There are many stimulants available. Doctors sometimes prescribe newer drugs because they wish to gain experience with the newer medications. That may not best serve the unique needs of your five year old grandson who has autism. 

Ask the doctor to discuss with you the pro's and con's of long acting verses short acting stimulants. Before you leave the office, write down when and how the dosage should be increased during the trial period, what is typically considered the lower and upper dose range for the medication in young children, and what positive behavior changes and side effects to monitor for. 

One of the advantages of older, short acting stimulants is that you can start at a low dose, and slowly increase the dose over time to reduce the possibility and severity of unwanted side effects such as loss of appetite or sleep. Short acting stimulants in tablets form can also be broken into half. (This is NOT the case with most long acting stimulant medications. Do not break up long acting stimulants.) 

For example, Ritalin, a short acting stimulant, when I took it in the 1990's was available in 5, 10, and 20 mg tablets. By breaking a 5 mg tab in half, I was able to increase the dosage slowly, both up and down by 2.5 mg at a time to find what worked best for me. Your doctor may not believe this, but I kid you not when I tell you that 20 mg was too much and 15 mg was not enough. I took 17.5 mgs per dose for many years before switching to 5 mg Dexedrine Spansules.

We live in a results oriented society. Sometimes getting a therputic benefit from a medication as quickly as possible is important. But I ask you, is it always? Particularly when medicating young children?

Starting with a low dose and adjusting the dosage up slowly gives the body a chance to adjust to the medication. It's a gentler approach, particularly for young children.

Too often, treatment decisions are made quickly by the doctor and without including the caregiver or patient in the decision process. As a result, it's getting harder and harder to get appropriate treatment.  

I encourage you to contact your local CHADD (www.chadd.org) or other AD/HD parent organization (search on "AD/HD support [your city, state]" and attend one meeting for the purpose of 1) finding out which physicians are the most experienced in treating AD/HD symptoms and which publications are the most useful for learning about the medications used to treat AD/HD and other co-morbid conditions in children. If no AD/HD groups are near you, contact your local National Alliance on Mental Illness office (www.nami.org). They often have a directory of psychiatrists, psychologists, and counselors and a description of their areas of specialty.

www.amazon.com is a good source of information on books as is http://addwarehouse.com/shopsite_sc/store/html/index.htm  

It's up to you, the caregiver, to get a book on AD/HD medications used for children, so you know what questions to ask and when to say "no".

I read the original edition of this book: Straight Talk about Psychiatric Medications for Kids, Third Edition by Timothy E. Wilens, (2008). He is a respected researcher and clinician. That said, all researchers, clinicians, and writers are biased in their presentation of information. For this reason, I encourage you to seek information about medication from alternate sources too, as many as you can find. 

My hope is that the local AD/HD parent organization can reccommend additional books on medications and how they are prescribed for children. Here's a link where you can learn more about Wilen's book: http://www.amazon.com/Straight-about-Psychiatric-Medications-Third/dp/1593858426/ref=sr_1_13?s=books&ie=UTF8&qid=1301160406&sr=1-13 

When researching books on Amazon, I find it helpful to read all of the reviews. I encourage you to do so too.

Glad you're asking questions. Better to ask now so you fully understand the treatment decisions you're making on behalf of your grandson. No one cares more about him than you!

grandma lise