Purpose of review
To provide an overview of clinical advances and research findings related to attention
deficit hyperactivity disorder (ADHD) in preschool children, with an emphasis on
assessment and management.
The American Academy of Pediatrics has just released new clinical practice guidelines
for the diagnosis and management of ADHD. These guidelines are broader in scope,
now extending down to preschool children (ages 4 and 5 years). With respect to
diagnosis, the American Psychiatric Association has recently proposed modifications to
the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); the current draft
version of DSM-V includes changes to the diagnosis criteria for ADHD. With respect to
treatment of preschool children with ADHD, studies continue to support the efficacy of
behavioral interventions. Regarding pharmacotherapy, a large, recently completed,
placebo-controlled study of methylphenidate for preschool ADHD identified some agerelated
ADHD can be reliably diagnosed in preschool children. Behavior therapy remains the
recommended first-line treatment approach; pharmacotherapy is sometimes indicated
as a treatment adjunct, or, less commonly, a treatment alternative.