I know this will come across as old-fashioned, since I'm 72 and a grandmother, but let me tell you our story. Of our 7 children, including a sibling family of four adopted children, 2 were extremely hyperactive, one of those extremely dyslexic-dysgraphic, with many school and learning problems. At that time, the drug was Ritalin, and frankly, in many respects, it did wonders. A third child was not hyperactive -- just the opposite, dreamy and disconnected and unable to concentrate. With him also, the medication seemed miraculous. All were able to participate in school. One of the sons and my daughter graduated from college, and both went on to fine careers (although my daughter unfortunately died of cancer at 38). Unfortunately, the other two sons of the four both inherited bipolar disorder from their natural parents, and also suffered from many more emotional problems from being in orphanages their first 7 and 8 years, so they have not done as well, but their learning problems did go away as they were able to concentrate in school, and both can read fluently, and discuss many topics with intelligence. Although they complained as adults that the medication had made them sometimes feel "bland," and expressed resentment at having to take it, I think I was able to see what their school years would have been like without the medication.
More recently, we have had a young man in our household -- since about age 7 until now, at age 16. It took a long time for me to convince his Mom (who is a licensed nurse) to take him for evaluation and help with his complete inability to concentrate. Since he took medication, his grades have soared, and his teachers now recognize his intelligence and verbal abilities. Before, he was pigeon-holed, as a Latino, as a poor learner. I don't believe he still takes the medication, as junior at University High School, one of the toughest and best high schools in the country, but he is doing well and is proud of his ability to complete his homework and participate in class.
I will mention another experience, although it doesn't relate directly to medication. As a middle school teacher, I formed a class of the "misfits" that no other teacher wanted to take on. Probably some of them were on medication, and others might have done better had they had medication, but what they needed and craved was a stable classroom environment that did not present them with a room, teacher, and student-mix change every 45 minutes. Having me as a teacher for at least two periods, and usually for two years, and being presented with some very achievable goals and rewards (When the bell rings, you are seated with feet on the floor, unbroken pencil and eraser, leisure reading book or magazine of choice, textbook and notebook, ready to learn!) that later offered a choice of treats and prizes, did wonders for many hyperactive students. Added to that was the fact that as the class time went on, they were allowed to fashion study holes for themselves under tables, etc, and we often went outside to listen and discuss things. These are all substitutes for medication for some children, and adjuncts for others.
Sometimes it just takes that small break-through in learning how to concentrate, and in receiving praise for doing well in school to push the person to learning how to better control his or her own behavior. I think my daughter learned that, and certainly, although she remained a very "hyper" person until her death, she was able to channel it into getting three separate certificates at community college and being an outstanding art student at Long Beach State, as well as going on to a career at Disney and also as an individual ceramics artist.
At this age, I frankly do not place as much faith in medication for any of a variety of emotional and mental conditions as I once did, and I think all have to be approached with care, and with a sense that one size does not fit all, but with that many people recommending medication, I would give it a try, and make sure that other ways of helping were present as well. Your son's early start will mean how he goes on.
S. Toji