New Guidelines for ADHD Diagnosis and Treatment
The American Academy of Pediatrics (AAP) has issued new guidelines for attention deficit/hyperactivity disorder (ADHD) concerning diagnosis and treatment in younger children and teenagers. While previous guidelines covered children ages 6 to 12, new guidelines expand the range from ages 4 to 18 years.
New ADHD guidelines may help more children
ADHD is one of the most common chronic conditions among young people, affecting 4 to 12 percent of school-aged children and boys three times more often than girls. The main behavior symptoms of ADHD—inattention, impulsivity, and hyperactivity—can make it difficult for children to perform well in school, interact with other children, and get along with siblings and family members.
When diagnosing ADHD, pediatricians often ask questions about the child’s behavior, such as how he or she is doing in school, whether teachers have noticed any learning problems, if the child seems happy in school, and if there are any behavior problems at school or home when the child plays with friends. The answers to these questions may result in further evaluation.
The new report, entitled “ADHD: Clinical Practice Guidelines for the Diagnosis, Evaluation and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder,” provides special considerations necessary to diagnose and treat preschool children and adolescents.
For preschool children, for example, the guidelines recommend doctors first try individual or group parent training in how to manage the child’s behavior. If a child has moderate to severe symptoms that do not respond to behavior therapy, a low dose of methylphenidate may be prescribed.
Mark Wolraich, MD, FAAP, the report’s lead author, noted that “Treating children at a young age is important, because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school.” Improvements in diagnostic and treatment techniques are also making it possible for more children to be helped.
Current treatments of ADHD include medications (stimulants, nonstimulants, and antidepressants), behavior therapy, or both. Due to the chronic nature of ADHD, a multidisciplinary treatment approach involving parents, teachers, therapists, and pediatricians is recommended.
Some research suggests alternative treatment options may help some children with ADHD. A recent study published in Mind & Brain, The Journal of Psychiatry reported that transcendental meditation improved ADHD symptoms, academic skills, and brain functioning in students ages 11 to 14. There is also evidence that a Western style diet, characterized by fast food, processed meats, refined sugars, and preservatives contributes to ADHD and that dietary changes may offer some improvement.
The new guidelines for ADHD were designed to help healthcare providers in the diagnosis and treatment of this common condition and hopefully help more young people and their parents better manage and live a full, productive life.
American Academy of Pediatrics
Travis F et al. Mind & Brain, The Journal of Psychiatry 2011 Jul 25; 2(1)
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