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Diagnosis and management of children with attention deficit hyperactivity disorder

  • Symposium on Neurodevelopmental Disorders-II
  • Published:
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Abstract

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent childhood psychiatric disorder which is characterized by three core symptoms of inattention, hyperactivity and impulsivity. It is estimated that 5% to 10% of school aged children suffer from this disorder. This disorder is more common in boys than girls. Comorbidity is a major problem and is present in as many as two thirds of children with ADHD. A multiple modality approach to treatment which combines pharmacotherapy, psycho education, behaviour therapy, environmental changes and social skills training is recommended. The outcome of ADHD is variable and unless properly treated in early years may predispose the child to serious psychopathology in adulthood.

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References

  1. American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 3rd edn (DSM III). Washington D.C.; American Psychiatric Association, 1980.

    Google Scholar 

  2. American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 3rd edn revised (DSM III-R). Washington D.C.; American Psychiatric Association, 1987.

    Google Scholar 

  3. American Psyschiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 4th edn (DSM IV). Washington D.C., American Psychiatric Association. 1994.

    Google Scholar 

  4. Biederman J, Newcorn J, Spirch S. Comorbidity of attention deficit hyperactivity disorder with conduct, depression, anxiety, and other disorders.Am J Psychiatry 1991; 148: 564–577.

    PubMed  CAS  Google Scholar 

  5. Jensen PS, Martin D, Cantwell DP. Comorbidity in ADHD: Implications for research, practice and DSM-V.J Am Acad Child Adolesc Psychiatry 1997; 36: 1065–1079.

    PubMed  CAS  Google Scholar 

  6. P Malhi, P Singhi. Spectrum of attention deficit hyperactivity disorder in children among referrals to psychology services.Indian Pediatr 2000; 37: 1256–1260.

    PubMed  CAS  Google Scholar 

  7. Barkley RA, Fischer M, Edelbrock CS, Smallish L. The adolescent outcome of hyperactive children diagnosed by research criteria 1: An 8-year prospective follow-up study.J Am Acad Adolesc Psychiatry 1990; 29: 546–557.

    Article  CAS  Google Scholar 

  8. Weiss G, Hechtman L.Hyperactive Children Grow up. New York; Guilford Press, 1993.

    Google Scholar 

  9. Cantwell DP. Attention deficit disorder: A review of the past 10 years.J Am Acad Child Adolesc Psychiatry 1996; 35 : 978–987.

    Article  PubMed  CAS  Google Scholar 

  10. American Academy of Child and Adolescent Psychiatry. Practice parameters for the assessment and treatment of children, adolescents and adults with attention deficit/hyperactivity disorder.J Am Acad Child Adolesc Psychiatry 1997; 36 (Suppl) 085S-12IS.

    Article  Google Scholar 

  11. Anderson JC, Williams S, McGee R, Silva PA. DSM III disorders in. preadolescent children.Arch Gen Psychiatry 1987; 44: 69–76.

    PubMed  CAS  Google Scholar 

  12. Swanson JM, Sergeant JA, Taylor E et al. Attention deficit hyperactivity disorder and hyperkinetic disorder.Lancet 1998; 351–429–433.

  13. Bhatia MS, Nigam VR, Bohra N, Malik SC. Attention deficit disorder with hypreactivity among pediatric outpatients.J Child Psychol Psychiatry 1991; 32: 297–306.

    Article  PubMed  CAS  Google Scholar 

  14. Bhatia MS, Chaudhary S, Sidana A. Attention deficit hyperactivity disorder among psychiatric outpatients.Indian Pediatr 1999; 36: 583–587.

    PubMed  CAS  Google Scholar 

  15. Wolraich ML, Hannah JN, Pinnock TY, Baumgaertel A, Brown J. Comparison of diagnostic criteria for attention deficit hyperactivity disorder in a country wide sample.J Am Acad Child Adolesc Psychiatry 1996; 35: 319–324.

    Article  PubMed  CAS  Google Scholar 

  16. Baumgaertel A, Wolraich ML, Dietrich M. Comparison of diagnostic criteria for attention deficit disorders in German elementary school.J Am Acad Child Adolesc Psychiatry 1995; 34: 629–638.

    Article  PubMed  CAS  Google Scholar 

  17. Szatmari P, Offord DR, Boyle MH. Ontario Child health study: Prevalence of attention deficit hyperactivity disorder with hyperactivity.J Child Psychol Psychiatry 1989; 30 : 219–230.

    Article  PubMed  CAS  Google Scholar 

  18. Sleator E, Ullman R. Can the physician diagnose hyperactivity in the office ?Pediatrics 1988; 67: 13–17.

    Google Scholar 

  19. Hynd GW, Semrud-Clikeman M, Lorys AR, Novey ES, Ellophes D. Brain morphology in developmental dyslexia and attention deficit disorder with hyperactivity.Arch Neurol 1990; 47: 919–926.

    PubMed  CAS  Google Scholar 

  20. Giedd JN, Castenalos FX, Korzuch Pet al. Quantitative morphology of the corpus callosum in attention deficit hyperactivity disorder.Am J Psychiatry 1994; 151: 665–669.

    PubMed  CAS  Google Scholar 

  21. Steere G, Arnsten AFT. Corpus callosum morphology in ADHD.Am J Psychiatry 1995; 152: 1105–1107.

    PubMed  CAS  Google Scholar 

  22. Zametkin AJ, Nordahl TE, Grosset al. Cerebral Glucose metabolism in adults with hyperactivity of childhood onset.N Engl J Med 1990; 323: 1361–1366.

    Article  PubMed  CAS  Google Scholar 

  23. Rostain AL. Attention deficit disorders in children and adolescents.Pediatr Clin North Am 1991; 38: 607–635.

    PubMed  CAS  Google Scholar 

  24. Zametkin A, Rapaport JL. Neurobiology of attention deficit disorder with hyperactivity: Where have we come in 50 years ?J Am Acad Child Adolesc Psychiatry 1987; 26 : 676–686.

    Article  PubMed  CAS  Google Scholar 

  25. Whalen CK. Attention deficit and hyperactivity disorder. In Olendick TH, Hersen M, eds.Handbook of Child Psychopathology. 2nd edn. New York, Plenum Press, 1989; 131–169.

    Google Scholar 

  26. Paternite CE, Loney J. Childhood hyperkinesis: Relationship between symptomatology and home environment. In Whalen CK, Henker B, eds.Hyperactive Children: The Social Ecology of Identification and Treatment. Orlando, Academic Press, 1980; 105–141.

    Google Scholar 

  27. Arnold LE, Jensen PS. Attention deficit disorders. In Kaplan HI, Sadok BJ, eds.Comprehensive Text book of Psychiatry. 7th edn. Baltimore, Williams and Wilkins, 1995; 2295–2310.

    Google Scholar 

  28. Reiff MI, Banez GA, Culbert TP. Children who have attentional disorders: diagnosis and evaluation.Pediatr Rev 1993; 12: 455–465.

    Google Scholar 

  29. Kelly DP, Aylward GP. Attention deficits in school-aged children and adolescents: Current issues and practice.Pediatr Clin North Am 1992; 39 : 487–511.

    PubMed  CAS  Google Scholar 

  30. Achenbach TM, Edelbrock C.Manual for the Child Behaviour Checklist and Revised Child Behaviour Profile. Burlington, University of Vermont, 1983.

    Google Scholar 

  31. Achenbach TM. Manual for the Teacher’s Report Form and 1991 Profile. Burlington; University of Vermont, 1991.

    Google Scholar 

  32. Conners CK.Manual for Conner’s Rating Scales. North Tomananda, New York, Multi Health Systems, 1989.

    Google Scholar 

  33. Shaywitz SE, Shaywitz BA, Schnell C. Concurrent and predictive validity of the Yale Children’s Inventory: An instrument to assess children with attentional deficits and learning disabilities.Pediatr 1988; 81 : 562–571.

    CAS  Google Scholar 

  34. Barkley RA, Edelbrock C. Assessing situational variation in children’s problem behaviour: The home and school situations questionnaires. In Prinz RJ, ed.,Advances in Behavioural Assessment of Children and Families. Greenwich, TAI Press, 1987, 157–176.

    Google Scholar 

  35. Landman GB, McCrindle B. Pediatric management of non pervasively “hyperactive” children.Clin Pediatr (Phila) 1986; 25: 600–604.

    Article  CAS  Google Scholar 

  36. Brud L, Kerbeshian J, Fisher W. Does the use of phenobarbital as an anti convulsant permanently exacerbate hyperactivity ?Can J Psychiatry 1987; 32: 10–13.

    Google Scholar 

  37. Mc Gee R, Share DL. Attention deficit disorder-Hyperactivity and academic failure which comes first and what should be treated ?J Am Acad Adolesc Psychiatry 1988; 27: 318–325.

    Article  CAS  Google Scholar 

  38. Murir K, Biederman J, Knee D. Psychiatric comorbidity in patients with attention deficit disorder: A controlled study.J Am Acad Child Adolesc Psychiatry 1987, 6: 844–848.

    Google Scholar 

  39. Newcorn JH, Halperin JM. Comorbidity among disruptive behaviour disorders: Impact on severity, impairment and response to treatment.Child Adolesc Psychiatr Clin North Am 1994; 3 : 227–252.

    Google Scholar 

  40. August GJ, Garfinkel BD. Comorbidity of ADHD and reading disability among clinic referred children.J Abnorm Child Psychol 1990; 18: 29–45.

    Article  PubMed  CAS  Google Scholar 

  41. Anderson JC, Williams S, Mc Gee R, Silva PA. DSM III disorders in pre-adolescent children: prevalence in a large sample from the general population.Arch Gen Psychiatry 1987; 44: 69–76.

    PubMed  CAS  Google Scholar 

  42. Hechtman L. Aims and methodological problems in multimodal treatment studies.Can J psychiatry 1993; 38: 458–464.

    PubMed  CAS  Google Scholar 

  43. Forehand RL, McMahon RJ. Helping the non compliant child: A clinician’s guide to parent training. New York: Guilford 1981.

    Google Scholar 

  44. Ayllon T, Rosenbaum MS. The behavioural treatment of disruption and hyperactivity in shcool setting. In Lahey BB, Kazdin AE, eds.Advances in Clinical Child Psychology, New York, Plenum Press, 1977; 83–118.

    Google Scholar 

  45. Dubey DR, O’Leary SG, Kaufman KF. Training parents of hyperactive children in child management: a comparitive outcome study.J Abnorm Child Psychol 1983; 11: 229–246.

    Article  PubMed  CAS  Google Scholar 

  46. Abromowitz AJ. Classroom interventions for disruptive behaviour disorders.Child Adolesc Psychiatr Clin North Am 1994; 3: 343–360.

    Google Scholar 

  47. Malhi P, Singhi P. Psychosocial management of attention deficit hyperactivity disorder in school aged children: Some guidelines for school teachers.J Comm Guid Res 1998; 15: 311–323.

    Google Scholar 

  48. Ziegler R, Holden L. Family therapy for learning disabled and attention-deficit disordered children.Am J Orthopsychiatry 1988; 58: 196–210.

    Article  PubMed  CAS  Google Scholar 

  49. Barkley RA. The effects of methylphenidate on the interactions of preschool ADHD children and their mothers.J Am Acad Child Adolesc Psychiatry 1988; 27: 336–341.

    Article  PubMed  CAS  Google Scholar 

  50. Dadds MR, Schwartz S, Sanders MR. Martial discord and treatment outcome in behavioural treatment of child conduct disorders.J Consult Clin Psychol 1987; 55: 396–403.

    Article  PubMed  CAS  Google Scholar 

  51. Erhardt D, Hinshaw SP. Initial sociometric impressions of attention deficit hyperactivity disorders and comparison boys: Predictions from social behaviour and from non-behavioural variables.J Consult Clin Psychol 1994; 62 : 833–842.

    Article  PubMed  CAS  Google Scholar 

  52. Hinshaw SP, Melnick SM. Peer relationships in boys with attention deficit hyperactivity disorder with and without comorbid aggression.Dev Psychopathol 1995; 7: 627–647.

    Article  Google Scholar 

  53. Whalen CK, Henker B. The social profile of attentiondeficit hyperactivity disorder: Five fundamental facets.Child Adolesc Psychiatr Clin North Am 1992; 1, 395–410.

    Google Scholar 

  54. Abikoff H. An evaluation of cognitive behaviour therapy for hyperactive children. In: Lahey BB, Kazdin AE eds.Advances in Clinical Child Psyhology, Vol. 10, New York, Plenem Press, 1987, 171–216.

    Google Scholar 

  55. Hinshaw SP, Erhardt D. Attention deficit hyperactivity disorder. In Kendall PC, ed.Child and Adolescent Therapy: Cognitive-behavioural Procedures. New York, Guilford Press, 1991; 98–128.

    Google Scholar 

  56. Hinshaw SP, Henker B, Whalen CK. Self-control in hyperactive boys in anger-inducing situations: effects of cognitive-behavioural training and of methylphenidate.J Abnorm Child Psychol 1984, 12: 55–77.

    Article  PubMed  CAS  Google Scholar 

  57. Abikoff H. Efficacy of cognitive training interventions in hyperactive children: a critical review.Clin Psychol Rev 1985, 5: 479–512.

    Article  Google Scholar 

  58. Hechtman L, Weiss G, Perlman T. Young adult outcome of hyperactive children who received long-term stimulant treatment.J Am Acad Child Adolesc Psychiatry 1984; 23: 261–265.

    Article  CAS  Google Scholar 

  59. Hechtman L. Adolescent outcome of hyperactive children treated with stimulants in childhood: a review.Psychopharmacol Bull 1985; 21 : 178–194.

    PubMed  CAS  Google Scholar 

  60. Elia J. Drug treatment for hyperactive children: Therapeutic guidelines.Drugs 1993; 46 : 863–871.

    PubMed  CAS  Google Scholar 

  61. Swanson JM. Effect of stimulant medication on children with attention deficit disorder: a “review of reviews”.Exceptional Child 1993; 60: 154–162.

    Google Scholar 

  62. Johnston C, Pelham WE, Hoza J. Psychostimulant rebound in attention deficit disordered boys.J Am Acad Child Adolesc Psychiatry 1988; 27: 806–810.

    Article  PubMed  CAS  Google Scholar 

  63. Hunt, RD, Minderaa RB, Cohen DJ. Clonidine benefits children with attention deficit disorder and hyperactivity: report of a double blind placebo cross over therapeutic trial.J Am acad Child Adolesc Psychiatry 1985; 24 : 617–629.

    Article  CAS  Google Scholar 

  64. Hunt RD, Lau S, Ryu J. Alternative therapies for ADHD. In Greenhill LL, Osman BB. eds.Ritalin: Theory and Patient Management. New York, Mary Ann Liebert, 1999, 75–95.

    Google Scholar 

  65. Gammon GD, Brown TE. Fluxetine augumentation of methylphenidate for attention deficit and comorbid disorders.J Child Adolesc Psycho pharmacol 1993; 3: 1–10.

    CAS  Google Scholar 

  66. Hechtman L. Resilience and vulnerability in long term outcome of attention deficit hyperactivity disorder.Can J Psychiatry 1991; 36: 415–421.

    PubMed  CAS  Google Scholar 

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Correspondence to Prahbhjot Malhi.

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Malhi, P., Singhi, P. Diagnosis and management of children with attention deficit hyperactivity disorder. Indian J Pediatr 68, 547–555 (2001). https://doi.org/10.1007/BF02723251

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