ADHD
Also known as: attention deficit · attention-deficit/hyperactivity disorder
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Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
American Academy of Pediatrics (AAP) · 2019
The AAP's current guideline on diagnosing, evaluating and treating ADHD in children and adolescents in primary care. It updates the 2011 AAP guideline to reflect DSM-5 criteria and newer evidence, adds material on diagnosing and treating co-occurring conditions, and includes a revised process-of-care algorithm. Linked via PubMed because the publisher's site blocks automated access.
Attention deficit hyperactivity disorder: diagnosis and management
NICE (UK) · 2018 · NG87
UK national guidance on recognising, diagnosing and managing ADHD across the lifespan, covering children, young people and adults. Published in 2018 and last updated in September 2019.
US vs EU key differences
- Who may diagnose differs fundamentally: the AAP guideline is written for primary care clinicians to diagnose and manage ADHD, while NICE restricts diagnosis to a specialist psychiatrist, paediatrician or other appropriately qualified specialist. source
- Drug ordering differs: NICE names methylphenidate as first-line for children aged 5 and over with lisdexamfetamine considered only after a six-week trial at an adequate dose, whereas the AAP guideline endorses FDA-approved medications generally without designating a single first-line molecule outside the preschool group. source
- The medication threshold differs for school-age children: NICE offers medication only if symptoms still cause persistent significant impairment after environmental modifications have been tried, while the AAP recommends medication together with behaviour training for children aged 6 and older. source
- Both converge on preschoolers: behavioural parent training comes first (AAP parent training in behaviour management; NICE an ADHD-focused group parent-training programme), with medication reserved for inadequate response and specialist involvement. source
What changed recently
- US2011 → 20192019-01-01
The 2019 AAP guideline updates the 2011 version for DSM-5 and adds a new key action statement requiring clinicians to screen for and address coexisting conditions, since most children with ADHD have at least one comorbidity and around 18 percent have three or more. Other recommendations were adjusted only incrementally, with specific guidance retained for preschool-aged children and adolescents across ages 4 to 18.
source ↗curation confidence 90% - EUCG72 (2008) → NG872018-01-01
NG87 replaces CG72 and technology appraisal TA98, and changes adult pharmacotherapy by making lisdexamfetamine or methylphenidate the first-line choice and moving atomoxetine out of the second-line position it held in 2008. For children aged 5 and over methylphenidate remains first-line, with lisdexamfetamine, dexamfetamine and then atomoxetine as sequential alternatives after inadequate six-week trials, and new sections cover recognition, information and support, adherence, and medication review and discontinuation.
source ↗curation confidence 90%
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