Pediatric Group Issues Updated ADHD Guidelines

Web MD
09 Oct, 2019 ,

Dr. Mark Wolraich has released new and updated guidelines regarding ADHD diagnosis, management and treatment. He has added that these guidelines are in sync with the AAP recommendations. Some of these guidelines include at at which symptoms have first started has been raised from 7 years to 12 years, emphasising the need to differentiate between ADHD and other issues in teenagers as well as adolescents. 

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Attention-deficit/hyperactivity disorder (ADHD) is in the news a lot, and now newer research has prompted a leading pediatricians' group to update its guidelines for diagnosing and treating the disorder for the first time since 2011.

Dr. Mark Wolraich, lead author of the guidelines, noted that there weren't any dramatic differences between these and previous guidelines. But, he said, these latest updates keep the American Academy of Pediatrics guidelines in sync with the same diagnostic and treatment criteria used by child and adolescent psychiatrists.

ADHD "is not a 'new' diagnosis. It's a real diagnosis that needs treatment," said Wolraich.

"There are two forms of treatment effective for ADHD: medications, especially stimulant medications; and behavioral treatments. Neither treatment is curative," he said, but they can help manage the symptoms. Wolraich is an emeritus professor at the University of Oklahoma, in Oklahoma City.

More than 9% of U.S. children between the ages of 2 and 17 have been diagnosed with ADHD, according to the guideline authors. Boys are more than twice as likely as girls to be diagnosed with the disorder. Kids with ADHD often have symptoms of another mental disorder, such as depression or anxiety, and they may also have learning and language problems.

Updates to the guidelines include:

  • Changing the age at which symptoms need to have first started. Previously, symptoms needed to begin before age 7. That's now been raised to age 12.
  • In patients older than 17, fewer problem behaviors are needed to make an ADHD diagnosis. Wolraich said as children get older, symptoms can change and behaviors such as hyperactivity usually diminish.
  • Emphasizing the need to rule out other causes of ADHD-like symptoms and to identify other conditions that may occur with ADHD, such as depression, anxiety, substance use, autism or trauma.
  • Highlighting the need for ongoing medical care and coordination within the school and community.
  • Recommending parent training in behavior management as a first-line treatment for preschoolers. Wolraich said behavior modification is an effective treatment that generally has two phases of treatment. The positive phase rewards a child for appropriate behavior, and the reward may just be praising, such as, "Johnny, I like the way you're sitting in your chair." The second phase includes consequences, such as "time-out." But, he said, if you don't have the positive side of treatment, time-out isn't as helpful.