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ADHD New Guidelines

By: The Kid's Doctor Staff
Updated: January 26, 2012
The American Academy of Pediatrics just released new guidelines for diagnosing and treating children with attention deficit hyperactivity disorder (ADHD).  The new guidelines recommend that pediatricians assess patients between the ages of 4 - 18 for signs of ADHD.

The previous recommendations, published in 2000, recommended diagnosing children between the ages of 6 -12 years and did not address younger or older children. According to the CDC, somewhere between 6 - 9% of children/adolescents have ADHD, with a higher rate seen in the adolescent population.

ADHD symptoms including, difficulty with focusing, paying attention, in- attentiveness, behavioral problems or hyperactivity, may begin in early childhood and may persist into adolescence and even adulthood.  It is important to address behavioral issues in younger children as they are entering school and to look for learning disabilities as well as school becomes more academic. 

By definition, the symptoms of ADHD must exist at both school, at home, as well as in peer relationships. In other words, it manifests itself across all areas of a child's life.

 As your child enters pres-school and elementary school, your pediatrician should routinely be asking about your child's behavior and school progress. While some symptoms of ADHD may appear in pre-school, these behaviors may change as a child matures.

The diagnosis of ADHD is often made over time and is a process. ADHD cannot be diagnosed by a "blood test", but rather is diagnosed by interviews, parent/teacher questionnaires and observation of a child.  In my experience it is not uncommon for some preschoolers (especially boys) to have some inattention and even hyperactivity that they may "outgrow" as they get older. Boys may be identified earlier than girls because they are more active, while girls are often found to be inattentive and may not be seen to be a behavior problem in the early school years. 

Early behavior modification has been shown to be important for a younger child who is suspected of having ADHD and parents and teachers should work together to use similar behavioral strategies. Reinforcement at both home and school is equally important. (This is really true for all age children).

For children who have been followed and continue to have symptoms of ADHD, medication as well as behavior modification may be the most effective strategy for controlling their symptoms. Before starting any age child on medication I think it is important to have both parents and teachers involved. Your child is "under the care" of their teacher for 6 - 8 hours a day, and who better to comment on your child's behavior/attention/mood.
 
For the teenage population it is also important to look for other conditions that may be seen in conjunction with ADHD. These would include drug or alcohol abuse, anxiety and depression. Treating underlying issues is a priority as well in a teen with ADHD.

Treatment for ADHD should be individually tailored for each child and this requires that the parent/doctor/teacher work together to ensure the best possible treatment.

That's your daily dose for today. I'm Dr. Sue Hubbard from The Kid's Doctor.

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