Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents

Kemper, Alex R.; Maslow, Gary; Hill, Sherika; Namdari, Behrouz; LaPointe, Nancy M. Allen; Goode, Adam P.; Coeytaux, Remy R; Befus, Deanna; Kosinski, Andrzej S.; Bowen, Samantha; McBroom, Amanda J; Lallinger, Kathryn R; Sanders, Gillian D

doi:10.23970/ahrqepccer203

Cited by 36 publications

(38 citation statements)

References 4 publications

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“…The subcommittee developed a series of research questions to direct an evidence-based review sponsored by 1 of the Evidence-based Practice Centers of the US Agency for Healthcare Research and Quality (AHRQ). 23 These questions assessed 4 diagnostic areas and 3 treatment areas on the basis of research published in 2011 through 2016.…”

Section: Research Questionsmentioning

confidence: 99%

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2019

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The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. All clinical practice guidelines from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Dr Holbrook was not an author of the accompanying supplemental section on barriers to care. This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

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Section: Research Questionsmentioning

confidence: 99%

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2019

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“…Whereas cognitive behavioral therapies aimed at improving attention and executive function are relatively common in patients with attention-deficit/hyperactivity disorder, they are less often considered in epilepsy treatment. 95,96 Nonetheless, recent studies suggest that behavioral and psychological treatments may enhance quality of life in epilepsy. 97 Medications to improve alertness might also be explored in this patient population, although the potential for lowering seizure threshold would need to be cautiously considered.…”

Section: Behavioral or Pharmacological Therapiesmentioning

confidence: 99%

Impaired vigilance networks in temporal lobe epilepsy: Mechanisms and clinical implications

2020

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Mesial temporal lobe epilepsy (mTLE) is a neurological disorder in which patients suffer from frequent consciousness‐impairing seizures, broad neurocognitive deficits, and diminished quality of life. Although seizures in mTLE originate focally in the hippocampus or amygdala, mTLE patients demonstrate cognitive deficits that extend beyond temporal lobe function—such as decline in executive function, cognitive processing speed, and attention—as well as diffuse decreases in neocortical metabolism and functional connectivity. Given prior observations that mTLE patients exhibit impairments in vigilance, and that seizures may disrupt the activity and long‐range connectivity of subcortical brain structures involved in vigilance regulation, we propose that subcortical activating networks underlying vigilance play a critical role in mediating the widespread neural and cognitive effects of focal mTLE. Here, we review evidence for impaired vigilance in mTLE, examine clinical implications and potential network underpinnings, and suggest neuroimaging strategies for determining the relationship between vigilance, brain connectivity, and neurocognition in patients and healthy controls.

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“…Unfortunately, the objective assessments currently available for ADHD are of limited use in clarifying the diagnosis, including neuropsychological tests (which have a low strength of evidence 14 ) as well as EEG and neuroimaging (for which the evidence remains insufficient 14 ). The scientific community has also been interested in understanding how neurotransmitter systems are involved in ADHD because animal models, neuroimaging studies, and pharmacologic studies provide support for the involvement of dopaminergic and adrenergic derangements in ADHD.…”

Section: Diagnosismentioning

confidence: 99%

“…23 Since that time, hundreds of additional rigorous studies have consistently confirmed their efficacy and safety when taken in the therapeutic dose range for children from 4 years of age to adulthood. 14 Behavioral interventions that are focused on behavior modification, such as parent behavior-management training and school behaviormanagement programs, have also long been demonstrated to be efficacious. 24 Other interventions, including diets, herbal and other supplements, EEG training, and neuropsychological or cognitive training interventions, lack the level of empirical support for their efficacy achieved by the US Food and Drug Administration-approved ADHD medications and the aforementioned behavioral interventions.…”

Section: Diagnosismentioning

confidence: 99%

“…24 Other interventions, including diets, herbal and other supplements, EEG training, and neuropsychological or cognitive training interventions, lack the level of empirical support for their efficacy achieved by the US Food and Drug Administration-approved ADHD medications and the aforementioned behavioral interventions. 14 In the Multimodal Treatment of ADHD (MTA) study, funded by the National Institute of Mental Health, 25 researchers examined the benefits of both stimulant medication and behavioral interventions in a multisite study over a 14-month period, with 10-year follow-up surveillance. Although stimulant medication had the strongest effect on core ADHD symptoms and behavioral interventions were most acceptable to families, combined medication and behavioral therapy was most effective, particularly when comorbidity or additional family issues were present.…”

Section: Diagnosismentioning

confidence: 99%

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ADHD Diagnosis and Treatment Guidelines: A Historical Perspective

et al. 2019

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Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral condition and the second most common chronic illness in children. The observance of specific behaviors in multiple settings have remained the most successful method for diagnosing the condition, and although there are differences in specific areas of the brain, and a high heritability estimate (∼76%), they are not diagnostically specific. Medications, and particularly stimulant medication, have undergone rigorous studies to document their efficacy dating back to the 1970s. Likewise, behavioral interventions in the form of parent training and classroom programs have demonstrated robust efficacy during the same time period. Both medication and behavioral interventions are symptomatic treatments. The availability of only symptomatic treatments places ADHD in the same category as other chronic conditions such as diabetes and asthma. Successful treatment of most individuals requires ongoing adherence to the therapy. Improved communication between patients and their families, primary and mental health providers, and school personnel is necessary for effective ADHD treatment. Further enhancement of electronic systems to facilitate family, school, and provider communication can improve monitoring of ADHD symptoms and functional performance. The American Academy of Pediatrics ADHD guidelines were initially developed to help primary care clinicians address the needs of their patients with ADHD and were further refined with the second revision in 2019.

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Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents

Cited by 36 publications

References 4 publications

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

Impaired vigilance networks in temporal lobe epilepsy: Mechanisms and clinical implications

ADHD Diagnosis and Treatment Guidelines: A Historical Perspective

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