The new American Academy of Pediatrics 2011 ADHD Guidelines have came out in October. Parents and teachers can review the guidelines at
The guidelines make the following recommendations:
Any child between the ages of 4 and 18 yrs with who is having significant academy difficulties or social difficulties who appears to be hyperactive, inattentive, or impulsive should be evaluated for ADHD as it is the most common neurobehavioral problem in children.
The doctor should use the criteria of the DSM-IV in making the diagnosis of ADHD. The diagnosis depends on the observations of parents, teachers, and others who interact with the child. The doctor should be alert to other medical problems that might be causing the symptoms.
The doctor should look for other mental health problems that can co-exist with ADHD. These conditions include anxiety, depression, oppositional-defiant disorder, and conduct disorder. Learning and language disorder problems need to be considered and ruled out as do physical problems and sleep disorders.
The doctor and family should acknowledge that ADHD is a chronic condition.
The guidelines make the following treatment recommendations:
For preschool children (4 and 5 years old) behavior therapy administered by parent or teacher is the first line treatment for ADHD. If behavior therapy is does not work and there is moderate to severe continuing problems in the child’s functioning, the doctor may prescribe methylphenidate.
For elementary school children (6 to 11 years old) with ADHD, the doctor should prescribe an FDA approved ADHD medicine and/or parent administered behavior therapy and/or teacher administered behavior therapy. Best is to use medicine and behavior therapy.
For adolescents (12 to 18 years old) the doctor should prescribe FDA approved ADHD medicines with the consent of the teenager. Behavior therapy may be prescribed for ADHD. And both therapies may be prescribed together.
The correct dose of ADHD medicine is the dose that maximizes the child’s function while minimizing medicine side effects.
To diagnose ADHD the doctor consults the symptom list for ADHD in the DSM-IV to see if the patient has the symptoms required to make the diagnosis.
But just having the symptoms is not nearly enough. To diagnose ADHD the child must also have significant problems in academic performance, in getting along with other children, in getting along with teachers and other authority-figures, in planning and accomplishing tasks, or in getting along with parents and siblings.
Next post: How to Monitor Your Child’s ADHD Using the 2011 AAP Guidelines