Struggling with my suspected ADHD 5 year old, none of the doctors in our area will diagnose before the age of 6

My son just turned 5 last month, from about 4.5 he’s shown *identical* symptoms to his 7 year old sister, who has been diagnosed and his medicated, when she was this age.

We live in an area with very few ADHD specialists, and none of them are willing to formally diagnose him or begin medication until he’s 6.

He is *very* high needs and high energy. He gets a fair amount of negative feedback from his pre-K teacher for unsafe behavior (throwing things, eloping when told no, climbing furniture, ect) the moment I walk in the door. She’s said that he only acts this way when he’s just dropped off or when I get there to pick him up (having someone bring him to me outside of the classroom is not an option).

Some of the things that I’m struggling with that seem to be strong indicators of ADHD include:

Being very demanding and screaming across the room/house for me nonstop, even when I’m right there in the room.

He does not form habits, even with visual and audio timers and a visual schedule.

He cannot stand to see anyone be busy and will pretend to be physically hurt in order to get attention if he sees me doing the dishes, for example.

He does not take “no” seriously at all, no matter the consequences.

.

I am a teacher with years of special education experience and SPED certification. I know the difference between age appropriate “button pushing” to test boundaries VS dopamine seeking behavior. I’ve read all the recommended books like How to Talk so Little Kids Will Listen and The Explosive Child (and dozens more). I am in therapy and we have done years of parent/child interaction therapy with his older sister and with him.

I am struggling to handle the nonstop attention seeking behavior and the unsafe behaviors that he does not learn from.