Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents: Updates from APA 2019

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ADHD is a common neuropsychiatric disorder, estimated to affect 7.2% of school age children worldwide and 11% in the US. The presence of the disorder is often not detectable until ...

ADHD is a common neuropsychiatric disorder, estimated to affect 7.2% of school age children worldwide and 11% in the US. The presence of the disorder is often not detectable until school workload increases, and it has a significant impact on child and adolescent development, health, education, and family situations. There is evidence of a wide variability in clinicians’ ability to diagnose ADHD, suggesting opportunities for improvement and a gap in care that might be remedied by CME.

Although ADHD may be linked to a variety of social and environmental factors, including maternal smoking, fetal alcohol syndrome, lead poisoning, and meningitis, genetics also play a large role, with heritability studies showing the likelihood of passing the condition on between 40% and 90%. The exact pathophysiology is unclear, but there is some evidence of decreased brain volume, which may affect executive functioning needed for prioritizing, decision making, motor control, and awareness of space and time. Alterations in dopaminergic, cholinergic, and serontonergic functions have been documented in ADHD, which may impair the ability to delay gratification, resist distractions, regulate arousal, and focus on uninteresting tasks.

The stimulant drug class presently represents first-line pharmacotherapy. There had previously been concern about the health risks of pharmacotherapy. However, time has brought additional experience with the medication, as ADHD medication use has risen by over 35% overall. Another concern in recent years that may have been addressed is prescription drug abuse in children and young adults; research is now finding a significant gap between perceptions of abuse of ADHD stimulant medications and actual rates of misuse and abuse. This activity is intended to be a one-hour learning activity focused on ADHD and its complications, designed to bring healthcare providers up to date in their practice and give them a sense of coming changes to practice and the literature.

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