The American Academy of Pediatrics (AAP) created some
controversy with their recently released updated guidelines for diagnosing and
treating ADHD. The guidelines recommend medication treatment for children as
young as four years who have academic or behavioral problems and difficulties
with attention, hyperactivity or impulsivity. Previous ADHD guidelines applied
only to children ages 6 through 12 years.
Dr. Allen Frances argues in an article for Psychiatric Times that encouraging such
early use of medication “will further
the already problematic overdiagnosis of ADD/ADHD and expand the inappropriate
prescription of medication to young children.” Preschool-age children are more
difficult to diagnose accurately, and they may be more susceptible to side
effects of the medications, such as loss of appetite, headaches, and disturbed
sleep.
The lead author of
the guidelines, Dr. Mark Wolralch, stated that the intent behind them was to
give doctors improved diagnostic criteria while identifying children with ADHD who have
gone undiagnosed or untreated. He defends the AAP’s decision by saying,
“Treating children at a young age is important, because when we can identify
them earlier and provide appropriate treatment, we can increase their chances
of succeeding in school.” In addition, the guidelines also recommend a trial of
behavioral interventions first, followed by treatment with medication if the
behavioral therapy is ineffective. Dr. Frances cautions that if past experience
is any indication, these recommendations will be widely ignored because
behavioral therapies are not easily available and medication is.
Read more here.