In evaluating children and adolescents for ADHD, clinicians should use standardized assessment tools or questionnaires such as the Vanderbilt or Conner’s rating scales ( 1, 6, 7). The symptoms must also result in impairment of social, academic, or other functioning, and the symptoms must not be better explained or attributed to another physical condition, mental health condition, or social situation ( 6- 8). The symptoms of inattention, hyperactivity, and impulsivity should be observed in at least two different settings, and must be present for 6 months or longer ( 8). ADHD is categorized into three subtypes: predominantly inattentive type ADHD, predominantly hyperactive/impulsive type ADHD, and combined type ( 8). The diagnosis of ADHD is based on the criteria outlined by The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ( 8). Commonly prescribed ADHD medications have dopaminergic and noradrenergic activities, suggesting this neurobiological role in etiology ( 9- 13). The underlying neuropathology of ADHD remains uncertain, but is likely multifactorial, including genetic causes, structural and functional differences in brain circuitry, and environmental and psychosocial factors. It is uncertain what the primary cause of the increased prevalence is, but factors such as changing diagnostic criteria, over- or misdiagnosis, or conversely heightened awareness and screening for ADHD may all play a role ( 1- 8). In the United States, two-thirds (3.5 million) of children and adolescents with ADHD were taking medication for treatment in 2011 ( 3, 4). This represents 11% of children and adolescents in this age range whose parents report ever having received an ADHD diagnosis ( 2- 4). Over the past several years, the prevalence of ADHD has been increasing by an average of 5% annually, with approximately 6.4 million children and adolescents in the United States, between the ages of 4 and17 years, having ever received a diagnosis of ADHD based on parent or caregiver reports ( 3, 4). Medical practitioners should evaluate for ADHD in any child over age 4 years who presents with symptoms of inattention, hyperactivity, or impulsivity and academic or behavioral difficulties ( 1, 2). ADHD affects not just young children, but can continue into adolescents and adulthood ( 1). It is a complex chronic condition that begins in childhood, and individuals diagnosed with ADHD are considered children and youth with special healthcare needs. Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in children and adolescents.
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