I have a suggestion for the doors. They sell these sensors that stick to your door. They work like an ADT alarm system where if you open the door it triggers the swicth and a LOUD alarm goes off (but only in your home not to a company). They are inexpensive and no way he can leave the house without you knowing. My girlfirend has a son with autism and they use them, they even bring them on vacation for hotel rooms!
Please know that 4 year olds are VERY defiant. 4 year olds with ADHD are just awful! Some of this WILL get better with age and a solid behavior plan.
I have a 3 year old son (he will be 4 in Aug.) Who was diagnosed with adhd 3 months ago. I know it is unusual for someone his age to be diagnosed but it was to the point that his normal doctor wanted him admitted to the mental health hospital. So after a lot of phone calls I was able to get him an appt. with a behavorial health office who did the diagnosis. After 5 appt. she started him on 2.5 mg adderal in the morning and 2.5 at noon. That showed no effect so she upped it to 5mg in the morning and 2.5 at noon. That help on the morning but the afternoon was noi help. So she upped it to 5mg in the morning and 5mg at noon. That worked well but when the med wore off at 4 was not a good thing so he started taking 5mg in the morning 5mg at noon and 2.5 at 4pm. Well that was working great but he wouldn't sleep. She said that .1mg of catapris would help him sleep. I was not crasy about the idea due to his age but said we could try it. (I am a stay at home mom so i can watch him for any side effects) It worked and we haven't had any side effects so i agreed to continue. Well at his appt this week we talked about his impulse control. He will do somthing that he knows he is not supposed to sit in time out for it and then go back 2 min later and do the same thing. (going outside with out asking, dumping cups out, hitting his brother). she told me that he has the impulse contol of an 18 month old that he couldn't help it. I just said ok that makes sence and went home. Well thing the next morning he woke up at 3:30am climbed up to the top of the fridge via the counter got my keys out of my purse went outside started my van so he could watch a movie (we just got a new van that has a dvd player in it) Thank god he didn't put it in gear. At this point his impulse control is becoming a saftey issue. He knows he can't play in the van, go outside without asking or get up before the sun does but it is like he doesn't care. I called the doctor to see what i can do about this i am worried about his saftey. (a locked door doesn't do much good if he has the key) she wants to put him on risperidol. I don't know about adding another medication he is only 3 and already on two. Has anyone eles had this problem or used this med. for adhd? please help any tips or advice you can give will be great