ADHD diagnosis for children as young as four

ADHD diagnosis for children as young as four

By Catherine Walker

The last time that clinical guidelines were issued for the diagnosis of attention-deficit hyperactivity disorder (ADHD) was in 2000 and 2001.  This covered children from the ages of 6 to 12.  Over the past decade knowledge has expanded which now makes it possible to diagnose and manage ADHD in children from the ages of 4 to 18.

The American Academy of Paediatrics has issued new guidelines for ADHD and suggests that the condition can now be diagnosed in children as young as four years old.  It recommends that behavioural treatments, not drugs, be used for the youngest children with the disorder.

The new guidelines set out the special considerations involved in the diagnosis and treatment of pre-school children and adolescents.  Also included are interventions to help children with hyperactive/impulsive behaviours that do not meet the full diagnostic criteria for ADHD.

‘Treating children at a young age is important, because we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school,’ said Mark Wolraich, M.D., who is the lead author of the report.

‘Because of greater awareness about ADHD and better ways of diagnosing and treating this disorder more children are being helped,’ Wolraich added.

ADHD occurs in about 8% of children and adolescents which makes it the most common neurobehavioural disorder in children.

The American Academy of Paediatrics (AAP) guidelines also suggest that for pre-school children, between the ages of 4 and 5, with ADHD, doctors should first try behavioural interventions such as group or individual parent training in behaviour management techniques.  Ritalin (methylphenidate) may be considered for pre-school children with moderate to severe symptoms who do not gain significant improvement after behaviour therapy.  This should be started at a low dose.  For children and adolescents in elementary school, the recommendation of the AAP is the dual use of approved medication and behaviour therapy.

Wolraich said ‘Because ADHD is a chronic condition, it requires a team approach, including the patients, their parents, the paediatrician, therapists and teachers.’

The report was released this week at the AAP National Conference & Exhibition in Boston.  It will be published in the November 2011 issue of Paediatrics.

Source: American Academy of Paediatrics