New Clinical Guidelines: Holistic Treatment Is Best for Children with ADHD and Comorbidities

February 3, 2020

Psychosocial interventions paired with medication is the recommended treatment for children and teens with ADHD and comorbid conditions such as learning disabilities, anxiety, or mood disorders, according to new clinical guidelines from the Society for Developmental and Behavioral Pediatrics (SDBP) published in the Journal of Developmental Behavior and Pediatrics.¹

These new clinical guidelines echo those of the American Academy of Pediatrics, which similarly recommends treating “complex” ADHD with a combination of medication and psychosocial interventions such as behavioral therapy, classroom-based management tools, parent education, organizational skills training, initiatives to improve peer interactions, and school services.

William Barbaresi, MD, chief of the Division of Developmental Medicine at Boston Children’s Hospital and chair of the SDBP Complex ADHD Guidance Panel, explained: “Treatment for children and adolescents with complex ADHD should focus on improvement in function — behaviorally, socially, academically — over the patient’s life, not just improving ADHD symptoms.”²

The SDBP guidelines, developed over three years by a panel of developmental behavioral pediatricians, child psychologists, and CHADD representatives, comprise five key action statements:²

• Children under 19 with suspected or diagnosed complex ADHD should receive a comprehensive assessment by a clinician with specialized training or expertise, who should develop a multi-faceted treatment plan. The plan should be designed to diagnose and treat ADHD and other coexisting disorders and complicating factors including other neurodevelopmental disorders, learning disorders, mental health disorders, genetic disorders and psychosocial factors like trauma and poverty.
• The evaluation should verify previous diagnoses and assess for other conditions; it should include a psychological assessment based on a child’s functional disabilities, and intellectual and developmental level.
• All children with complex ADHD should receive behavioral and educational interventions addressing behavioral, educational, and social success.
• Treatment of complex ADHD should also include coexisting conditions, such as autism spectrum disorder or substance abuse disorder, and focus on areas of impairment, not just reducing symptoms.
• Monitoring and treatment of complex ADHD should continue throughout life.

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