Medication for Children With an Attention Deficit Disorder

BACKGROUND In 1975, the AAP Council1 on Child Health issued a statement on medication for hyperkinetic children. Since that time, the nomenclature for such disorders has changed, as has the knowledge and usage of the medications involved. In this statement the role of medications for hyperactive children is reviewed in light of current nosology. In recent years, the term "attention deficit disorder" has become established as a recognized diagnostic category with three major subtypes: (1) attention deficit disorder with hyperactivity, (2) attention deficit disorder without hyperactivity, and (3) attention deficit disorder residual.2 In 1987, the American Psychiatric Association2 adopted the new, inclusive term, attention deficit hyperactivity disorder. Some clinicians and authors imply that the educational problems in these children are caused by their attention deficit.3 Although attention deficit disorder may infrequently occur in isolation, it is more commonly manifested as one of a series of symptoms associated with disorders of higher cortical functioning that include disturbances in movement, cognition, communication, and social competence. Many educators and physicians do not realize that a differential diagnosis exists for these behaviors much as it does for any other complex of symptoms. To establish an accurate diagnosis, information must be obtained on factors such as: (1) the child's birth, developmental, family, medical, psychosocial, and scholastic history; (2) sensory screening (ie, vision and hearing), and (3) a physical, neurologic, and neuromaturational examination. As was originally stated by the Council on Child Health,1 The use of drug therapy in the management of the hyperkinetic child does not differ appreciably from drug therapy in other treatable maladies.