An update on the diagnosis and treatment of attention-deficit/hyperactivity disorder in children.

Abstract

What are the most appropriate empirically supported diagnostic and treatment approaches to children with attention-deficit/hyperactivity disorder (ADHD)? This article summarizes the nomenclature, prevalence and course, comorbidity, etiology, assessment, and federal laws associated with ADHD. The authors then review clinical research and consensus guidelines for the treatment of ADHD, including the largest randomized treatment study completed on ADHD (MTA Cooperative Group, 1999a). The empirical evidence supports either a behavioral–psychosocial or a combined behavioral–psychosocial and medication intervention in the treatment of children with ADHD. Thomas S. Kuhn (1962) wrote eloquently regarding the process and structure of scientific change 40 years ago. Initial interpretation of the Multimodal Treatment Study of Attention-Deficit/ Hyperactivity Disorder (MTA; MTA Cooperative Group, 1999a) presented somewhat of a Kuhnian crisis to the accepted and empirically supported approaches to the treatment of attentiondeficit/hyperactivity disorder (ADHD), with its finding that medical management was significantly more effective for the core symptoms of ADHD than behavioral–psychosocial treatment. However, subsequent analyses of the MTA, as well as previous and subsequent research and consensus guidelines, have supported behavioral–psychosocial and combined behavioral–psychosocial and medication interventions as effective treatments for ADHD. This article, drawing on these findings and guidelines, describes the active roles psychologists take in providing the most reliable and valid diagnostic and treatment services for ADHD.