worried about my 5 year old son

[Becmn]

My 5 year old son is showing some behaviors that are concerning. When he was 3 and 4 in preschool he was very busy and somewhat impulsive. He is very smart and verbal. We thought he would out grow the hyperactivity/impulsivness.
Know in kindergarten it is just as bad. He often will get in his friends faces while playing or touch their faces/heads etc. not meaning to be aggressive but ofcourse they don't like it. So far it is not affecting him socially -he is a leader in the class and kids tend to flock toward him.
He also bites his nails and during a time where he needs to be sitting and listening he chews on his shirt sleeve- actual holes in his shirt.
He also has bit and hit a few times this year.
His teacher says she sees it as very impulsive not premeditated.
She enjoys him in the class b/c he adds so much to discussions and haS GREAT IDEAS. wE ARE TRYING A MARBLE SYSTEM WHERE HE EARNS THREE MARBLES AND earns a happy face and we reinforce it at home with a sticker,book etc..
He was not earning them so we have tweeked it so that he will earn them for 2 weeks and we will get buy in them we wil target the harder behaviors.
We are doing timeouts for any aggresive behavior- time out immedietly- no warning. Verbal behaviors -whinning etc. we are ignoring completely-

He does seem to want to control his body and just can't.
He is in a class of 12 which I thought would help but it does not seem to be.
I am not at all worried about acedemics I am wooried about social behavior. We have met with a behavior person who says its most likely ADHD-
I am wondering if there could be other things going on.
Home life is very stable- 2 parents
1 brother 1 sister -he is the oldest
Not wanted to use meds but I will if I have to. I want his school experience to be positive- so far he loves school and wants to go every day but everyday there is some incident where he has been impulsive or just hyper-

[D99G03]

Does sound like ADHD to me.  My son (7yrs.) has severe ADHD and against my wants we began medicating him at 4, but he was clearly ADHD since very young, possibly birth? It's just that as he emerged from toddler-hood his toddler like energy & lack of control did not cease.  Also keep in mind that Adderall was horrific for us, he hallucinated, had very severe anxiety etc.  Just wanted you to know that if you decided to medicate it may take a while to find one that fits.  We are fortunate to live in Boston and have a fabulous PsychoPharm doctor at one of the major hospitals.  I will say that Ritalin LA has been our wonder drug. To give you an idea of how bad my guy is ... PCP told me text books state that no one should ever recieve more than 60mg per day, however my son is safely prescribed (via PsychoParm Doc) 80mg DAILY and takes 40mg upon waking, 20mg at noon (added last year, because he would fall apart at school in the afternoons, crying, not finish work etc.) and this year we added another 20mg at 4pm so that he can get through the harder demands of homework and actually eat his dinner without getting up and down from the table 100x.  They also added 1mg of Tenex (sp?) daily for anxiety.  It seems to be working, although we have other hurdles with him.  He's been on an School Ed Plan since 3 yrs., but please know that he is also highly intelligent just can't get it out or slow his head down long enough to do so. He is very good at things like Legos, puzzles and my computer.  Anyone who works with him adores him since he has such enthusiam about things ... but he is still a handful!!  When younger, I could not let go of his hand for a second in public, he would take off at places like the beach etc. and I would think twice about going somewhere asking was it worth all the work it would be for me?  I finally medicated because I asked myself, is it better that I not medicate because I am against it ... and I yell and stress out at him all day when I know he can't help it? making him (and me) more stressed out and upset?? or is it better that we use drugs and return his mother to the calm, patient mother that she once was??  and have him be less stressed and more relaxed?  I am happy we choise what we did.  My 1 piece of advice ... always go with your gut.

[Kevin Kennedy, Ph.D.]

For such young children, Adderall is likely the best choice of psychostimulant medication. If your son's symptoms are not particularly bothersome at home, shorter-acting Adderall would be fine. If the symptoms are bothersome at home as well as at school, Adderall XR would be a reasonable choice.

[Becmn]

we have done all the questionare assesments-BASC/ Conners-
is this what you are talking about?
What is your opinion on meds for ADHD with suc ha small child

[Kevin Kennedy, Ph.D.]

It is certainly possible that he displays ADHD - the symptoms you describe are typical of young children who do exhibit this condition. It would make sense to arrange an evaluation and see what comes of it. If you continue with the reward system, have him earn a reward each day. He is too young for a system that requires him to earn points for days at a time before he earns a reward.