ADHD: An Update on Diagnosis and Treatment for Kids
Diagnosing attention deficit hyperactivity disorder (ADHD) is sometimes controversial. But for children with the condition, treatment options are working.
Drug Warnings continued...
The recommendation for the black-box warning created controversy, with some
FDA consultants maintaining that the label was especially important for adults
(increasingly being prescribed ADHD medications), who might have high
blood pressure. Many calling for the warning label concede that the
drugs have important benefits but say that increasing the awareness of the
potential risks is crucial.
"The real question is whether there is any risk for children without
heart problems," says Andrew Adesman, MD, chief of developmental and
behavioral pediatrics at the Schneider Children's Hospital, Lake Success,
As for the possible link to suicides, the ADHD drug Strattera is under
special scrutiny. In late 2005, the FDA issued a public health advisory after
reports of suicidal thoughts in five kids and a suicide attempt by one child in
a clinical trial involving 2,200 participants. The advisory cautioned doctors
and parents to watch for any behavior changes in children who were on the
Parents such as the Ryanses worry about misdiagnoses and overprescribing,
and experts concede that both can happen. But, Adesman says, overprescribing
and misdiagnosis are more likely to happen if the evaluation is not thorough
and is not done by a health care professional experienced in diagnosing and
treating the condition.
What Is ADHD?
Kids diagnosed with ADHD -- which was once known as attention deficit
disorder (ADD), or hyperactivity -- have trouble focusing on tasks, sitting
still, and paying attention. While most parents have occasionally wished that
their child would calm down and focus, ADHD behavior is more frequent and
extreme. The condition is diagnosed three times more often in boys than
ADHD is now the most common neurobehavioral disorder of childhood, according
to the American Academy of Pediatrics. "That doesn't mean [every child]
needs treatment," says Martin T. Stein, MD, professor of pediatrics at
University of California-San Diego. But, he adds, "It is very
Making the Diagnosis
ADHD tends to run in families, says Stein, who co-chaired the American
Academy of Pediatrics committee that developed guidelines for diagnosing and
treating ADHD. "It refers to three behaviors that cause impairment:
hyperactivity, impulsiveness, and inattention."