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A clinical study of attention-deficit/hyperactivity disorder in preschool children--prevalence and differential
Kenji Nomura1, Kaori Okada1, Yoriko Noujima2
1Center for Developmental Clinical Psychology and Psychiatry, Nagoya University, Nagoya, Japan.
Insights
Attention-Deficit/Hyperactivity Disorder (ADHD) affects 5.8% of preschoolers. This study establishes a diagnostic baseline for ADHD in early childhood, differentiating it from other developmental and behavioral conditions.
Area of Science:
- Child Psychology
- Developmental Pediatrics
- Neurodevelopmental Disorders
Background:
- Preschool children exhibiting inattention and hyperactivity-impulsivity require careful diagnostic evaluation.
- Understanding the prevalence and characteristics of ADHD in early childhood is crucial for timely intervention.
Purpose of the Study:
- To determine the prevalence and characteristics of Attention-Deficit/Hyperactivity Disorder (ADHD) in preschool-aged children.
- To differentiate ADHD diagnoses from other conditions presenting with similar symptoms in early childhood.
Main Methods:
- A cohort of 583 Japanese preschoolers (age 5) were screened for ADHD symptoms.
- Follow-up assessments including consultations, preschool visits, and behavioral observations were conducted.
- Diagnoses were made by child psychiatrists and clinical psychologists based on DSM-IV-TR criteria.
Main Results:
- 15.6% of children were initially suspected of having ADHD, with 5.8% ultimately diagnosed.
- Differential diagnoses included pervasive developmental disorders (6.6%), intellectual comprehension problems (4.4%), and anxiety disorders (7.7%).
- A significant portion of initially suspected cases had unclear diagnoses (31.9%) or other issues like abuse/neglect (4.4%).
Conclusions:
- Preschool ADHD symptom presentation can be context-dependent and evolve with development.
- This study provides essential prevalence data to establish a diagnostic baseline for early childhood ADHD.
- Accurate differential diagnosis is key for appropriate management of inattentive and hyperactive-impulsive behaviors in young children.
Objective:
We aimed to examine (1) the prevalence and characteristics of ADHD in preschool children, and (2) differential diagnoses among children who display symptoms of inattention and hyperactivity-impulsivity in early childhood.
Methods:
The participants were children living in Kanie-cho, in Japan's Aichi Prefecture, who underwent their age 5 exams at the municipal health center between April 2009 and March 2011. We first extracted children who were observed to be inattentive or hyperactive-impulsive during their age 5 exams and considered as possibly having ADHD. We conducted follow-ups with these children using post-examination consultations, visits to preschools, and group rehabilitation. The results of the age 5 exams were combined with behavior observations and interview content obtained during subsequent follow-ups. A child psychiatrist and several clinical psychologists discussed these cases and made a diagnosis in accordance with the DSM-IV-TR.
Results:
91 (15.6%) of the 583 children selected were considered as possibly having ADHD; we were able to conduct follow-ups with 83 of the 91 children. Follow-up results showed that 34 children (5.8% of all participants) remained eligible for a diagnosis of ADHD. Diagnoses for the remaining children included: pervasive developmental disorders (six children, or 6.6% of suspected ADHD children), intellectual comprehension problems (four children, or 4.4%), anxiety disorders (seven children, or 7.7%), problems related to abuse or neglect (four children, or 4.4%), a suspended diagnosis for one child (1.1%), and unclear diagnoses for 29 children (31.9%).
Conclusions:
ADHD tendencies in preschool children vary with changing situations and development, and the present study provides prevalence estimates that should prove useful in establishing a diagnostic baseline.
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