Professional group seeks consistency in diagnosing attention deficiency in children

May 2, 2000
Web posted at: 12:31 p.m. EDT (1631 GMT)

From staff reports

ATLANTA (CNN) -- The American Academy of Pediatrics urged pediatricians and family doctors to take a more active role in diagnosing attention deficit/hyperactivity disorder (ADHD) in children, and issued guidelines Monday to help them.

"ADHD is the most common neurobehavioral disorder of childhood," the Academy reported in this month's issue of the journal Pediatrics. "ADHD is also among the most prevalent chronic health conditions affecting school-aged children."

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Researchers estimated that 4 to 12 percent of youngsters -- some 2.5 million -- may be affected. Children with ADHD often exhibit a pattern of inattention, hyperactivity and impulsiveness, and may have trouble in school or relating to their peers. These problems can seriously interfere with a child’s development and continue into adult life, academy researchers said.

Prescriptions of the drug Ritalin to control ADHD have increased several-fold over the past decade, leading many experts to worry that the disorder is being overdiagnosed. But others have a different fear.

"Over-treatment and overdiagnosis does happen, but the much bigger problem to my mind is that many children are being missed and ignored," said Dr. Peter Jensen of Columbia University.

Experts say more than 1.5 million children who could benefit from treatment are not getting it. The researchers issued the guidelines to help establish consistency in diagnosing ADHD.

They recommended that doctors evaluate children between the ages of six and 12 who exhibit symptoms over the course of two or three office visits. In addition to conducting a routine medical exam to rule out other causes, the researchers said physicians should routinely ask parents the following questions:

• How is your child doing in school?
• Are there any problems with learning that you or the teacher has seen?
• Is your child happy in school?
• Are you concerned with any behavioral problems in school, at home, or when your child is playing with friends?
• Is your child having problems completing classwork or homework?

The committee also said doctors should get evidence directly from the child’s classroom teachers or other school professional before diagnosing ADHD. In addition, doctors should evaluate children for psychological conditions that often accompany ADHD, such as depression or learning disabilities.

The committee of respected practitioners in pediatrics, neurology, psychology, child psychiatry, family medicine, education and associated fields developed the guidelines over a period of two years.

The group is expected to issue guidelines for treating ADHD early next year. Until then, a recent study shows children with ADHD do best with a combination of treatments -- including stimulant drugs like Ritalin, behavior therapy and parent training.

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American Academy of Pediatrics
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