Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

doi:10.1097/chi.0b013e318054e724

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 46, Issue 7, July 2007, Pages 894-921

https://doi.org/10.1097/chi.0b013e318054e724 Get rights and content

ABSTRACT

This practice parameter describes the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) based on the current scientific evidence and clinical consensus of experts in the field. This parameter discusses the clinical evaluation for ADHD, comorbid conditions associated with ADHD, research on the etiology of the disorder, and psychopharmacological and psychosocial interventions for ADHD.

Section snippets

METHODOLOGY

The list of references for this parameter was developed by searching PsycINFO, Medline, and Psychological Abstracts; by reviewing the bibliographies of book chapters and review articles; by asking colleagues for suggested source materials; and from the previous version of this parameter. The searches were conducted from September 2004 through April 2006 for articles in English using the key word “attention-deficit/hyperactivity disorder.” The search covered the period 1996 to 2006 and yielded

EPIDEMIOLOGY AND CLINICAL COURSE

Recently, epidemiological studies have more precisely defined the prevalence of ADHD and the extent of its treatment with medication. Rowland et al. (2002) surveyed more than 6,000 parents of elementary school children in a North Carolina county. Ten percent of the children had been given a diagnosis of ADHD and 7% were taking medication for ADHD. Parents of 2,800 third through fifth graders were surveyed in Rhode Island; 12% of parents reported that their child had been referred for evaluation

COMORBIDITIES

It is well established that ADHD frequently is comorbid with other psychiatric disorders (Pliszka et al., 1999). Studies have shown that 54%-84% of children and adolescents with ADHD may meet criteria for oppositional defiant disorder (ODD); a significant portion of these patients will develop conduct disorder (CD; Barkley, 2005, Faraone et al., 1997). Fifteen percent to 19% of patients with ADHD will start to smoke (Milberger et al., 1997) or develop other substance abuse disorders (Biederman

ETIOLOGY

Neuropsychological studies have shown that patients with ADHD have deficits in executive functions that are “neurocognitive processes that maintain an appropriate problem solving set to attain a future goal” (Willcutt et al., 2005). Specifically, a meta-analysis of 83 studies with more than 6,000 subjects showed that patients with ADHD have impairments in the executive functioning domains of response inhibition, vigilance, working memory, and some measures of planning (Willcutt et al., 2005).

RECENT ADVANCES IN TREATMENT

At the time of publication of the first AACAP practice parameter for ADHD in 1997 (American Academy of Child and Adolescent Psychiatry, 1997), the literature devoted to the treatment of ADHD was already voluminous. Stimulant treatment of ADHD was also the subject of an AACAP practice parameter (American Academy of Child and Adolescent Psychiatry, 2002). Most of that literature focused on the short-term treatment of ADHD, either with medication or psychosocial interventions. At the time of the

EVIDENCE BASE FOR PRACTICE PARAMETERS

The AACAP develops both patient-oriented and clinician-oriented practice parameters. Patient-oriented parameters provide recommendations to guide clinicians toward the best treatment practices. Treatment recommendations are based both on empirical evidence and clinical consensus, and are graded according to the strength of the empirical and clinical support. Clinician-oriented parameters provide clinicians with the information (stated as principles) needed to develop practice-based skills.

Recommendation 1. Screening for ADHD Should Be Part of Every Patient's Mental Health Assessment [MS].

In any mental health assessment, the clinician should screen for ADHD by specifically asking questions regarding the major symptom domains of ADHD (inattention, impulsivity, and hyperactivity) and asking whether such symptoms cause impairment. These screening questions should be asked regardless of the nature of the chief complaint. Rating scales or specific questionnaires containing the DSM symptoms of ADHD can also be included in clinic/office registration materials to be completed by parents

Recommendation 2. Evaluation of the Preschooler, Child, or Adolescent for ADHD Should Consist of Clinical Interviews With the Parent and Patient, Obtaining Information About the Patient's School or Day Care Functioning, Evaluation for Comorbid Psychiatric Disorders, and Review of the Patient's Medical, Social, and Family Histories [MS].

The clinician should perform a detailed interview with the parent about each of the 18 ADHD symptoms listed in DSM-IV. For each symptom, the clinician should determine whether it is present as well as its duration, severity, and frequency. Age at onset of the symptoms should be assessed. The patient must have the required number of symptoms (at least six of nine of the inattention cluster and/or at least six of nine of the hyperactive/impulsive criteria, each occurring more days than not), a

Recommendation 6. A Well-Thought-Out and Comprehensive Treatment Plan Should Be Developed for the Patient With ADHD [MS].

The patient's treatment plan should take account of ADHD as a chronic disorder and may consist of psychopharmacological and/or behavior therapy. This plan should take into account the most recent evidence concerning effective therapies as well as family preferences and concerns. This plan should include parental and child psychoeducation about ADHD and its various treatment options (medication and behavior therapy), linkage with community supports, and additional school resources as

STIMULANTS

Many randomized clinical trials of stimulant medications have been performed in patients with ADHD during the past 3 decades. Stimulants are highly efficacious in the treatment of ADHD. In double-blind, placebo-controlled trials in both children and adults, 65% to 75% of subjects with ADHD have been determined to be clinical responders to stimulants compared with 4% to 30% of subjects treated with placebo, depending on the response criteria used (Greenhill, 2002). When clinical response is

SUMMARY

The key to effective long-term management of the patient with ADHD is continuity of care with a clinician experienced in the treatment of ADHD. The frequency and duration of follow-up sessions should be individualized for each family and patient, depending on the severity of ADHD symptoms; the degree of comorbidity of other psychiatric illness; the response to treatment; and the degree of impairment in home, school, work, or peer-related activities. The clinician should establish an effective

PARAMETER LIMITATIONS

AACAP practice parameters are developed to assist clinicians in psychiatric decision making. These parameters are not intended to define the standard of care, nor should they be deemed inclusive of all proper methods of care or exclusive of other methods of care directed at obtaining the desired results. The ultimate judgment regarding the care of a particular patient must be made by the clinician in light of all of the circumstances presented by the patient and his or her family, the

REFERENCES (187)

H Abikoff et al.
Social functioning in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment
J Am Acad Child Adolesc Psychiatry
(2004)
H Abikoff et al.
Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment
J Am Acad Child Adolesc Psychiatry
(2004)
H Abikoff et al.
Sequential pharmacotherapy for children with comorbid attention-deficit/hyperactivity and anxiety disorders
J Am Acad Child Adolesc Psychiatry
(2005)
RA Barkley
Driving impairments in teens and adults with attention-deficit/hyperactivity disorder
Psychiatr Clin North Am
(2004)
RA Barkley et al.
The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study
J Am Acad Child Adolesc Psychiatry
(1990)
RA Barkley et al.
Young adult outcome of hyperactive children: adaptive functioning in major life activities
J Am Acad Child Adolesc Psychiatry
(2006)
J Biederman et al.
Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study
J Am Acad Child Adolesc Psychiatry
(1997)
G Bush et al.
Functional neuroimaging of attention-deficit/hyperactivity disorder: a review and suggested future directions
Biol Psychiatry
(2005)
A Charach et al.
Stimulant treatment over 5 years: effects on growth
J Am Acad Child Adolesc Psychiatry
(2006)
A Charach et al.
Stimulant treatment over five years: adherence, effectiveness, and adverse effects
J Am Acad Child Adolesc Psychiatry
(2004)

CK Conners et al.

Bupropion hydrochloride in attention deficit disorder with hyperactivity

J Am Acad Child Adolesc Psychiatry

(1996)

DF Connor et al.

A meta-analysis of clonidine for symptoms of attention-deficit hyperactivity disorder

J Am Acad Child Adolesc Psychiatry

(1999)

DF Connor et al.

Psychopharmacology and aggression. I: a meta-analysis of stimulant effects on overt/covert aggression-related behaviors in ADHD

J Am Acad Child Adolesc Psychiatry

(2002)

DJ Cox et al.

Impact of methylphenidate delivery profiles on driving performance of adolescents with attention-deficit/hyperactivity disorder: a pilot study

J Am Acad Child Adolesc Psychiatry

(2004)

JM Daly et al.

The use of tricyclics antidepressants in children and adolescents

Pediatr Clin North Am

(1998)

S Durston et al.

Magnetic resonance imaging of boys with attention-deficit/hyperactivity disorder and their unaffected siblings

J Am Acad Child Adolesc Psychiatry

(2004)

SV Faraone et al.

Molecular genetics of attention-deficit/hyperactivity disorder

Biol Psychiatry

(2005)

LL Greenhill et al.

Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD

J Am Acad Child Adolesc Psychiatry

(2006)

LL Greenhill et al.

Efficacy and safety of dexmethylphenidate extended-release capsules in children with attention-deficit/hyperactivity disorder

J Am Acad Child Adolesc Psychiatry

(2006)

LL Greenhill et al.

Effect of two different methods of initiating atomoxetine on the adverse event profile of atomoxetine

J Am Acad Child Adolesc Psychiatry

(2007)

LL Greenhill et al.

A pharmacokinetic/pharmacodynamic study comparing a single morning dose of Adderall to twice-daily dosing in children with ADHD

J Am Acad Child Adolesc Psychiatry

(2003)

H Gutgesell et al.

AHA scientific statement: cardiovascular monitoring of children and adolescents receiving psychotropic drugs

J Am Acad Child Adolesc Psychiatry

(1999)

BL Handen et al.

Efficacy of methylphenidate among preschool children with developmental disabilities and ADHD

J Am Acad Child Adolesc Psychiatry

(1999)

L Hechtman et al.

Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment

J Am Acad Child Adolesc Psychiatry

(2004)

PS Jensen et al.

ADHD comorbidity findings from the MTA study: comparing comorbid subgroups

J Am Acad Child Adolesc Psychiatry

(2001)

RG Klein et al.

Design and rationale of controlled study of long-term methylphenidate and multimodal psychosocial treatment in children with ADHD

J Am Acad Child Adolesc Psychiatry

(2004)

S Kollins et al.

Rationale, design, and methods of the Preschool ADHD Treatment Study PATS

J Am Acad Child Adolesc Psychiatry

(2006)

JR Kramer et al.

Predictors of adult height and weight in boys treated with methylphenidate for childhood behavior problems

J Am Acad Child Adolesc Psychiatry

(2000)

S Kutcher et al.

International consensus statement on attention-deficit/hyperactivity disorder ADHD and disruptive behaviour disorders DBDs: clinical implications and treatment practice suggestions

Eur Neuropsychopharmacol

(2004)

SF Law et al.

Do typical clinical doses of methylphenidate cause tics in children treated for attention-deficit hyperactivity disorder?

J Am Acad Child Adolesc Psychiatry

(1999)

JE Max et al.

Attention-deficit hyperactivity symptomatology after traumatic brain injury: a prospective study

J Am Acad Child Adolesc Psychiatry

(1998)

JT McCracken et al.

Analog classroom assessment of a once-daily mixed amphetamine formulation, SLI381 Adderall XR, in children with ADHD

J Am Acad Child Adolesc Psychiatry

(2003)

J McGough et al.

Pharmacogenetics of methylphenidate response in preschoolers with ADHD

J Am Acad Child Adolesc Psychiatry

(2006)

JJ McGough et al.

Long-term tolerability and effectiveness of once-daily mixed amphetamine salts Adderall XR in children with ADHD

J Am Acad Child Adolesc Psychiatry

(2005)

American Academy of Child and Adolescent Psychiatry

Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder

J Am Acad Child Adolesc Psychiatry

(1997)

American Academy of Child and Adolescent Psychiatry

Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults

J Am Acad Child Adolesc Psychiatry

(2002)

American Academy of Pediatrics

Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder

Pediatrics

(2001)

American Psychiatric Association

Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR)

(2000)

KM Antshel et al.

Social skills training in children with attention deficit hyperactivity disorder: a randomized-controlled clinical trial

J Clin Child Adolesc Psychol

(2003)

LE Arnold

Methylphenidate vs. amphetamine: comparative review

J Atten Disord

(2000)

LE Arnold et al.

Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD

J Consult Clin Psychol

(2003)

WJ Barbaresi et al.

How common is attention-deficit/hyperactivity disorder? Incidence in a population-based birth cohort in Rochester, Minn

Arch Pediatr Adolesc Med

(2002)

RA Barkley

Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment

(1990)

RA Barkley

Defiant Children: A Clinician's Manual for Assessment and Parent Training

(1997)

RA Barkley

ADHD-long term course, adult outcome, and comorbid disorders

RA Barkley

Attention Deficit Hyperactivity Disorder: A Clinical Handbook

(2005)

RA Barkley et al.

The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder

J Abnorm Psychol

(2002)

RA Barkley et al.

Young adult follow-up of hyperactive children: antisocial activities and drug use

J Child Psychol Psychiatry

(2004)

J Biederman

Resolved: mania is mistaken for ADHD in prepubertal children, affirmative

J Am Acad Child Adolesc Psychiatry

(1998)

J Biederman

Impact of comorbidity in adults with attention-deficit/hyperactivity disorder

J Clin Psychiatry

(2004)

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The causal impact of maternal smoking around birth on offspring ADHD: A two-sample Mendelian randomization study
2024, Journal of Affective Disorders
The previous literature highlights a relationship between maternal smoking around birth (MSAB) and offspring attention-deficit/hyperactivity disorder (ADHD). These studies have focused on the causal effects of MSAB on offspring ADHD.
A Mendelian randomization analysis was conducted using summary statistics. Data on MSAB were obtained from a recent study including 391,992 participants. ADHD data were obtained from six sources for 246,888 participants. The present study used five methods to examine the causal impact from outcomes on exposures. The inverse variance weighted (IVW) was the main method of analysis, while the other four methods were supplementary methods.
The IVW revealed that MSAB was a risk factor for offspring ADHD (OR: 2.54; 95 % confidence interval [CI]: 1.61–4.00, p = 6.04 × 10⁻⁵). Concerning ADHD in both sexes, MSAB was associated with females (OR = 3.96, 95 % CI: 1.99–7.90, p = 8.98 × 10⁻⁵) and males (OR = 3.74, 95 % CI: 1.74–5.72, p = 1.48 × 10⁻⁴). In different diagnosis periods for ADHD, MSAB increased the risk of childhood (OR = 3.63, 95 % CI: 2.25–5.87, p = 1.31 × 10⁻⁷), late-diagnosed (OR = 2.99, 95 % CI: 1.74–5.14, p = 7.33 × 10⁻⁵), and persistent (OR = 4.77, 95 % CI: 1.88–12.14, p = 1.03 × 10⁻³) ADHD. The final analysis did not reveal heterogeneity.
A causal impact of MSAB on offspring ADHD was observed. These findings highlight the need for careful consideration of prenatal exposure (MSAB) during the assessment of offspring ADHD. Additionally, it can provide targeted guidance for prenatal interventions. Future studies should analyze the effects of different doses of maternal smoking on ADHD.
Can exposure to lisdexamfetamine dimesylate from juvenile period to peripubertal compromise male reproductive parameters in adult rats?
2024, Toxicology and Applied Pharmacology
Lisdexamfetamine (LDX) is a d-amphetamine prodrug used to treat attention deficit and hyperactivity disorder, a common neurodevelopmental disorder in children and adolescents. Due to its action mediated by elevated levels of catecholamines, mainly dopamine and noradrenaline, which influence hormonal regulation and directly affect the gonads, this drug may potentially disrupt reproductive performance. This study evaluated the effects of exposure to LDX from the juvenile to peripubertal period (critical stages of development) on systemic and reproductive toxicity parameters in male rats. Male Wistar rats (23 days old) were treated with 0; 5.2; 8.6 or 12.1 mg/kg/day of LDX from post-natal day (PND) 23 to 53, by gavage. LDX treatment led to reduced daily food and water consumption, as well as a decrease in social behaviors. The day of preputial separation remained unaltered, although the treated animals exhibited reduced weight. At PND 54, the treated animals presented signs of systemic toxicity, evidenced by a reduction in body weight gain, increase in the relative weight of the liver, spleen, and seminal gland, reduction in erythrocyte and leukocyte counts, reduced total protein levels, and disruptions in oxidative parameters. In adulthood, there was an increase in immobile sperm, reduced sperm count, morphometric changes in the testis, and altered oxidative parameters, without compromising male sexual behavior and fertility. These findings showed that LDX-treatment during the juvenile and peripubertal periods induced immediate systemic toxicity and adversely influenced reproductive function in adult life, indicating that caution is necessary when prescribing this drug during the peripubertal phase.
Educational attainment, income, and attention deficit hyperactivity disorder: A mediation analysis based on two-step Mendelian randomization
2024, Social Science and Medicine
Previous studies have reported the relationship between educational attainment and attention deficit hyperactivity disorder (ADHD). However, the mechanism of this relationship remains unknown. It is well known that educational attainment correlates with income. Therefore, based on summary data from a genome-wide association study we used two-step Mendelian randomization (MR) to explore the role of income between education and ADHD. The inverse variance weighted (IVW) method was used in our analysis. The IVW results suggested that educational attainment and income were protective factors against ADHD. Educational attainment affects ADHD through income [ADHD: Beta = −0.68, 95% confidence interval (CI) = −0.87, −0.49; female: Beta = −0.87, 95% CI = −1.28, −0.47; male: Beta = −1.01, 95% CI = −1.34, −0.68; childhood: Beta = −0.52, 95% CI = −0.74, −0.30; late-diagnosed: Beta = −0.78, 95% CI = −1.11, −0.47; persistent: Beta = −0.82, 95% CI = −1.33, −0.31]. Income also affected ADHD through educational attainment [female: Beta = −1.08, 95% CI = −1.35, −0.83; male: Beta = −1.16, 95% CI = −1.57, −0.77; persistent: Beta = −1.48, 95% CI = −2.09, −0.94]. In the final analysis, data with heterogeneity were analyzed using IVW random effects results. The mechanism is that income will mediate the relationship between educational attainment and ADHD.
Editorial: The Use of Continuous Performance Tasks in Attention-Deficit/Hyperactivity Disorder Diagnosis: A Cautionary Note
2024, Journal of the American Academy of Child and Adolescent Psychiatry
Adolescent Cannabis Use, Comorbid Attention-Deficit/Hyperactivity Disorder, and Other Internalizing and Externalizing Disorders
2023, Psychiatric Clinics of North America
Adverse Events During Dosing of Delayed-release/Extended-release Methylphenidate: Learnings From the Open-label Phase of a Registration Trial and a Real-world Postmarketing Surveillance Program
2023, Clinical Therapeutics
Delayed-release/extended-release methylphenidate (DR/ER-MPH) (formerly HLD200) is an evening-dosed agent used for the treatment of attention-deficit/hyperactivity disorder. Postmarketing surveillance data from approximately 74,000 patients exposed to DR/ER-MPH (up to June 17, 2022) were reported and compared with the open-label, treatment-optimization phase of a Phase III clinical trial to derive possible learnings on how to approach adverse events (AEs) that emerge during dose titration.
An analysis of AEs spontaneously reported to Ironshore in postmarketing surveillance included, where available, age, dose, timing, and discontinuations. Data were summarized using descriptive statistics.
A total of 395 children, adolescents, and adults reported 601 AEs in postmarketing surveillance. Five AEs were classified as serious. AEs preceded drug use discontinuation in 172 patients. Many AEs occurred early (52% were reported within 30 days) and at lower doses (54% were reported at 20 to 40 mg), similar to the trial data. Reported AEs included those similar in type but orders of magnitude lower in number than those from the clinical trial.
No new safety concerns were revealed in this real-world setting compared with the safety profile identified in DR/ER-MPH trial data. In real-world practices, clinicians tended to discontinue DR/ER-MPH treatment after AE onset, whereas trial investigators continued to optimize treatment and found that AEs were generally tolerable, suggesting that health care practitioners may consider developing strategies to manage tolerability issues with DR/ER-MPH treatment on AE emergence rather than immediately discontinuing use of the drug to provide optimal therapeutic benefit. ClinicalTrials.gov identifier: NCT02493777.

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Accepted February 18, 2007.

This parameter was developed by Steven Pliszka, M.D., principal author, and the AACAP Work Group on Quality Issues: William Bernet, M.D., Oscar Bukstein, M.D., and Heather J. Walter, M.D., Co-Chairs; Valerie Arnold, M.D., Joseph Beitchman, M.D., R. Scott Benson, M.D., Allan Chrisman, M.D., Tiffany Farchione, M.D., John Hamilton, M.D., Helene Keable, M.D., Joan Kinlan, M.D., Jon McClellan, M.D., David Rue, M.D., Ulrich Schoettle, M.D., Jon A. Shaw, M.D., and Saundra Stock, M.D. AACAP Staff: Kristin Kroeger Ptakowski and Jennifer Medicus.

The authors acknowledge the following experts for their contributions to this parameter: Larry Greenhill, M.D., Timothy Wilens, M.D., Thomas Spencer, M.D., Joe Biederman, M.D., Mina Dulcan, M.D., Lily Hechtman, M.D., Paul Hammerness, M.D., John Hamilton, M.D., Caryn Carlson, Ph.D., Gregory Fabiano, M.A., William Pelham, Ph.D., James Swanson, Ph.D., and Daniel Waschbusch, Ph.D.

This parameter was reviewed at the Member Forum at the Annual Meeting of the AACAP in October, 2005.

From July 2006 to September 2006, this parameter was reviewed by a Consensus Group convened by the Work Group on Quality Issues. Consensus Group members and their constituent groups were as follows: Work Group on Quality Issues (Oscar Bukstein, M.D., Allan Chrisman, M.D., R. Scott Benson, M.D., and John Hamilton, M.D.), Topic Experts (Larry Greenhill, M.D., and Russell Barkley, Ph.D.), AACAP Work Group on Research (Larry Greenhill, M.D.), AACAP Assembly of Regional Organizations (Joan Gerring, M.D., and Guy Palmes, M.D.), and AACAP Council (Cynthia W. Santos, M.D., and Catherine Jaselskis, M.D.).

Disclosures of potential conflicts of interest for authors and Work Group chairs are provided at the end of the parameter. Disclosures of potential conflicts of interest for all other individuals named above are provided on the AACAP Web site on the Practice Information page.

This practice parameter was approved by the AACAP Council on October 18, 2006.

This practice parameter is available on the Internet (www.aacap.org).

Reprint requests to the AACAP Communications Department, 3615 Wisconsin Avenue NW, Washington, DC 20016.

Disclosure: Dr. Pliszka receives or has received research support from, acted as a consultant to, and/or served on the speakers' bureaus of Shire, McNeil Pediatrics, and Eli Lilly. Dr. Bukstein receives or has received research support from, acted as a consultant to, and/or served on the speakers' bureaus of Cephalon, Forest Pharmaceuticals, McNeil Pediatrics, Shire, Eli Lilly, and Novartis. Drs. Bernet and Walter have no financial relationships to disclose.

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AACAP OFFICIAL ACTIONPractice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

ABSTRACT

Section snippets

METHODOLOGY

EPIDEMIOLOGY AND CLINICAL COURSE

COMORBIDITIES

ETIOLOGY

RECENT ADVANCES IN TREATMENT

EVIDENCE BASE FOR PRACTICE PARAMETERS

Recommendation 1. Screening for ADHD Should Be Part of Every Patient's Mental Health Assessment [MS].

Recommendation 6. A Well-Thought-Out and Comprehensive Treatment Plan Should Be Developed for the Patient With ADHD [MS].

STIMULANTS

SUMMARY

PARAMETER LIMITATIONS

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Psychiatr Clin North Am

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Biol Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Pediatr Clin North Am

J Am Acad Child Adolesc Psychiatry

Biol Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Eur Neuropsychopharmacol

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder

J Am Acad Child Adolesc Psychiatry

Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults

J Am Acad Child Adolesc Psychiatry

Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder

Pediatrics

Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR)

Social skills training in children with attention deficit hyperactivity disorder: a randomized-controlled clinical trial

J Clin Child Adolesc Psychol

Methylphenidate vs. amphetamine: comparative review

J Atten Disord

Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD

J Consult Clin Psychol

How common is attention-deficit/hyperactivity disorder? Incidence in a population-based birth cohort in Rochester, Minn

Arch Pediatr Adolesc Med

Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment

Defiant Children: A Clinician's Manual for Assessment and Parent Training

ADHD-long term course, adult outcome, and comorbid disorders

Attention Deficit Hyperactivity Disorder: A Clinical Handbook

The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder

J Abnorm Psychol

Young adult follow-up of hyperactive children: antisocial activities and drug use

J Child Psychol Psychiatry

Resolved: mania is mistaken for ADHD in prepubertal children, affirmative

J Am Acad Child Adolesc Psychiatry

Impact of comorbidity in adults with attention-deficit/hyperactivity disorder

J Clin Psychiatry

AACAP OFFICIAL ACTION
Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder