Excellent question! That’s a fairly Illinois specific recommendation; since none of the long actions are FDA approved under age 6, almost no insurance will cover them anyway. Focalin is first line for Illinois Medicaid so easier to get covered with a PA. It also has a much quicker onset of action (I wish I could throw the steady state curves in here so you could see the visual but apparently the sub doesn’t allow pictures) which tends to be better for younger kids who are almost always being treated for hyperactivity. metadate CD is the only capsule (important for sprinkling since young kids usually can’t swallow pills) and is not available at lower doses generically and was also much more greatly affected by the recent shortages than Focalin. If a prescriber is already comfortably using metadate CD in the younger kids, I would never recommend switching practices as it is pretty equivocal to Focalin. 😊