The American Academy of Pediatrics (AAP) has revised the guidelines for the care of children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) which offers clinicians updated information and opportunities as they work towards providing treatment plans for patients in their care.
Caring for patients with ADHD is complex, and according to the updated treatment models, occurs best in a patient-centered medical home. These new guidelines have been updated from 2011, and can serve as sources of current applications and information for primary care pediatricians, nurse practitioners, physician assistants, and family medicine practices.
Establishing the diagnosis, these guidelines are based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While the DSM-5 guidelines are similar to those of 2011, there are two noteworthy exceptions. Fewer problem behaviors for those age 17 and over are required, and evidence that symptoms began before the age of 12 years instead of age 7.
Also remaining essentially unchanged are the recommended courses of treatments for ADHD. Stimulant medications amphetamines and methylphenidate in various forms are typically the initial approach to counteracting the symptoms of this disorder. Additions included an increase in the number of extended-release forms of stimulant medications, such as Atomexetine, which remains a secondary alternative medication.
Alpha-2 agonists guanfacine and clonidine also continue to be preferred methods of secondary alternative medications. These extended-release medications are also approved by the Food and Drug Administration as adjuvant treatments.
While behavior therapy is recommended as the first line treatment approach for preschoolers, it is noted in the new guidelines that descriptions of ‘behavior therapy’ for children remain vague, and more detailed treatment plans should be identified.
The predominant studies that were reviewed included recommendations for parents and caregivers that describe behavior management tactics for preschoolers diagnosed with ADHD. Valuing parent and teacher training in behavior management for high school aged children, several included studies outlined the importance of a continuum of care.
Additional concerns touch on the challenges that can be experienced by clinicians when seeking to implement these guidelines, including poor paediatric training in mental health, limited consultative services, and barriers to communication with schools.
The Drug Law Journal provides a wealth of information on updates to medical and mental health guidelines, pertinent information on drug recalls and lawsuits, and current treatment approaches for ADHD diagnosis as well as other health related topics. Staying informed and updated on current findings is an important piece of ensuring the best care is received.
Tracy Everhart
Tracy Everhart is the Editor for Drug Law Journal. A highly-trained and certified medical professional, Tracy is also an accomplished medical writer. After spending years on the front lines of the medical profession, Tracy now devotes her expertise and skills to researching and reporting on new drugs and devices that enter the market, as well as their side-effects and the real-life stories involved. Prior to joining Drug Law Journal, Tracy wrote for benchmark online healthcare resources focused on families and, in particular, women’s health issues. Tracy holds post-graduate degrees from both the American College of Healthcare Sciences and the Yale School of Nursing. She is also a graduate of both Hampshire College, where she studied microbiology and the University of South Carolina school of nursing.