ADHD Guidelines Released

The American Academy of Pediatrics issued its first-ever guidelines for the treatment of attention-deficit/hyperactivity disorder (ADHD) yesterday, under the direction of a reporting committee co-chaired by Harvard Medical School Professor of Pediatrics James M. Perrin.

The newly released guidelines defend the efficacy of drug treatment of ADHD but also suggest that behavioral therapy be used to supplement medicine.

ADHD affects as many as 3.8 million children annually, with three times as many boys diagnosed as girls. Its symptoms include difficulty concentrating, poor impulse control, and repeated disciplinary problems.

“Doctors are really asking us for advice on better diagnosis and treatment,” said Perrin, who works out of Massachusetts General Hospital. He credited new research on the success of medicinal therapy for making widespread agreement on the guidelines possible.

This research, according to Perrin, indicates that doctors should develop balanced treatment plans.

“Most children with routine ADHD should get a combination of stimulant medications and behavioral therapy,” he said.

Perrin’s committee’s report also recommends greater cooperation and communication at all treatment levels for children with ADHD.

“It’s especially important that parents, teachers and doctors work together to form a team,” Perrin said.

There is no sure-fire method for diagnosing ADHD, and physicians that treat the condition are often criticized for over-prescribing stimulants like Ritalin.

“There are many things that cause people not to pay attention. ADHD is only one of them. There is no blood test; it is only a clinical diagnosis,” said Dr. Leonard A. Rappaport, director of developmental medicine at Children’s Hospital in Boston.

Rappaport estimates that 30 percent of his ADHD patients are not treated with medicines, though he said he has great confidence in their success.

“They give great efficacy if used judiciously, and with close follow-up they have very few side effects,” he said.

Perrin said he hopes the Academy’s recommendations lead to a greater confidence in medicinal treatments for ADHD.

“They do work, they do make kids better,” he said.