[CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD): CLINICAL ACTIVITY IN ISRAEL]

This editorial relates to the study published in the current issue on how our current knowledge is practiced in screening, diagnosing and treating children suffering from ADHD in Israel. It seems that there is an awareness of the disorder by parents and teachers, thus there is no need for community screening. The roles of the different medical professions: pediatricians (after receiving training on ADHD), child neurologists and child psychiatrists are not clear enough and thus services are not utilized properly. The diagnosis demands a physical, developmental, psychosocial and mental evaluation, including information from multiple settings (home and school) and the use of validated questionnaires. The extremely common psychiatric differential diagnosis and comorbidities point to the importance of psychiatric consultation, just as neurological comorbidities demand a neurological evaluation in complex cases. The recommended treatment plan combines psychoeducation and a collaborative and flexible decision about the combination of pharmacological (most commonly stimulants) and evidence-based non-pharmacological treatments (mainly parent training and cognitive behavioral therapies). Since ADHD is a chronic and complex neurodevelopmental disorder, continuous and long term medical follow-up relating to both treatment targets and side effects are crucial, and are not adequately stressed in clinical practice.