Attention Deficit Hyperactivity Disorder: Effectiveness of Treatment in At-Risk Preschoolers; Long-Term Effectiveness in All Ages; and Variability in Prevalence, Diagnosis, and Treatment. Executive Summary

摘要

Children with attention deficit hyperactivity disorder (ADHD), a condition characterized by inattention, overactivity, and impulsivity, are most frequently identified and treated in primary school. Population studies indicate that 5 percent of children worldwide show impaired levels of attention and hyperactivity. Boys are classified with ADHD approximately twice as frequently as girls, and primary schoolage children approximately twice as frequently as adolescents. ADHD symptoms exist on a continuum in the general population and are considered a disorder to a greater or lesser degree, depending on the source of identification (e.g., parent or teacher), extent of functional impairment, diagnostic criteria, and the threshold chosen for defining a case. The developmentally excessive levels of inattention, overactivity, and impulsivity characteristic of ADHD are present from an early age. However, preschoolers with early signs of ADHD may also have co-occurring oppositional noncompliant behaviors, temper tantrums, and aggression that overshadow symptoms of inattention and overactivity and confound the diagnosis. These behaviors may be given the more general label of disruptive behavior disorder (DBD), which includes oppositional defiant disorder (ODD) and conduct disorder (CD), as well as ADHD. If not already identified at an early age, preschool youngsters with ODD frequently meet criteria for ADHD by grade school.