3 yr olds and ADHD and meds/therapy

Hello! My son is 3 and was diagnosed with "severe ADHD" a month before his third birthday. He has a long medical history as we adopted him out of foster care and his bio mom did drugs during his pregnancy and he was born premature. He has also had 3 surgeries and been put to sleep a total of 5 times already counting the surgeries and other procedures. He has been started on Tennex and the developmental ped wants to add Ritalin....I haven't added the Ritalin yet. He is functioning at about 24-30 month level. He has been in speech therapy since he was 5months old. He now has speech and OT twice a week. Does anyone else have 3 yr olds with ADHD and on meds? Do you guys know of specific types of therapies he could benefit from? I asked about ABA therapy but was told that he wouldn't benefit from that bc he isn't autistic? Also, has anyone taken their child to a neuropsychologist for evals? I was looking at that option too. I feel like he has some other issues going on, but I don't know what. His developmental ped. says he is not autistic. He does toe walk and he is attached to a blanket that more recently he has been excessively chewing on to the point that the blanket is soaked. He started a new daycare 2 weeks ago, and his blanket has been so wet when I pick him up that I thought he must have spilled something on it, but he has not. I think he is nervous. I live in a small town where resources for adhd are limited or nonexistent for adhd bc of his age. I have been told to cut out ALL sugars...including milk, fruit, etc all preservatives, stay away from dyes, make a strict routine...which at home we have a good routine of the times we eat and his bed time routine is strict. Trying to make all of these changes is overwhelming that I feel like I don't know where to start. My son is a picky eater as it is and he loves milk and strawberries and I'm told to cut it out. Honestly, almost everything has SOME sugar in it right? What would I even feed him? I am thinking about starting the Ritalin to see how he does but I am afraid of the side effects especially bc he won't be able to explain to me how it's making him feel as he is behind in his speech. It's awesome when he says a 3-5 word sentence. Any advice would be greatly appreciated!

I’ll write more later but I would only cut refined sugars out of his diet. Our Pediatrician told us natural sugars are fine. Natural sugars are what are found in milk, fruit, etc. Also many doctors will not even diagnosis adhd until the age of 8 years old because the the child’s brain is still developing & some behaviors many just be due to brain development. Though I know you son has very special circumstances. Thinking of you & hoping a regular routine helps. I know in our case if our daughters routine is changed in any way she it takes her sometime to adjust. After I get back from take my girls to school I’ll write more.

While our family hasn’t dealt with a lot of what you are going through, please don’t feel like you are alone!
We did the elimination diet, and here is my take-away: It is very useful for identifying what things will trigger a behavioral change in your child. For us, Yellow #5 and high-fructose/high-maltose corn syrups are kryptonite. A high protein diet also helps our guy feel better through out the day. One of the basic tenets is to eliminate a lot of stuff and then once he is “free”, add stuff back slowly, one at a time (i.e. your son’s beloved strawberries) to see if he reacts. We went gluten-free as well but found that gluten had absolutely no effect on our son’s behavior, so we aren’t gluten-free any more.
I found that viewing the very restricted diet as a short-term means to a long-term end helped me stick with it better. We made long-term changes but it isn’t as drastic as it was at 1st.
As for medication, I was extremely reluctant to start my child on them, but now I am very glad I did. Ritalin didn’t work for us (or any of the reformulated Ritalins), but every child is different.
Bottom line, you are your child’s best resource. Don’t be afraid to try new things (like meds, supplements), but also don’t be afraid to say no to things you don’t feel are in his best interest (overly restrictive diet, this med isn’t working, etc…).
Hang in there!

A consistent routine is really good and including a little time for affection and smiles might sound silly but sometimes I got preoccupied with other things and forgot to remind myself of how essential it is :).