Familial aggregation of ADHD characteristics

Attention and conduct problems in children exposed to family violence

This study examines the impact of family violence on the development of attention and conduct problems in girls and boys. Mothers (n = 287) were interviewed and given diagnostic assessment instruments to measure attention deficit/hyperactivity disorder and conduct disorder in 1 of their children. Six years later, youths were interviewed about their delinquent behavior. Family violence related to attention and conduct problems in girls only. Girls who displayed these problems in childhood were not necessarily at risk for later delinquency. Family violence in childhood had a direct effect on delinquency in girls. Boys who developed attention problems were more likely to show conduct problems that eventually led to adolescent delinquency. Family violence failed to account for problems or delinquency in boys.

Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder

This clinical practice guideline provides evidence-based recommendations for the treatment of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). This guideline, the second in a set of policies on this condition, is intended for use by clinicians working in primary care settings. The initiation of treatment requires the accurate establishment of a diagnosis of ADHD; the American Academy of Pediatrics (AAP) clinical practice guideline on diagnosis of children with ADHD(1) provides direction in appropriately diagnosing this disorder. The AAP Committee on Quality Improvement selected a subcommittee composed of primary care and developmental-behavioral pediatricians and other experts in the fields of neurology, psychology, child psychiatry, education, family practice, and epidemiology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Evidence-based Practice Center at McMaster University, Ontario, Canada, to develop the evidence base of literature on this topic.(2) The resulting systematic review, along with other major studies in this area, was used to formulate recommendations for treatment of children with ADHD. The subcommittee also reviewed the multimodal treatment study of children with ADHD(3) and the Canadian Coordinating Office for Health Technology Assessment report (CCOHTA).(4) Subcommittee decisions were made by consensus where definitive evidence was not available. The subcommittee report underwent extensive review by sections and committees of the AAP as well as by numerous external organizations before approval from the AAP Board of Directors. The guideline contains the following recommendations for the treatment of a child diagnosed with ADHD:

Psychosocial treatment issues in the MTA: a reply to Greene and Ablon

Discussed several of Greene and Ablon's (this issue) key points in their article about the Multimodal Treatment Study (MTA) of Children with Attention Deficit Hyperactivity Disorder (ADHD). In particular, the following issues are addressed: (a) whether the medication management and behavioral arms of the MTA individualized treatment to comparable degrees; (b) whether cognitive-behavioral interventions were incorporated to an adequate extent; (c) whether core ADHD symptoms were overemphasized relative to other functional domains, both as treatment targets and outcome measures; and (d) whether parent and teacher characteristics warranted more emphasis than they were given. These issues are discussed and an attempt is made to fit the MTA findings into the larger context of prior studies on treatment of childhood ADHD. A theme of this commentary is the concern that in the current age of biological emphasis in the field of ADHD research, social, family, and motivational processes may not get the attention they deserve.