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
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.
Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral condition and the second most common chronic illness in children. The observance of specific behaviors in multiple ...settings have remained the most successful method for diagnosing the condition, and although there are differences in specific areas of the brain, and a high heritability estimate (∼76%), they are not diagnostically specific. Medications, and particularly stimulant medication, have undergone rigorous studies to document their efficacy dating back to the 1970s. Likewise, behavioral interventions in the form of parent training and classroom programs have demonstrated robust efficacy during the same time period. Both medication and behavioral interventions are symptomatic treatments. The availability of only symptomatic treatments places ADHD in the same category as other chronic conditions such as diabetes and asthma. Successful treatment of most individuals requires ongoing adherence to the therapy. Improved communication between patients and their families, primary and mental health providers, and school personnel is necessary for effective ADHD treatment. Further enhancement of electronic systems to facilitate family, school, and provider communication can improve monitoring of ADHD symptoms and functional performance. The American Academy of Pediatrics ADHD guidelines were initially developed to help primary care clinicians address the needs of their patients with ADHD and were further refined with the second revision in 2019.
Children and adolescents affected by prenatal exposure to alcohol who have brain damage that is manifested in functional impairments of neurocognition, self-regulation, and adaptive functioning may ...most appropriately be diagnosed with neurobehavioral disorder associated with prenatal exposure. This Special Article outlines clinical implications and guidelines for pediatric medical home clinicians to identify, diagnose, and refer children regarding neurobehavioral disorder associated with prenatal exposure. Emphasis is given to reported or observable behaviors that can be identified as part of care in pediatric medical homes, differential diagnosis, and potential comorbidities. In addition, brief guidance is provided on the management of affected children in the pediatric medical home. Finally, suggestions are given for obtaining prenatal history of in utero exposure to alcohol for the pediatric patient.
Bright Futures Pediatrics, American Academy of; Hagan , Joseph F; Shaw, Judith S ...
2017, 20170101, 2017-03-30
eBook
This essential resource provides key background information and recommendations for themes critical to healthy child development along with well-child supervision standards for 31 age-based ...visits--from Newborn through 21 Years. What's in the Bright Futures Guidelines, Fourth Edition? Twelve health promotion themes addressing * lifelong health for families and communities NEW * family support * health for children and youth with special health care needs NEW * healthy development * mental health * healthy weight * healthy nutrition * physical activity * oral health * healthy adolescent development * healthy and safe use of social media NEW * safety and injury prevention 31 age-based health supervision visits--Newborn to 21 Years All the information and guidance that's needed to give children optimal health outcomes -Context -Health Supervision -History -Surveillance of Development -Review of Systems -Observation of Parent-Child Interaction -Physical Examination -Medical Screening -Immunizations -Anticipatory Guidance What's NEW in the 4th Edition? *Builds upon previous editions with new and updated content that reflects the latest research. *Incorporates evidence-driven recommendations. *Includes three new health promotion themes: -Promoting Lifelong Health for Families and Communities -Promoting Health for Children and Youth With Special Health Care Needs -Promoting the Healthy and Safe Use of Social Media *Includes new screen time recommendations *Provides greater focus on lifelong physical and mental health -Weaves social determinants of health throughout the Visits, allowing health care professionals to consider social factors like food insecurity, violence, and drug use that may affect a child's and family's health - Features updated Milestones of Development and Developmental Surveillance questions *Provides new clinical content that informs health care professionals about the latest recommendations and provides guidance on how to implement them in practice: -Maternal depression screening, Safe sleep, Iron supplementation in breast fed infants, Fluoride varnish, Dyslipidemia blood screening *Includes updates to several Adolescent screenings With Bright Futures, health care professionals can accomplish 4 tasks in 18 minutes! *Disease detection *Disease prevention *Health promotion *Anticipatory guidance What is Bright Futures? *A set of theory-based, evidence-driven, and systems-oriented principles, strategies, and tools that health care professionals can use to improve the health and well-being of children through culturally appropriate interventions. Bright Futures addresses the current and emerging health promotion needs of families, clinical practices, communities, health systems, and policymakers. *The Bright Futures Guidelines are the blueprint for health supervision visits for all children. *Bright Futures is the health promotion and disease prevention part of the patient-centered medical home. Who can use Bright Futures? *Child health professionals and practice staff who directly provide primary care *Parents and youth who participate in well-child visits *Public Health Professionals *Policymakers *Pediatric Educators *MD Residents
During and after disasters, pediatricians can assist parents and community leaders not only by accommodating the unique needs of children but also by being cognizant of the psychological responses of ...children to reduce the possibility of long-term psychological morbidity. The effects of disaster on children are mediated by many factors including personal experience, parental reaction, developmental competency, gender, and the stage of disaster response. Pediatricians can be effective advocates for the child and family and at the community level and can affect national policy in support of families. In this report, specific children's responses are delineated, risk factors for adverse reactions are discussed, and advice is given for pediatricians to ameliorate the effects of disaster on children.
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