Overview Review Sections (17)
   Attention Deficit Hyperactivity Disorder

Attention deficit-hyperactivity disorder (ADHD) has been defined as "the inability to marshal and sustain attention, modulate activity level and moderate impulsive actions" (1). A commonly used diagnostic protocol for the primary care physician is the American Academy of Pediatrics (AAP) "Clinical Practice Guideline: Diagnosis and Evaluation of the Child With Attention-Deficit/Hyperactivity Disorder" (2). This guideline includes the following 6 recommendations:
RECOMMENDATION 1: In a child 6 to 12 years old who presents with inattention, hyperactivity, impulsivity, academic underachievement, or behavior problems, primary care clinicians should initiate an evaluation for ADHD.

RECOMMENDATION 2: The diagnosis of ADHD requires that a child meet the Diagnostic and Statistical Manual of Mental health Disorders, Fourth Edition (DSM-IV) criteria.

RECOMMENDATION 3: The assessment of ADHD requires evidence directly obtained from parents or caregivers regarding the core symptoms of ADHD in various settings, the age of onset, duration of symptoms, and degree of functional impairment.

RECOMMENDATION 4: The assessment of ADHD requires evidence directly obtained from the classroom teacher (or other school professional) regarding the core symptoms of ADHD, the duration of symptoms, the degree of functional impairment, and coexisting conditions. A physician should review any reports from a school-based multidisciplinary evaluation where they exist, which will include assessments from the teacher or other school-based professionals.
RECOMMENDATION 4A: Use of these scales is a clinical option when diagnosing children for ADHD.

RECOMMENDATION 4B: Use of teacher global questionnaires and rating scales is not recommended in the diagnosing of children for ADHD, although they may be useful for other purposes.
RECOMMENDATION 5: Evaluation of the child with ADHD should include assessment for coexisting conditions.

RECOMMENDATION 6: Other diagnostic tests are not routinely indicated to establish the diagnosis of ADHD.

(1) Rappley MD. Clinical practice. Attention deficit-hyperactivity disorder. N Engl J Med 2005 Jan 13;352(2):165-73.

(2) Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. American Academy of Pediatrics. Pediatrics 2000 May;105(5):1158-70.
Clinical Reviews
Attention Deficit Hyperactivity Disorder: Prevention

Risk factors for attention deficit-hyperactivity disorder (ADHD) are difficult to firmly establish due to the uncertain nature of the condition. A great deal of controversy exists related to its biological cause and diagnosis. Without the knowledge of its etiology or objective tests for diagnosis, it is difficult to properly design a study to determine risk factors. Consequently all evidence relating to risk factors are primarily observational in nature and must be evaluated on that basis.
Attention Deficit Hyperactivity Disorder: Diagnosis

Attention deficit-hyperactivity disorder (ADHD) has been defined as "the inability to marshal and sustain attention, modulate activity level and moderate impulsive actions". A commonly used diagnostic protocol for the primary care physician is the American Academy of Pediatrics (AAP) "Clinical Practice Guideline: Diagnosis and Evaluation of the Child With Attention-Deficit/Hyperactivity Disorder".
Attention Deficit Hyperactivity Disorder: Therapy

Concerns pertaining to the use of psychostimulants for children have led many parents to seek alternatives for the treatment of attention deficit hyperactivity disorder (ADHD). Up to 64% of children with ADHD have been treated with some form of alternative therapy. Although diet therapy, chiropractic and homeopathy are the most common interventions, good quality studies on any alternative intervention are limited.
Medical Subject Heading (MeSH) Information
MeSH Term: Attention Deficit Disorder with Hyperactivity

Scope Note: A behavior disorder originating in childhood in which the essential features are signs of developmentally inappropriate inattention, impulsivity, and hyperactivity. Although most individuals have symptoms of both inattention and hyperactivity-impulsivity, one or the other pattern may be predominant. The disorder is more frequent in males than females. Onset is in childhood. Symptoms often attenuate during late adolescence although a minority experience the full complement of symptoms into mid-adulthood. (From DSM-IV)

MeSH Synonyms:
  • Attention Deficit Disorder with Hyperactivity
  • Hyperkinetic Syndrome
  • Syndromes, Hyperkinetic
  • Attention Deficit Hyperactivity Disorder
  • Attention Deficit Disorders with Hyperactivity
  • Attention Deficit Hyperactivity Disorders
  • Brain Dysfunction, Minimal
  • Dysfunction, Minimal Brain
  • Minimal Brain Dysfunction
  • Attention Deficit Disorder
  • Attention Deficit Disorders
  • Deficit Disorder, Attention
  • Deficit Disorders, Attention
  • Disorder, Attention Deficit
  • Disorders, Attention Deficit
Applicable MeSH Subheadings:
  • blood
  • cerebrospinal fluid
  • chemically induced
  • classification
  • complications
  • diagnosis
  • diet therapy
  • drug therapy
  • economics
  • embryology
  • enzymology
  • epidemiology
  • ethnology
  • etiology
  • genetics
  • history
  • immunology
  • metabolism
  • microbiology
  • mortality
  • nursing
  • parasitology
  • pathology
  • physiopathology
  • prevention and control
  • psychology
  • radiography
  • radionuclide imaging
  • rehabilitation
  • surgery
  • therapy
  • ultrasonography
  • urine
  • virology
Informative Links
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