, here in October, and he's doing okay. Not great, not bad. He probably does still need the medication. He asked about it, said he could pay attention better. When he asks me, that to me says, ok, yeah, he needs it.
One other thing I'm gonna say here. If ANY psychiatrist, ever, ever, ever even THOUGHT I should drug one kid to help another, I would run, run, run for the damn hills. You have GOT TO BE KIDDING that he said that? That is totally friggin' unreal. Unreal. No way would I ever see him again. Never.
J