Pediatricians issue new guidelines for diagnosing, treating ADHD

Staff Writer
Baystateparent Magazine

Pediatricians are receiving new guidance on how to treat Attention Deficit Hyperactivity Disorder (ADHD), which affects nearly one in ten children nationwide.

For the first time since 2011, the American Academy of Pediatrics (AAP) has updated its clinical guidelines for ADHD, stressing the need for ongoing team-based treatment that includes medical and mental health professionals, as well as families and school staff.

The updates are based on the most recent research on ADHD, a common disorder that can profoundly affect a child’s academic achievement, well-being and social interactions. 

“ADHD is a chronic illness that can have a devastating impact if left untreated,” said Dr. Mark L. Wolraich, lead author of the report that appeared recently in the journal Pediatrics. “A pediatrician can help families figure out what is going on and work with families to help children succeed in managing their symptoms and behavior.”

More than 9 percent of U.S. children ages 2-17 have been diagnosed at one time with ADHD, with hyperactive and impulsive symptoms that tend to decline during adolescence and lead to inattentiveness. Boys are more than twice as likely as girls to be diagnosed with ADHD. Both boys and girls with the disorder typically show symptoms of an additional mental disorder and may also have learning and language problems, according to the AAP. 

The new guidelines recommend that when kids are diagnosed with ADHD, they also get screened for any mental illnesses. The goal is to rule out other causes of ADHD-like symptoms and identify co-occurring conditions, such as depression, anxiety, substance use, autism and trauma. 

In addition, fewer problem behaviors are required as criteria for ADHD in patients age 17 and older.

The treatment recommendations, however, remain mostly the same as previous guidelines. 

Children 5 and younger are advised to start with behavioral treatment first. Parent training in behavior management is recommended as the first-line treatment for preschoolers.

They advise that anyone 6 or older should start taking medication and get behavioral therapy as soon as they are diagnosed. 

But they also emphasize the need for ongoing medical care in coordination with others from the child’s school and community. 

“We know that a child diagnosed with ADHD will benefit most when there is a partnership between families, their doctors, and their teachers, who may need to create special instructional plans and support,” said Dr. Joseph F. Hagan, co-author of the new guidelines. “Coaches, school guidance counselors and other people who play a significant role in a child’s life often have a lot they can contribute in providing information and working on solutions.”