Practitioner Review: Assessment and treatment of preschool children with attention-deficit/hyperactivity disorder.

Autor: Halperin JM; Department of Psychology, Queens College and the Graduate Center, City University of New York, New York, NY, USA., Marks DJ; Department of Child and Adolescent Psychiatry, NYU Child Study Center, New York, NY, USA.
Jazyk: angličtina
Zdroj: Journal of child psychology and psychiatry, and allied disciplines [J Child Psychol Psychiatry] 2019 Sep; Vol. 60 (9), pp. 930-943. Date of Electronic Publication: 2019 Jan 28.
DOI: 10.1111/jcpp.13014
Abstrakt: Background: Attention-deficit/hyperactivity disorder (ADHD) often emerges during the preschool years and remains impairing throughout the life span. Early identification and intervention may yield lasting benefits that alter the often-adverse trajectory of the disorder.
Methods: This Practitioner Review provides up-to-date information regarding the evaluation and treatment of ADHD in preschool children. The clinical presentation of ADHD in preschool children, its persistence into later childhood, the applicability of DSM-5 criteria for preschoolers with ADHD, and early predictors of long-term trajectories are addressed, as well as current findings from randomized controlled trials of both nonpharmacological and pharmacological interventions.
Results: Symptoms of hyperactivity/impulsivity extend down to age 3, but several inattention symptoms, as defined by DSM-V, less accurately differentiate preschoolers with and without ADHD. Most preschool youth with ADHD symptoms continue to manifest symptoms and impairment into school-age and adolescence. However, few predictors of persistence beyond early severity have been identified. Behavioral interventions constitute a first-line treatment for preschool ADHD symptoms, with telepsychiatry increasing in prominence to help to mitigate financial, geographic, and/or logistical barriers to care. Pharmacological interventions, particularly psychostimulants, also confer demonstrable benefits, yet efficacy and safety profiles are less desirable relative to findings in school-age youth.
Conclusions: Acute treatments have demonstrable efficacy, but do not appear to fundamentally alter underlying mechanisms or long-term trajectories.
(© 2019 Association for Child and Adolescent Mental Health.)
Databáze: MEDLINE
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