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New ADHD Guidelines Include Preschoolers, Older Teens
Date:10/17/2011

tion of both medication and behavioral therapy is probably the best choice when possible."

A recent study, published online on Sept. 28 in the American Journal of Psychiatry, found that the use of ADHD medication is on the rise, with 5 percent of American children now taking stimulant medications such as Ritalin or Adderall to treat the disorder. Those researchers suggested that the increase might be due to a greater recognition of ADHD as a chronic condition, leading to children staying on medications for longer periods.

The new guidelines recommend that unless a child in the 4- to 6-year-old age group has a serious problem, that behavior therapy should be the first treatment tried. If necessary, medications can be added later.

"Although there is less evidence [on outcomes for this age group], the hope is that starting treatment in preschool if a child has serious problems will lead to better outcomes," said Wolraich.

Dr. Richard Gallagher, director of special projects at the Institute for Attention-Deficit Hyperactivity and Behavior Disorders at the NYU Child Study Center in New York City, said, "Medications should be used very carefully. I'm admittedly biased since I primarily do behavioral work, but behavioral work does have its limits. If a child is getting into dangerous situations or presenting with problems interacting appropriately with peers and adults, medications can be very useful. When monitored carefully, medications are safe for the vast majority of kids."

The guidelines also emphasize the need for pediatricians to recognize that ADHD is a chronic condition, and while treatments are available to control symptoms, there is no cure for the disorder.

Wolraich said that one of the reasons the AAP expanded the age up to 18 is because there have been more studies showing that ADHD continues into late adolescence, and even into adulthood.

"ADHD is a chronic condition. We can provide symptomatic treatment, bu
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