Evaluation and Management of Attention-Deficit/ Hyperactivity Disorder (ADHD) in Children and Adolescents

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Children and adolescents with ADHD are at increased risk for behavioral issues, academic issues, substance abuse issues, and legal problems. Approximately 50% of cases of childhood ADHD will persist into adulthood where it can impact employment, organizational skills, and frustration tolerance. Use of amphetamine and methylphenidate stimulant medications have shown to have the best outcomes, and are considered first line treatments. It is important to monitor stimulant use closely in individuals with substance abuse concerns, however, studies in adolescents with both substance abuse histories and ADHD tend to support their use and benefits. It is important to identify other co-morbid conditions that a patient with ADHD may be struggling with and treat those accordingly. Providers should re-evaluate the symptoms and clinical presentation of patients that show minimal or no improvement with treatment to ensure a proper diagnosis has been made.