Doctor Betti Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children." Managing Attention Deficit Disorder Question: I have a 4 1/2 year old daughter. She has been diagnosed with ADHD by a neurologist about a year ago. We would like to take the next step and medicate her, as she is getting worse. She cannot sit still while eating, is very hyperactive and distractive in pre-school. I got a call 3 times this week alone from her school saying she won't behave and is a distraction to the others during nap time. We do not want to give her Ritalin, but what is your opinion on a low dose of Adderall or other medication? Which type of medication would be best for a 4 1/2 year old? Corinne Answer: Your Question: Attention Deficit Disorder with Hyperactivity (ADHD) is diagnosed when children or adults exhibit symptoms such as what you are describing. Inability to concentrate, easily distracted and poor attention span are just a few of the behaviors that can interfere with everyday activities, including school! You mentioned that she was diagnosed at age 3 and one half. This is very young, especially when considering any medication. Aside from medication, behavior modification (consistent parenting, positive reinforcement, etc.) is important. A thorough physical examination is important to rule out any physical problems as well. You stated that a Neurologist had diagnosed her. Was medication advised at that time? Ritalin (methylphenedate) is a medication that has been used for many years in the treatment of ADD or ADHD (the "H" is for hyperactivity). Adderall is also used in the treatment for ADD. This too is used on older children. Ritalin is an amphetamine-like medication and Adderall is amphetamine based. When used as prescribed, both have good results. Both are prescribed by a physician. Careful monitoring of growth and development is extremely important. Please consult with your daughter's pediatrician to find the best possible route to go. Medication alone is not advisable without the consistent parenting that I mentioned. Close communication with teachers and caretakers is also very important, especially if medication is to be started. ADD can be very frustrating. Frustration is both on the part of the child and the parent. If counseling is available, it may help everyone involved. Remember that it is a family affair! Also see: My 12 year old daughter experiences difficulty sleeping due to fear of the dark and being alone. Is this normal for her age? I recently took my seven year old daughter for her physical. The doctor informed me that she is about 10 pounds over the curve for her weight and age. Do you have any advice? Ask Dr. Betti your questions This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.