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J Child Psychol Psychiatry. 2019 Sep;60(9):930-943. doi: 10.1111/jcpp.13014. Epub 2019 Jan 28.

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

Author information

1
Department of Psychology, Queens College and the Graduate Center, City University of New York, New York, NY, USA.
2
Department of Child and Adolescent Psychiatry, NYU Child Study Center, New York, NY, USA.

Abstract

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.

KEYWORDS:

Attention-deficit/hyperactivity disorder; assessment; intervention; preschool children

PMID:
30690737
DOI:
10.1111/jcpp.13014

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