Can ADHD be diagnosed in children as young as 4?

Can children as young as 4 be diagnosed and treated for attention deficit hyperactivity disorder (ADHD). Yes, according to updated guidelines from the American Academy of Paediatrics.

Previous guidelines covered ADHD in kids 6 through 12. The latest ones address children ages 4 to 18, because there is additional research on that age range, says Mark Wolraich, chair of the committee that prepared the report, released Sunday at the American Academy of Paediatrics National Conference in Boston.

Earlier treatment can help the children and reduce family stress, he says. "These children may have been kicked out of preschool programs or they may have parents who are really getting angry at them much of the time."

ADHD occurs in about 8% of children and teens, he says.

The guidelines recommend that primary-care providers initiate an evaluation for ADHD in any children ages 4 to 18 who appear with symptoms of inattention, hyperactivity or impulsivity, says Wolraich, professor of paediatrics at the University of Oklahoma Health Sciences Center in Oklahoma City.

The first line of treatment for preschool children who have ADHD lies with parents. Through behaviour therapy, parents need to learn to be consistent in giving positive reinforcement for appropriate behaviours and ignoring or punishing inappropriate ones, he says.

If the young children do not show significant improvements with these behaviour techniques and they have moderate to severe ADHD symptoms, physicians can consider prescribing Ritalin, but doctors should start with low doses and go slowly, he says.

"We know that early intervention makes a difference — the sooner ADHD is identified and treated, the better for the child," says Ruth Hughes, chief executive officer of CHADD, Children and Adults with Attention-Deficit/Hyperactivity Disorder.

Word learning better in deaf children who receive cochlear implants by age 13 months

Word learning better in deaf children who receive cochlear implants by age 13 months

A growing body of evidence points to the importance of early auditory input for developing language skills. Indiana University Department of Otolaryngology researchers have contributed to that evidence with several projects, including their study involving 20 deaf children (22- to 40-months-old and 12 to 18 months after cochlear implantation) and 20 normal hearing children (12- to 40-months of age) that was presented Feb. 21 at the AAAS meeting.

The study's principal author, Derek Houston, Ph.D., associate professor and Philip F. Holton Scholar at the IU School of Medicine, said the study found that deaf children's word-learning skills were strongly affected by their early auditory experience.

"This research is significant because surgery at very young ages requires more expertise," said Dr. Houston. "It is important to know if the increased benefit of early auditory input warrants surgery at younger ages."

Currently, the Food and Drug Administration guidelines approve cochlear implantation at one year of age, although many children are implanted as young as 6 months of age.

Dr. Houston said the research showed that deaf children's word-learning skill was strongly affected by their early auditory experience, whether that experience was through normal means or with a cochlear implant.

Children who received the implant by the age of 13 months performed similarly to their normal-hearing counterparts while children who received a cochlear implant later performed, on average, more poorly than their normal-hearing peers.