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Practice Guideline
. 2019 Oct;144(4):e20192528.
doi: 10.1542/peds.2019-2528.

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

Mark L Wolraich  1 , Joseph F Hagan Jr  2   3 , Carla Allan  4   5 , Eugenia Chan  6   7 , Dale Davison  8   9 , Marian Earls  10   11 , Steven W Evans  12   13 , Susan K Flinn  14 , Tanya Froehlich  15   16 , Jennifer Frost  17   18 , Joseph R Holbrook  19 , Christoph Ulrich Lehmann  20 , Herschel Robert Lessin  21 , Kymika Okechukwu  22 , Karen L Pierce  23   24 , Jonathan D Winner  25 , William Zurhellen  26 ; SUBCOMMITTEE ON CHILDREN AND ADOLESCENTS WITH ATTENTION-DEFICIT/HYPERACTIVE DISORDER
Affiliations
Practice Guideline

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

Mark L Wolraich et al. Pediatrics. 2019 Oct.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is 1 of the most common neurobehavioral disorders of childhood and can profoundly affect children's academic achievement, well-being, and social interactions. The American Academy of Pediatrics first published clinical recommendations for evaluation and diagnosis of pediatric ADHD in 2000; recommendations for treatment followed in 2001. The guidelines were revised in 2011 and published with an accompanying process of care algorithm (PoCA) providing discrete and manageable steps by which clinicians could fulfill the clinical guideline's recommendations. Since the release of the 2011 guideline, the Diagnostic and Statistical Manual of Mental Disorders has been revised to the fifth edition, and new ADHD-related research has been published. These publications do not support dramatic changes to the previous recommendations. Therefore, only incremental updates have been made in this guideline revision, including the addition of a key action statement related to diagnosis and treatment of comorbid conditions in children and adolescents with ADHD. The accompanying process of care algorithm has also been updated to assist in implementing the guideline recommendations. Throughout the process of revising the guideline and algorithm, numerous systemic barriers were identified that restrict and/or hamper pediatric clinicians' ability to adopt their recommendations. Therefore, the subcommittee created a companion article (available in the Supplemental Information) on systemic barriers to the care of children and adolescents with ADHD, which identifies the major systemic-level barriers and presents recommendations to address those barriers; in this article, we support the recommendations of the clinical practice guideline and accompanying process of care algorithm.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the American Academy of Pediatrics board of directors. Dr Allan reports a relationship with ADDitude Magazine; Dr Chan reports relationships with TriVox Health and Wolters Kluwer; Dr Lehmann reports relationships with International Medical Informatics Association, Springer Publishing, and Thieme Publishing Group; Dr Wolraich reports a Continuing Medical Education trainings relationship with the Resource for Advancing Children’s Health Institute; the other authors have indicated they have no potential conflicts of interest to disclose.

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FIGURE 1
AAP rating of evidence and recommendations.
See this image and copyright information in PMC

References

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