The treatment of preschool-aged children with ADD should involve evidence-based behavioural therapy first, as it is more effective than psychostimulants in this age group. Preschool-aged children are more sensitive to all psychostimulant side effects, including those associated with growth velocity. Behavioural therapy requires more time and resources, but the benefits are more sustained with minimal adverse events.
Sources:
Charach A, et al. Interventions for preschool children at high risk for ADHD: a comparative effectiveness review. Pediatrics. 2013 May;131(5):e1584-604. PMID: 23545375.
Subcommittee on Attention-Deficit/Hyperactivity Disorder, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011 Nov;128(5):1007-22. PMID: 22003063.
Visser SN, et al. Vital Signs: National and State-Specific Patterns of Attention Deficit/Hyperactivity Disorder Treatment Among Insured Children Aged 2-5 Years – United States, 2008-2014. MMWR Morb Mortal Wkly Rep. 2016 May 6;65(17):443-50. PMID: 27149047.