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Current Approaches to Management of Attention Deficit Hyperactivity Disorder

Published online by Cambridge University Press:  29 October 2015

Frederick C. Jarman*
Affiliation:
Centre for Community Child Health and Ambulatory Paediatrics, Royal Children's Hospital Melbourne
*
Centre for Community Child Health & Ambulatory Paediatrics, Royal Children's Hospital Melbourne, Parkville Victoria 3052, Phone: (03) 9345-6150, Fax: (03) 9345-5900, Email: [email protected]
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Abstract

The last five years in Australia have been marked by an explosion in the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD). The use of stimulant medication for ADHD has increased exponentially across all states, raising questions about the appropriate role of drug treatment and its relationship to other therapies in these children. Despite widespread consensus that multimodal therapy is the preferred option for intervention, many treatments advocated for ADHD lack scientific evidence to support their use. Because no two children with ADHD or their families are the same, an individualised approach to management is advocated that targets both the primary symptoms of the disorder, its cornorbid pathology, and the secondary problems that have developed. Evidence indicates that stimulant medication used in conjunction with parent training, family support, and school based behaviour modification offers the best prospects for improving the disturbing long-term prognosis in these children.

Keywords

Type
Research Article
Copyright
Copyright © Australian Psychological Society 1996

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References

REFERENCES

Abikoff, H. (1991). Cognitive training in ADHD children: Less to it than meets the eye. Journal of Learning Disabilities, 24, 205209.CrossRefGoogle ScholarPubMed
Abikoff, H., & Gittelman, R. (1985). Hyperactive children treated with stimulants: Is cognitive behavioural training a useful adjunct? Archives of General Psychiatry, 42, 953961.CrossRefGoogle ScholarPubMed
Aman, M.G., Marks, R.E., Turbott, S.H., Wisher, C.P., & Merry, S.W. (1991). Methylphenidate and thioridazine in the treatment of intellectually subaverage children: Effects on cognitive and motor performance. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 816824.Google Scholar
American Academy of Pediatrics. (1987). Medication for children with an Attention Deficit Disorder. Pediatrics, 80, 758760.Google Scholar
Anastopoulos, A.D., DuPaul, G.J., & Barkley, R.A. (1991). Stimulant medication and parent training therapies for Attention Deficit Hyperactivity Disorder. Journal of Learning Disabilities, 24, 210218.CrossRefGoogle ScholarPubMed
Barkley, R.A. (1987). Defiant children: A clinician’s manual for parent training. New York: Guilford Press.Google Scholar
Barkley, R.A., Guevremont, D.C., Anastopoulos, A.D., & Fletcher, K.E. (1992). A comparison of three family therapy programs for treating family conflicts in adolescents with Attention Deficit Hyperactivity Disorder. Journal of Consulting and Clinical Psychology, 60, 450462.CrossRefGoogle ScholarPubMed
Barkley, R.A., Karlsson, J., Strzelecki, E., & Murphy, J.V. (1984). Effects of age and Ritalin dosage on the mother-child interactions of hyperactive children. Journal of Consulting and Clinical Psychology, 52, 750758.CrossRefGoogle ScholarPubMed
Barkley, R.A. (1989). Hyperactive girls and boys: Stimulant drugs effects on mother-child interactions. Journal of Child Psychology and Psychiatry, 30, 379389.CrossRefGoogle Scholar
Barkley, R.A., McMurray, M.B., Edelbrock, C.S., & Robbins, K. (1990). Side-effects of methylphenidate in children with Attention Deficit Hyperactivity Disorder: A systematic, placebo controlled evaluation. Pediatrics, 86, 184192.CrossRefGoogle Scholar
Barkley, R.A., Fischer, M., Edelbrock, C.S., & Smallish, M.A. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8 year prospective follow up study. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 546557.CrossRefGoogle ScholarPubMed
Barrickman, L., Noyes, R., Kuperman, S., Schumacher, E., & Verda, M. (1991). Treatment of ADHD with fluoxetine: A preliminary trial. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 762767.Google ScholarPubMed
Bartels, M.G., Varley, C.K., Mitchell, J., & Stamm, S.J. (1991). Pediatric cardiovascular effects of Imipramine and desipramine. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 100103.CrossRefGoogle ScholarPubMed
Biederman, J., Baldessarrini, R.J., Wright, V, Knee, D., & Harmatz, J.S. (1989). A double blind placebo controlled study of desipramine in the treatment of ADD: 11 Serum drug levels and cardiovascular findings. Journal of the American Academy of Child and Adolescent Psychiatry, 28,903907.CrossRefGoogle Scholar
Bowen, J., Fenton, T., & Rapaport, L. (1991). Stimulant medication and Attention Deficit Hyperactivity Disorder: The child’s perspective. American Journal of Diseases of Children, 145, 291295.CrossRefGoogle ScholarPubMed
Bradley, C. (1937). The behaviour of children receiving benedrine. American Journal of Psychiatry, 94, 577585.CrossRefGoogle Scholar
Buitelaar, J.K., Van der Gaag, R.J., Swaab-Barneveld, H., & Kuiper, M. (1995). Prediction of clinical response to methylphenidate in children with Attention Deficit Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 10251032.CrossRefGoogle ScholarPubMed
Comings, D.E., & Comings, B.G. (1987). A controlled study of Tourette syndrome. I. Attention Deficit Disorder, learning disorders, and school problems. American Journal of Human Genetics, 41, 701741.Google ScholarPubMed
Conners, C.K., Goyette, C.H., Southwick, D.A., Lees, J.M., & Andrulonis, P.A. (1976). Food additives and hyperkinesis: A controlled double blind experiment. Pediatrics, 58, 154166.Google ScholarPubMed
Cunningham, C.E., Siegel, L.S., & Offord, D.R. (1985). A developmental dose-response analysis of the effects of methylphenidate on the peer interactions of attention deficit disordered boys. Journal of Child Psychology and Psychiatry, 26, 955971.CrossRefGoogle ScholarPubMed
Cunningham, C.E., Benness, B.B., & Siegel, L.S. (1988). Family functioning, time allocation, and parental depression in the families of normal and ADDH children. Journal of Clinical Child Psychology, 17, 169177.CrossRefGoogle Scholar
de Sonneville, L.M.J., Njiokiktjien, C. & Hilhorst, R.C. (1991). Methylphenidate-induced changes in ADDH information processors. Journal of Child Psychology and Psychiatry, 32, 285295.CrossRefGoogle ScholarPubMed
Fehlings, D.L., Roberts, W., Humphries, T., & Dawe, G. (1991). Attention Deficit Hyperactivity Disorder: Does cognitive behavioral therapy improve home behavior? Journal of Developmental and Behavioural Pediatrics, 12, 223228.CrossRefGoogle ScholarPubMed
Feingold, B. (1975). Why your child is hyperactive. New York: Random House.Google Scholar
Garfinkel, B.D., Wender, P.H., Sloman, L., & O’Neill, I. (1983). Tricyclic antidepressants and methylphenidate treatment of attention deficit hyperactivity disorder in children. Journal of the American Academy of Child and Adolescent Psychiatry, 22, 343348.Google ScholarPubMed
Gittelman, R., Mannuzza, S.S., Shenker, R., & Bonagura, N. (1985). Hyperactive boys almost grown up. Archives of General Psychiatry, 42, 937947.CrossRefGoogle ScholarPubMed
Huestis, R.D., Arnold, L.E., & Smeltzer, D.J. (1975). Caffeine vs methylphenidate and d-amphetamine in minimal brain dysfunction: A double blind comparison. American Journal of Psychiatry, 132, 868870.Google Scholar
Hunt, E.D., Minderaa, R., & Cohen, D.J. (1985). Clonidine benefits with attention deficit disorder and hyperactivity: Report of a double blind placebo crossover therapeutic trial. Journal of the American Academy of Child and Adolescent Psychiatry, 24, 617629.Google ScholarPubMed
Hunt, R.D., Arnsten, A.F., & Asbell, M.D. (1995). An open trial of guanfacine in the treatment of Attention Deficit Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 5054.CrossRefGoogle ScholarPubMed
Jacobvitz, D., Sroufe, M., Stewart, M., & Leffert, N. (1990). Treatment of attentional and hyperactivity problems in children with sympathomimetic drugs: A comprehensive review. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 677688.CrossRefGoogle ScholarPubMed
Johnston, C., Pelham, W.E., Hoza, J., & Sturges, J. (1988). Psychostimulant rebound in attention deficit disordered boys. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 806810.CrossRefGoogle ScholarPubMed
Kaplan, B.J., McNichol, J., Conte, R.A., & Moghadam, H.K. (1989). Dietary replacement in preschool-aged hyperactive boys. Pediatrics, 83, 717.CrossRefGoogle ScholarPubMed
Kelly, P.C., Cohen, M.L., Walker, W.O., Caskey, O.L., & Atkinson, A.W. (1989). Self-esteem in children medically managed for Attention Deficit Disorder. Pediatrics, 55,211217.CrossRefGoogle Scholar
Kinsboume, M. (1994). Editorial: Sugar and the hyperactive child. New England Journal of Medicine, 550,355356.CrossRefGoogle Scholar
Levy, F. (1993). Side effects of stimulant use. Journal of Paediatric Child Health, 29,250.CrossRefGoogle ScholarPubMed
Pelham, W.E., Sturges, J., Hoza, J., Schmidt, C., Bijlsma, J.J., Milich, R., & Moorer, S. (1987). Sustained release and standard methylphenidate effects on cognitive and social behavior in children with Attention Deficit Disorder. Pediatrics, 80, 491501.CrossRefGoogle ScholarPubMed
Rapoport, J.L., Buchsbaum, M., Zahn, T.P., Weingartner, H., Ludlow, C., & Mikkelsen, E.J. (1978). Dextroamphetamine: Cognitive and behavioural effects in normal pre-pubertal boys. Science, 199, 560562.CrossRefGoogle Scholar
Rapport, M.D., DuPaul, G.J., Stoner, G., Birmingham, B.K., & Masse, G. (1985). Attention Deficit Disorder with Hyperactivity: Differential effects of methylphenidate on impulsivity. Pediatrics, 76, 938943.CrossRefGoogle ScholarPubMed
Rey, J.M., & Hutchins, P. (1993). Childhood hyperactivity. Medical Journal of Australia, 159, 289.CrossRefGoogle ScholarPubMed
Richters, J.E., Arnold, L.E., Jensen, P.S., Abikoff, H., Conners, K., Greenhill, L.I., Hechtman, L., Hinshaw, S.P.Pelham, W.E., & Swanson, J.H. (1995). NIMH collaborative multisite multimodal treatment study of children with ADHD: 1. Background and Rationale. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 9871000.CrossRefGoogle Scholar
Riddle, M.A., Hardin, M.T., Cho, S.C., Woolston, J.L., & Leckman, J.F. (1988). Desipramine treatment of boys with Attention Deficit Hyperactivity Disorder and tics: Preliminary clinical experience. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 811814.CrossRefGoogle ScholarPubMed
Rowe, K.S., & Rowe, K.J. (1994). Synthetic food colouring and behaviour: A dose response effect in a double blind, placebo controlled, repeated measures study. Journal of Pediatrics, 125, 691698.CrossRefGoogle Scholar
Safer, D.J., & Krager, J.M. (1988). A survey of medication treatment for hyperactive/ inattentive students. Journal of American Medical Association, 260, 22562258.CrossRefGoogle ScholarPubMed
Safer, D.J., & Allen, R.P. (1989). Absence of tolerance to the behavioural effects of methylphenidate in hyperactive and inattentive children. Journal of Pediatrics, 115, 10031008.CrossRefGoogle Scholar
Satterfield, J.H., Satterfield, B.T., & Cantwell, D.P. (1981). Three year multimodal treatment study of 100 hyperactive boys. Journal of Pediatrics, 98, 650655.CrossRefGoogle Scholar
Schultz, F.R., Hayford, J.T., Wolraich, M.L., Hintz, P.L., & Thompson, R.G. (1982). Methylphenidate treatment of hyperactive children: Effects on the hypothalamic-pituitary-somatomedin axis. Pediatrics, 70, 987992.CrossRefGoogle ScholarPubMed
Sebrechts, M.M., Shaywitz, S.E., Shaywitz, B.A., Jatlow, P., Anderson, G.M., & Cohen, P.J. (1986). Components of attention, methylphenidate dosage, and blood levels in children with Attention Deficit Disorder. Pediatrics, 77, 222228.CrossRefGoogle ScholarPubMed
Shaywitz, B.A., Sullivan, C.M., Anderson, G.M., Gillespie, S.M., Sullivan, B., & Shaywitz, S.E. (1994). Aspartame, behaviour, and cognitive function in children with Attention Deficit Disorder. Pediatrics, 93, 7075.CrossRefGoogle ScholarPubMed
Shaywitz, S.E., & Shaywitz, B.A. (1987). Attention Deficit Disorder: Current perspectives. Pediatric Neurology, 3, 129135.CrossRefGoogle ScholarPubMed
Sprague, R., & Sleator, E. (1977). Methylphenidate in hyperkinetic children: Differences in dose effects on learning and social behavior. Science, 198, 12741276.CrossRefGoogle ScholarPubMed
Steingard, R., Bierderman, J., Spence, T., Wilens, T., & Gonzalez, A. (1993). Comparison of Clonidine response in the treatment of Attention Deficit Hyperactivity Disorder with and without comorbid tic disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 32,350353.CrossRefGoogle ScholarPubMed
Stevenson, R.D., & Wolraich, M.L. (1989). Stimulant medication therapy in the treatment of children with Attention Deficit Hyperactivity Disorder. Pediatric Clinics of North America, 36, 11831195.CrossRefGoogle ScholarPubMed
Tannock, R., Schachar, R.J., Carr, R.P., & Logan, G.D. (1989). Dose-response effects on academic performance and overt behavior in hyperactive children. Pediatrics, 84, 648657.CrossRefGoogle ScholarPubMed
Trott, G.E., Friese, H.J., & Nissen, G. (1991, January 20–23). Moclobemide in children with Attention Deficit Hyperactivity Disorder. Paper presented in the second symposium on Moclobemide, Davos, Switzerland. (Session VI. Roche Medical Information Service, Abstract p.31).Google Scholar
Vallentine, J. (1996). National trends in the use of stimulant medication for Attention Deficit Disorder. Journal of Paediatrics and Child Health, 32, 223227.CrossRefGoogle Scholar
Weiss, G., Minde, K., Werry, J.S., Douglas, V, & Nemeth, K. (1971). Studies on the hyperactive child: Vili. Five year follow up. Archives of General Psychiatry, 24,409414.CrossRefGoogle Scholar
Weiss, G., Hechtman, L., Perlman, T., Hopkins, J., & Werner, A. (1979). Hyperactives as young adults: A controlled prospective 10 year follow up of the psychiatric status of 75 children. Archives of General Psychiatry, 36, 675681.CrossRefGoogle ScholarPubMed
Wender, E.H., & Solanto, M. (1991). Effects of sugar on aggressive and inattentive behavior in children with Attention Deficit Disorder with Hyperactivity and normal children. Pediatrics, 88, 960966.CrossRefGoogle ScholarPubMed
Whalen, C.K., Henker, B., Buhrmester, D., Hinshaw, S.P., Huber, A., & Laski, K. (1989). Does stimulant medication improve the peer status of hyperactive children? Journal of Consulting and Clinical Psychology, 57, 54355449.CrossRefGoogle ScholarPubMed
Williams, J.I., Cram, D.M., Tausig, F.T., & Webster, E. (1978). Relative effects of drugs and diet on hyperactive behaviors: An experimental study. Pediatrics, 61,811817.CrossRefGoogle ScholarPubMed
Wolraich, M.L., Lindgren, S.D., Stumbo, P.J., Stegink, L.D., Applebaum, H.I., & Kiritsyh, C. (1994). Effects of diets high in sucrose or aspartame on the behaviour and cognitive performance of children. New England Journal of Medicine, 330, 301307.CrossRefGoogle ScholarPubMed