What You Need To Know About The New AAP Guidelines For ADHD

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The American Academy of Pediatrics (AAP) recently updated their guidelines on Attention Deficit Hyperactivity Disorder based on recent research. You can read the details of exactly what has changed at the link above, but I shot a quick video to share my thoughts about what you need to know as a parent.

Transcript (lightly edited for clarity):

Hi – Dr. Jim here. Let’s talk today about the new guidelines that were put out by the American Academy of Pediatrics to care for, evaluate, and inform the ongoing treatment of those with ADHD.

As pediatricians, we look to the Academy of Pediatrics for guidelines to care for all kinds of diseases, entities, and everything we deal with as pediatricians. The last guidelines that came out were in 2011. The exciting part of these guidelines for me as a physician, is what it does for the Academy of Pediatrics as a whole. It underscores to the 60,000+ pediatricians everywhere that it is so important for us to understand that there is a comorbidity out there with these kids. That means that anywhere from 30-40% of children may have something else besides ADHD: anxiety, depression, mood disorders, autistic spectrum disorders. So we have to figure that out.

This is a particular problem with preschool children, and now these kids--from preschool to adolescents--are going to get the care they need. On top of all that, we’re also going to train parents and schools. So it’s really exciting for me to see what I think is the Academy coming out of the dark ages of ADHD into the light of all the aspects of taking care of kids that have attention and focus issues. 

As super as these updates are, all updates land short. As a physician, what would I like to see different, would be more about medication. I want to see new medications, I want to see different medications. We haven’t change the way we treat kids with ADHD in years and years. We just come out with a different formulation. So I want to see how we can help and affect change with these kids. What is the effect of nutrition? We know that it helps. I would like to see the Academy give us some really good nutrition guidelines for parents to follow.

What about a lot of things that are not approved by the FDA that we know work? Things that don’t necessarily work all the time, but we know that they work. Can we not come up with some ideas to help physicians on a day-to-day basis in our office to help the parent who day-to-day is having a heckuva time caring for their child. In the morning getting read them ready for school. In the evenings, homework, the stresses of the family. That’s where I want us to see us as the Academy to provide more guidelines. I want to help where the boots and the road meet. 

These guidelines came out to the general pediatric society, but I would like to see some strong guidelines going to the medical schools and pediatric residency programs and then the physicians who are caring for those with ADD. Not just a simple boom-boom-boom, but a really give us some strong guidelines and to give us the numbers of kids and patients that we can evaluate. Residency training is somewhere between 10 and 20 max and three years...that's not okay.

The United States is going through huge problems with mental health, and the Academy of Pediatrics is being singled out. We are the ones who are going to be on the firing line because the number of psychiatrists per thousand is going way down. So now all of a sudden pediatricians are the ones who are going to be in the medical forefront. We need more ways to help the families. We need more support from the Academy. We need more support from local and city governments. This is a major problem that’s hitting the United States.

A really hopeful program has been outlined. It didn't get stated expressly, but it has been outlined. That hopeful program is an interaction of a team. It’s an integrative approach of the teacher, parent, physician, child, social worker, nutritionists, the diet, the exercise…all these aspects are coming more to the forefront where pediatricians from the Academy of Pediatrics, really what we’ve been good for is we send a patient to a psychologist when they come back and say they’ve got ADD then we give them a drug.
This is changing now. This is really exciting that its not being determined that some test - by the way there’s no test for ADHD - that there’s no just go to a psychologist who says they need this. I’m not bashing psychologists but we as physicians need to stand up and help our kids and realize that it’s not a test that’s done on paper. It’s how does the child interact. And with that we are very very excited about the future of medicine.