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.
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