Attention deficit/hyperactivity disorder in preschool-age children: issues and concerns

The diagnosis of attention deficit/hyperactivity disorder (ADHD) in children has been steadily increasing over the past 10 years. ADHD is associated with numerous health, behavioral, social, and academic outcomes. The use of medication is common for the treatment of ADHD. However, the evidence base for pharmacological and non-pharmacological treatments for children younger than 6 years of age is limited. Both short-term and long-term studies of efficacy and safety of all interventions are needed in this population, especially the use of psychotropic medications. Understanding the long-term effects of psychotropic medication on the developing brains of preschoolers has important implications for outcomes into adulthood. Nonpharmacologic evidence-based interventions are available and should serve as the first line of treatment in this population. Future research needs include further evidence regarding specific curricula, dose, duration, delivery methods, and staff training to ensure optimal intervention outcomes.