ADHD Diagnosis and Treatment Guidelines: A Historical Perspective

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral condition and the second most common chronic illness in children. The observance of specific behaviors in multiple settings have remained the most successful method for diagnosing the condition, and although there are differences in specific areas of the brain, and a high heritability estimate (∼76%), they are not diagnostically specific. Medications, and particularly stimulant medication, have undergone rigorous studies to document their efficacy dating back to the 1970s. Likewise, behavioral interventions in the form of parent training and classroom programs have demonstrated robust efficacy during the same time period. Both medication and behavioral interventions are symptomatic treatments. The availability of only symptomatic treatments places ADHD in the same category as other chronic conditions such as diabetes and asthma. Successful treatment of most individuals requires ongoing adherence to the therapy. Improved communication between patients and their families, primary and mental health providers, and school personnel is necessary for effective ADHD treatment. Further enhancement of electronic systems to facilitate family, school, and provider communication can improve monitoring of ADHD symptoms and functional performance. The American Academy of Pediatrics ADHD guidelines were initially developed to help primary care clinicians address the needs of their patients with ADHD and were further refined with the second revision in 2019.

Children’s Relative Age and ADHD Medication Use: A Finnish Population-Based Study

“…1,2 ADHD is recognized as a lifelong disorder. 3,4 Prevalence of ADHD is estimated to be ∼5% in children. 2,5 However, the relative age effect (RAE) refers to the fact that the youngest children in classrooms are more likely to receive a diagnosis and be prescribed medication for ADHD than their relatively older classmates.…”

Assessment of a Robotic Assistant for Supporting Homework Activities of Children With ADHD

“…These treatments decrease the risks for a wide range of ADHDassociated functional outcomes [24]. 2) Psychological treatment is based on cognitivebehavioral therapy whose purpose is psychoeducation, which stands for, training and knowledge of the disorder, both by the patient and their family, to know how to cope with the symptoms and their impact on life every day [25]. 3) Psychopedagogical treatment seeks to respond to the educational needs of students and propose alternative forms of learning that help them overcome the difficulties which arise [25].…”

Improving Engagement in ADHD Care

“…These efforts have included developing extensive tool kits and online educational resources for PCCs 3,4 ; redesigning office workflows (eg, designating a staff member to manage rating scale collection) 5,6 ; using care managers to serve as the conduit of information across PCCs, parents, teachers, and other clinicians 7,8 ; and developing or adopting ADHD-specific electronic systems or portals that may stand alone and/or be integrated with the electronic health record to varying degrees. 9 Over time, these ADHD portals have become increasingly robust in their functionality and usability and have been shown to improve clinician adherence to ADHD guidelines as well as reduce ADHD symptoms in children. 10 In some practices, ADHD portals have become the standard of care for children with ADHD.…”