Endorsement of the Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD
The AAFP's endorsement (May 2012) applies to the AAP's ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment(18 page PDF). The AAP has developed a supplemental implementation document which may be of value but has not been reviewed by the AAFP.
Key action statements:
- The primary care clinician should initiate an evaluation for ADHD for
any child 4 through 18 years of age who presents with academic or
behavioral problems and symptoms of inattention, hyperactivity, or
impulsivity (quality of evidence B/strong recommendation).
- To make a diagnosis of ADHD, the primary care clinician should
determine that Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition criteria have been met (including documentation
of impairment in more than 1 major setting); information
should be obtained primarily from reports from parents or guardians,
teachers, and other school and mental health clinicians involved
in the child’s care. The primary care clinician should also rule
out any alternative cause (quality of evidence B/strong
- In the evaluation of a child for ADHD, the primary care clinician
should include assessment for other conditions that might coexist
with ADHD, including emotional or behavioral (eg, anxiety, depressive,
oppositional defiant, and conduct disorders), developmental
(eg, learning and language disorders or other neurodevelopmental
disorders), and physical (eg, tics, sleep apnea) conditions (quality of
evidence B/strong recommendation).
- The primary care clinician should recognize ADHD as a chronic
condition and, therefore, consider children and adolescents
with ADHD as children and youth with special health care needs.
Management of children and youth with special health care
needs should follow the principles of the chronic care model and
the medical home (quality of evidence B/strong recommendation).
Endorsement of the Clinical Practice Guideline for the Diagnosis and Evaluation of the Child with ADHD
The guideline contains the following recommendations for diagnosis of ADHD:
- In a child 6 to 12 years old who presents with inattention, hyperactivity, impulsivity, academic underachievement, or behavior problems, primary care clinicians should initiate an evaluation for ADHD;
- The diagnosis of ADHD requires that a child meetDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria;
- The assessment of ADHD requires evidence directly obtained from parents or caregivers regarding the core symptoms of ADHD in various settings, the age of onset, duration of symptoms, and degree of functional impairment;
- The assessment of ADHD requires evidence directly obtained from the classroom teacher (or other school professional) regarding the core symptoms of ADHD, duration of symptoms, degree of functional impairment, and associated conditions;
- Evaluation of the child with ADHD should include assessment for associated (coexisting) conditions; and
- Other diagnostic tests are not routinely indicated to establish the diagnosis of ADHD but may be used for the assessment of other coexisting conditions (eg, learning disabilities and mental retardation).
Diagnosis Attention-Deficit/Hyperactivity(aappolicy.aappublications.org) -- American Academy of Pediatrics (Endorsed May 2000)