Attention-Deficit Hyperactivity Disorder (ADHD)

Kytja K. S. Voeller, MD

Disclosures

J Child Neurol. 2004;19(10):798-814. 

In This Article

Abstract and Introduction

Approaches to the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) are undergoing a major change as a result of information from studies on the genetics of ADHD and the use of new neuroimaging technologies. Moreover, pharmacogenomics, although still in its infancy, will provide a basis for much more sophisticated treatment strategies for ADHD, particularly once more information is available about the genetics of ADHD. Even at this point in time, there is some pertinent information available that, although not ready for application in clinical settings, nonetheless provides a broader perspective for the clinician. In terms of etiology, ADHD is a neuropsychiatric disorder. There is a genetic basis in about 80% of the cases, involving a number of different genes, and in about 20% of the cases, ADHD is the result of an acquired insult to the brain. Some individuals likely have both genetic and acquired forms. Although medication works well in many cases of ADHD, optimal treatment of ADHD requires integrated medical and behavioral treatment. The family plays a crucial role in the management of children with ADHD. Because there is often a very high degree of comorbidity between ADHD and learning disabilities, teachers also have a great deal to contribute in the day-to-day management of these children. Early recognition and treatment prevent the development of more serious psychopathology in adolescence and adulthood.

Many children with a learning disability also have attention-deficit hyperactivity disorder (ADHD), which can significantly impair the child's ability to absorb and make use of educational experiences and to function effectively in both academic and social environments. Awareness of this association, which should lead to early diagnosis and appropriate treatment of ADHD, is an extremely important part of the management of the learning-disabled child. Appropriate management of ADHD helps the child deal with areas of deficit and use compensatory skills effectively. In this article, I review some of the neurobiologic features of ADHD and its management.

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