Review of clinical guidelines for children and adolescents with attention deficit hyperactivity disorder and their application to an Irish context

2014 ◽  
Vol 32 (3) ◽  
pp. 283-293 ◽  
Author(s):  
G. Kavanagh ◽  
S. O’Hanrahan ◽  
G. Hughes ◽  
F. McNicholas
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Healthcare System ◽  
Attention Deficit ◽  
Clinical Guidelines ◽  
Care Pathway ◽  
Neurodevelopmental Disorder ◽  
Clinical History ◽  
Hyperactivity Disorder ◽  
Irish Context

Background:Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with international prevalence rates estimated to be 5%. It is currently the most common disorder treated in Child and Adolescent Mental Health Services in Ireland. There have been a number of guidelines worldwide produced to aid clinicians in the diagnosis and treatment of ADHD; however, there are no guidelines available specifically for the Irish population and healthcare system.Objectives:The aim of this paper is to review the available clinical guidelines for the diagnosis and management of ADHD in children adolescents across North America, Canada, Europe and the United Kingdom and to apply these to an Irish context.Methods:A number of international guidelines were reviewed. A proposed pathway for the assessment and treatment of children and adolescents with ADHD has been devised with the recommendation that a formalised consensus guideline should be implemented.Conclusion:This review paper has highlighted that there is consensus between the guidelines for the diagnosis of ADHD with a thorough clinical history remaining the gold standard. They further agree on the importance of identifying co-morbid disorders. When it comes to the treatment, the guidelines are less unified. This current paper has devised a proposed care pathway for ADHD in Ireland to ensure high quality cost effective care within its healthcare system.

Review of international clinical guidelines for adolescents on transition to Adult Mental Health Services and adults with attention-deficit hyperactivity disorder and their application to an irish context

2016 ◽  
Vol 34 (1) ◽  
pp. 59-73 ◽  
Author(s):  
G. C. Hughes ◽  
S. O’Hanrahan ◽  
G. Kavanagh ◽  
F. McNicholas
Keyword(s):  
Mental Health ◽  
Attention Deficit Hyperactivity Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Attention Deficit ◽  
Clinical Guidelines ◽  
Diagnosis And Management ◽  
Hyperactivity Disorder ◽  
Adult Mental Health ◽  
Irish Context

ObjectivesTo review the available clinical guidelines from Canada, North America, Europe and the United Kingdom for the diagnosis and management of attention-deficit hyperactivity disorder (ADHD) for adolescents previously diagnosed in Child and Adolescent Mental Health Services (CAMHS) on transition to Adult Mental Health Services (AMHS) and for adults presenting with a diagnostic query re-ADHD. This article seeks to apply the available guidelines to an Irish context.MethodVarious clinical guidelines and consensus statements were identified by a literature search of PubMed, incorporating literature from the past 10 years from English speaking countries and inclusion of any additional guidelines of clinical relevance. A clinical guideline with specific reference for Irish clinicians was proposed for the diagnosis and management of adults presenting for the first time with a diagnostic query re-ADHD and also to include those young adults previously diagnosed in CAMHS on transition to AMHS.ConclusionsADHD is a lifelong disorder, which if undiagnosed or untreated can lead to significant impairment resulting in a high economic cost for society. Stimulant medication is a first-line treatment option for adults with ADHD; however, some formulations are unlicensed in Ireland. Recent licensing of Atomoxetine, for both adolescents on transition and for adults with newly diagnosed ADHD is a welcome development. Third-line agents are rarely prescribed due to their side effect profiles and are prescribed off-label:It is important to establish clinical guidelines for an Irish context incorporating a biopsychosocial approach. Further discussion amongst clinicians and stakeholders is needed to plan service development.

A child with inattention, hyperactivity, and impulsivity

2021 ◽  
pp. 25-34
Author(s):  
Sirin Ozdemir ◽  
Craig L. Donnelly
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Behavioral Interventions ◽  
Neurodevelopmental Disorder ◽  
Clinical History ◽  
Educational Interventions ◽  
Preschool Age ◽  
First Line ◽  
Hyperactivity Disorder ◽  
Pharmacologic Treatments

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that manifests in childhood with symptoms of inattention, hyperactivity, and impulsivity. The symptoms must occur in more than one setting and cause an impairment in functioning. Attention-deficit/hyperactivity disorder is one of the most common neurobehavioral disorders of childhood and may persist into adulthood. The assessment for ADHD should include a clinical history, review of information about school functioning, and assessment of common comorbid psychiatric disorders. Children with ADHD may be unaware of their symptoms, highlighting the need for collateral information from parents and teachers. Treatment may involve behavioral/psychologic interventions, educational interventions, and medications. Behavioral interventions are the first-line approach for preschool-age children, while medication treatment should be considered the first-line approach for school-aged children and adolescents. Pharmacologic treatments include stimulant and nonstimulant medications.

scholarly journals Behavioral and Electrophysiological Correlates of Performance Monitoring and Development in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

2020 ◽  
Vol 10 (2) ◽  
pp. 79 ◽  
Author(s):  
Yanni Liu ◽  
Gregory L. Hanna ◽  
Barbara S. Hanna ◽  
Haley E. Rough ◽  
Paul D. Arnold ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Child Behavior Checklist ◽  
Performance Monitoring ◽  
Longitudinal Design ◽  
Flanker Task ◽  
Developmental Trajectory ◽  
Time Variability ◽  
Hyperactivity Disorder

The pathophysiology of attention-deficit/hyperactivity disorder (ADHD) involves deficits in performance monitoring and adaptive adjustments. Yet, the developmental trajectory and underlying neural correlates of performance monitoring deficits in youth with ADHD remain poorly understood. To address the gap, this study recruited 77 children and adolescents with ADHD and 77 age- and gender-matched healthy controls (HC), ages 8–18 years, who performed an arrow flanker task during electroencephalogram recording. Compared to HC, participants with ADHD responded more slowly and showed larger reaction time variability (RTV) and reduced post-error slowing; they also exhibited reduced error-related negativity (ERN) and error positivity effects, and reduced N2 and P3 congruency effects. Age effects were observed across groups: with increasing age, participants responded faster, with less variability, and with increased post-error slowing. They also exhibited increased ERN effects and increased N2 and P3 congruency effects. Increased RTV and reduced P3 amplitude in incongruent trials were associated with increased ADHD Problems Scale scores on the Child Behavior Checklist across groups. The altered behavioral and ERP responses in ADHD are consistent with the pattern associated with younger age across groups. Further research with a longitudinal design may determine specific aspects of developmental alteration and deficits in ADHD during performance monitoring.

scholarly journals A Cross-Sectional Study of 0.6 Million Children with Attention-Deficit/Hyperactivity Disorder in the United States

2020 ◽  
Vol 10 (01) ◽  
pp. e97-e103
Author(s):  
Irene Rethemiotaki
Keyword(s):  
United States ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Family Income ◽  
Neurodevelopmental Disorder ◽  
Multiple Logistic Regression Analysis ◽  
The United States ◽  
Cross Sectional ◽  
Children With Adhd ◽  
Hyperactivity Disorder

AbstractAttention-deficit hyperactivity disorder (ADHD) is an increasingly recognized chronic neurodevelopmental disorder. This work aims at studying the prevalence and clinical characteristics of children with ADHD in the United States in the period between 2009 and 2018. Data from the National Health Interview Survey were analyzed by univariate and multivariate statistics to assess the role of socioeconomic factors in the development of ADHD. It has been studied 615,608 children, 51.2% male and 48.7% female. The prevalence of ADHD was 9.13%, with males predominating over females. The number of children with ADHD increased from 2009 to 2018 by 14.8%. As specified by multiple logistic regression analysis, males (odds ratio [OR] 2.38) who have neither mother nor father (OR 1.76) are twice as likely to have ADHD compared with their peers. In addition, family income (OR 1.40) and parent's education (OR 1.12) were significantly associated with ADHD. It has been highlighted the significance of deprivation of both family and financial comfort as primary indicators for ADHD in children. Moreover, children with ADHD were more likely to be males in the age group of 12 to 17.

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