ADHD draft guidelines released
ADHD is an issue often seen in the Family Law Courts, and very often one hears a parent, usually the mother, saying that the child has ADHD and the other parent, usually the father, saying that the child does not, but is just an active child. There is often then an argument about diet, with the parent with whom the child lives, usually the mother, insisting that the child needs to follow a special diet and the other parent saying that there is no need.
There is often controversy between the parties about whether or not the child has been diagnosed with ADHD, and if so, whether the child has been properly diagnosed.
Into the midst of this conflict, the Royal Australasian College of Physicians has released draft guidelines [PDF file] for attention deficit hyperactivity disorder, with public comment until 28 July.
In the words of the College:
Attention deficit hyperactivity disorder (ADHD) is a common condition which begins in childhood and often persists through adolescence and into adult life. The core symptoms are poor impulse control and lack of sustained attention. Many individuals with ADHD have one or more associated problems, such as learning difficulties, anxiety, autism spectrum disorders or tics. People with ADHD often find it hard to enjoy life to the fullest and achieve their potential. The flow-on effects of ADHD can have a significant impact on families, schools, workplaces and the community more broadly. We hope to prepare a guideline which will improve the assessment, treatment and care of people with ADHD in Australia.
The College estimates that about 7% of Australian children have ADHD, which is similar to overseas figures. About 67% of children with ADHD will have it in some form as adults.
There are series of checklists to be undertaken before ADHD is diagnosed, and the draft guidelines call for diagnosis by a clinician based on clinical practice and expert opinion.
There are proposed very strict guidelines about when ADHD should be prescribed for preschoolers when assessment should be undertaken especially thoroughly and:
it is essential to distinguish ADHD symptoms from normal developmental variation in impulsivity and attention.
For school age children,adolescents and adults, medication including ritalin is seen as first line treatment, and:
elimination and restriction diets may be of limited or no benefit in treating ADHD… If a special diet is instituted, it should be under the careful supervision of a health professional.
Assessment of school aged children and adolescents:
should cover the presence and functional significance of
comorbidities, including learning disabilities, anxiety/depression, and disruptive behaviour disorders. This could include use of broad-based screening questionnaires.