Problems in the Management of Attention-Deficit–Hyperactivity Disorder

Despite several name changes over the past 50 years, the current diagnosis of attention-deficit–hyperactivity disorder (ADHD) shares the core group of symptoms — impulsivity, inattention, and motor restlessness — with earlier terms such as minimal brain dysfunction, hyperactive child syndrome, and attention-deficit disorder with or without hyperactivity. The disorder is extremely common, affecting approximately 4 percent of all children, although estimates vary widely, from 3 to 11 percent or more.1,2 The cause of ADHD remains unknown.The presentation, although highly variable, is captured in the following vignettes:The parents of a nine-year-old boy are seeking help because their son . . .