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Objectives
ADHD
Outline
Controversial Topic
Frequent Topic for
Alternative Approaches
Demographics of ADHD
Demographics (Cont’d)
ADHD
The Management of ADD/ADHD Patients by Community Pediatricians:
National Guidelines
American Academy of Child and Adolescent Psychiatry- October, 1997
ACACP- February, 2002
AAP Guideline- Part 1-
AAP Guideline- Part 2- October, 2001
27th CCHMC
The “Evidence”
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Children who present with inattention, hyperactivity, impulsivity, academic underachievement or behavior problems 5-18 years of age
Why Adolescents?
Why not preschoolers?
Objectives of Guideline
GETTING STARTED
COMPONENTS OF ASSESSMENT
DSM-IV DIAGNOSTIC CRITERIA
Diagnostic Specificity
Great American Ball Park
Yankee Stadium
DSM-IV: ADHD SYMPTOMS
ADHD-INATTENTIVE TYPE
ADHD-HYPERACTIVE TYPE
DIAGNOSTIC NOMENCLATURE
DSM-IV: IMPAIRMENT
MEDICAL HISTORY
ALTERNATIVE DIAGNOSES
PMH: HIGH RISK ASSOCIATIONS
PHYSICAL EXAMINATION
LABORATORY TESTING
COMORBID CONDITIONS
COMORBIDITIES
THE OTHER 20%
SCREENING TOOLS
THE VANDERBILT FORM
VANDERBILT vs CONNERS
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Evidence based selection of Medication for the Treatment of ADHD in Children and Adolescents
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MTA Study:
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ADHD COMORBIDITY AND TREATMENT OUTCOMES IN THE MTA
Methylphenidate Dosage over time Lessons From the MTA
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Once-Daily Atomoxetine Treatment for Children & Adolescents with ADHD: A Randomized, Placebo-Controlled Study
Stimulant Rebound: How Common Is It and What does it Mean
Conclusions
Behavior Therapy
Target Behaviors
Behavior Therapy for ADHD
Parents
Parents
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Benefits of Group Treatment
School Interventions
Interventions with Child
What Behavior Therapy is NOT
Evidence for Behavior Therapy
MTA
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Limitations of Behavior Therapy
ADHD Task Force
Same Goal
How Do Parents and Providers
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Goals
Examples
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Emanuel Doyne, M.D., Phillip Lichtenstein, M.D., Daniel Nelson, M.D., Lori Stark, Ph.D.

ADHD Evidenced Based Guidlines