Unraveling ADHD for the pediatrician

To review current evidence on the pathophysiology, clinical features, differential diagnosis, and therapeutic management of Attention-Deficit/Hyperactivity Disorder (ADHD), emphasizing the pediatrician's role in diagnostic recognition and coordination of multidisciplinary care.

Narrative synthesis of the contemporary literature addressing genetic and neurobiological underpinnings, diagnostic criteria, comorbidities, and treatment strategies relevant to pediatric practice.

ADHD is a multifactorial neurodevelopmental disorder involving genetic predisposition and neurobiological alterations, particularly in cortico-subcortical circuits related to dopaminergic and noradrenergic modulation. Clinical presentation varies with age and context and may be accompanied by comorbidities such as learning disorders, anxiety, and depression. Diagnosis is clinical, based on standardized criteria and assessment across multiple settings, and requires exclusion of conditions that mimic ADHD. Management is multimodal, encompassing psychosocial interventions, school-based support, and, when indicated, pharmacological therapy. Pediatricians serve as the first point of contact and play a central role in early identification, family guidance, and integration of healthcare and educational teams.

Proactive pediatrician involvement is essential for early diagnosis and effective management of ADHD, supporting better prognosis and the child's overall development.