ADHD guidelines published by the American Academy of Pediatrics

The summary of some key ADHD guidelines published by the American Academy of Pediatrics in 2000

* Diagnosing ADHD requires determining that DSM criteria for the disorder have been met. Making this determination requires information to be obtained from parents or guardians, teachers, and others.

* ADHD evaluations should include assessment for other conditions that may co-occur with ADHD, including emotional or behavioral (e.g., anxiety, depressive, oppositional defiant, and conduct disorders), developmental (e.g., learning and language disorders or other neurodevelopmental disorders), and physical (e.g., tics, sleep apnea) conditions.

* Treatment and management of ADHD should reflect that it is a chronic condition and may impact children’s development and functioning over many years. Parents need to be supported in consistently implementing treatments for their child over an extended period.

* For children ages 4-5, evidence-based parent- and/or teacher-administered behavior therapy should be the first line of treatment. Stimulant medication may be prescribed if improvement is not significant and there remain moderate-to-severe disturbances in the child’s function.

* For 6- to 11-year-old children, FDA-approved medications for ADHD and/or evidence-based parent- and/or teacher-administered behavior therapy are the front line treatments for ADHD; ideally, these treatments would be combined.
For adolescents, FDA-approved medications should be prescribed with the adolescent’s assent. Behavior therapy may also be prescribed and will ideally be combined with medication.

* When prescribing medication, clinicians should titrate doses of ADHD medication to achieve the maximum benefit with minimum side effects.

* It is important for medication efficacy to be systematically monitored at regular intervals so that adjustments can be made when indicated.

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