New guidelines for attention-deficit/hyperactivity disorder (ADHD) from the American Academy of Pediatrics suggest the condition can now be diagnosed in children as young as 4 years old and recommend behavioral treatments, not drugs, for the youngest kids with the disorder.
Clinical guidelines were last issued in 2000 and 2001 and covered children ages 6 to 12. Expanding knowledge over the past decade has made it possible to diagnose and manage ADHD in children from ages 4 to 18.
The new guidelines describe the special considerations involved in diagnosing and treating preschool children and adolescents. They also include interventions to help children with hyperactive/impulsive behaviors that do not meet the full diagnostic criteria for ADHD.
“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,” said Mark Wolraich, M.D., lead author of the report. “Because of greater awareness about ADHD and better ways of diagnosing and treating this disorder, more children are being helped.”
ADHD is the most common neurobehavioral disorder in children, occurring in about 8 percent of children and youth.
According to the AAP guidelines, in preschool children (ages 4 and 5) with ADHD, doctors should first try behavioral interventions, such as group or individual parent training in behavior management techniques. Methylphenidate (Ritalin) may be considered for preschool children with moderate to severe symptoms who do not see significant improvement after behavior therapy, starting with a lower dose. For elementary school children and adolescents, the AAP recommends both FDA-approved medications and behavior therapy.
“Because ADHD is a chronic condition, it requires a team approach, including the patients, their parents, the pediatrician, therapists, and teachers,” Wolraich said.
The report was released Sunday at the AAP National Conference & Exhibition in Boston, and will be published in the November 2011 issue of Pediatrics (published online Oct. 16).
In addition to the formal recommendations for assessment, diagnosis and treatment of ADHD, the guidelines provide a single algorithm to guide the clinical process. To help parents understand the new guidance on ADHD, the AAP has published a detailed and updated consumer resource book entitled “ADHD: What Every Parent Needs to Know.” Parent information is also available at www.healthychildren.org/adhd.
Source: American Academy of Pediatrics