This Psychiatric Times Clinical Case Collective focuses on attention deficit hyperactivity disorder (ADHD) management in pediatric populations. The expert panel includes Ann Childress, MD, Stephen Mateka, DO, Michelle Voegels, PMHNP-BC, and Michael Asbach, DMSc, PA-C, who discuss ADHD treatment approaches, care transitions, and emerging therapies for children and adolescents.
The session begins with a comprehensive 10-year-old patient case study featuring persistent behavioral difficulties including following instructions, interrupting behaviors, inability to remain seated, emotional outbursts, and organizational challenges. The patient presents with ADHD combined presentation, has a family history of ADHD (father treated with stimulants), mild asthma, and has undergone six months of behavioral interventions with only moderate improvement.
Key diagnostic considerations include the importance of symptoms appearing across multiple settings (home and school environments), genetic predisposition factors, and the timing of ADHD diagnosis. Most children are diagnosed during elementary to middle school years when academic demands increase and compensation strategies become insufficient. The panel emphasizes that while symptoms must be present before age 12 according to diagnostic criteria, many patients retrospectively identify struggles beginning in early elementary school years.
