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Early and Long-Term ADHD

ADHD Long-Term Course Diagnosed in Early Years Can Be Severe

According to a study published in the February 11, 2013 online version of the Journal of the American Academy of Child and Adolescent Psychiatry, ADHD (Attention Deficit Hyperactivity Disorder) initially diagnosed in the early preschool years often becomes a chronic, severe condition. However, every individual child's illness course associated with this disorder is different. These findings are according to the follow up data obtained from the PATS (Preschool ADHD Treatment Study) that was funded by the National Institute of Mental Health (NIMH).

The majority of studies which examine ADHD primarily focus on school-aged children. This is particularly true in the case of boys. The PATS study was the first large, long-term clinical trial that was actually developed to concentrate on preschoolers who have ADHD, as well as to ascertain the efficacy and safety of using methylphenidate (Ritalin) as a treatment method in this age group.

PATS Study Shows Ritalin is Safe and Effective

The initial study results indicated that low dosages of Ritalin, administered over a short period of time, are both safe and effective. This is assuming that the preschooler is closely monitored since this age group is especially prone to side effects. As part of this follow up clinical study, original participants (who were 3 to 5 years of age at the time of the PATS study) were tracked for a six year period after PATS began. This was done in order to monitor the clinical course of the study participants' ADHD. In addition, their teachers and parents were questioned concerning children's symptoms at the 3, 4 and 6 year periods following completion of the study.

Out of the 304 preschoolers who began the trial, 68% took part in the follow up study. Six years after the initial study, 89% of participants continued to meet ADHD criteria. While some of their symptoms were reduced, many still exhibited severe ADHD symptoms even with the use of medications. Overall, the illness trajectories of the participants varied considerably.

Girls Experience Worse ADHD Symptoms than Boys

In this new study, boys and girls exhibited differences in their illness course. At the baseline point of the study, girls tended to experience more severe symptoms. This is especially true for inattentiveness. Even though girls realized a steeper reduction in the severity of their symptoms over time as compared to boys, girls' symptoms continued to be more severe throughout the study. The exception to this rule was displays of both impulsivity and hyperactivity within classroom settings.

Since a larger number of preschoolers are being given an ADHD diagnosis and receiving treatment for it, possessing knowledge of the long-term illness course is very important in order to establish the most effective interventions early on. A diagnosis of ADHD, given during the preschool years, often persists throughout the rest of childhood. Therefore, intense early treatments including behavioral interventions, parent training, and appropriate medications are necessary.

In an ongoing attempt to improve overall outcomes for ADHD preschoolers, additional research is required. These studies need to concentrate on the effects of ADHD medications on this age group over long periods as well as the various effects of different medication combinations. Also, more research is needed in order to identify any specific characteristics that have the potential to increase the risks of long-term ADHD plus particular characteristics of those children whose ADHD symptoms subside as they get older.


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