In 2001, after extensive review of the scientific literature, the American Academy of Pediatrics (AAP) published an evidence-based clinical practice guideline for the treatment of school age children who have ADHD. Pharmacologic intervention for ADHD was found to be more effective than behavioral treatment alone unless the child had coexisting conditions, such as anxiety or oppositional defiant disorder, where combination (medication and counseling) therapy was found to be more effective.
Medication for ADHD
Stimulant medications are the first line agents for the treatment of ADHD and are effective in reducing symptoms in 80% of children. Two categories of stimulant medication are available: (1) methylphenidate and (2) amphetamine compounds.
Most pediatricians have found that, for some children, a few medication trials may be needed to find the most effective medication. The primary mode of action of the medications is to enhance central nervous system catecholamine action increasing the availability of dopamine and norepinephrine in the frontal cortex of the brain that regulates attention, arousal, and impulse control.
Children who have ADHD and are treated with stimulants show improvement in attention to task and decrease in impulsivity and hyperactivity. These medications may also improve parent/child and teacher/ child interactions, reduce aggressive behavior, and improve the child’s academic productivity and accuracy.
Ongoing ADHD Treatment
Children who have a diagnosis of ADHD require longterm follow up because evidence is increasing that ADHD does not resolve as a child gets older. With aging, their hyperactive and impulsive symptoms improve. However, most children continue to meet criteria for ADHD as adolescents and adults.
Children whose ADHD is untreated are at increased risk for developing substance abuse problems, high risk behaviors, poor self esteem, and school/work failure. As a parent, if you feel that your child is having difficulties with any of the three core areas of ADHD, inattention, hyperactivity, and impulsivity, and it is adversely affecting their life in several areas such as school, home, social activities, you should discuss this with your pediatrician and make plans for a comprehensive physical exam with their doctor and psychological evaluation by a qualified psychologist or social worker experienced with ADHD. As pediatricians, we have seen the success stories of properly diagnosed and treated ADHD and will help you work out a plan that is best for your child.
This page was authored by Dr. Edward C. Davis