[Hyperkinetic disorders with attention deficit. Diagnostic and therapeutic approach]

Attention deficit disorder (ADD) is the most common neurobehavioral disorder in the pediatric age group. The development of diagnostic criteria based on the "diagnostic and statistical manual of Mental Disorders" represents an advance in the reliable and valid diagnosis of ADD. An examination of neuromaturational signs (soft signs) and neuropsychologic and psychometric tests to specify the behavioral functions and the origin of learning disabilities are very important. ADD must be differentiated from other conditions such as psychiatric, developmental, neurological, psychosocial and environmental disorders. Management of the child with ADD should focus on the optimization of an educational plan. When stimulant pharmacotherapy is used, the physician must determine not only the optimal time at which pharmacotherapy should be initiated, but also the particular symptoms he hopes to ameliorate. The action and side-effects of pharmacotherapy are discussed. Psychotherapy or other specific associated therapy should be also proposed.