Attention Deficit/Hyperactivity Disorder (ADHD) in Children
Synopsis
This chapter provides a comprehensive, evidence-based analysis of Attention-Deficit/Hyperactivity Disorder (ADHD) in pediatric populations. It opens with a precise clinical definition based on DSM-5 criteria, detailing the distinct manifestations of inattention, hyperactivity, and impulsivity. Incorporating recent global epidemiological data, the text highlights prevalence rates, gender disparities, and common psychiatric comorbidities that challenge academic and social development. The etiological framework maps a complex interplay of high genetic heritability (such as variants in dopamine regulation) alongside prenatal and postnatal environmental risk factors. Furthermore, it explores underlying neurobiological mechanisms, focusing on subcortical-cortical dysconnectivity within executive and motivational brain circuits. A central focus is placed on holistic, multimodal management. The chapter evaluates pharmacological options, positioning stimulants as the gold standard for symptom control, while critically reviewing non-pharmacological supportive therapies—including physical exercise, cognitive training, behavioral interventions, and neurofeedback. Finally, it highlights the expanding roles of nurses, particularly school nurses, as vital bridges in early identification, treatment monitoring, family-school collaboration, and the reduction of social stigma, ultimately aiming to maximize each child's potential.
References
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AlAzzam, M., Suliman, M., & ALBashtawy, M. (2017). School Nurses' Role in Helping Children With Attention-Deficit/Hyperactivity Disorders. NASN school nurse (Print), 32(1), 36–38. doi.org/10.1177/1942602X16648192
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). doi.org/10.1176/appi.books.9780890425756
Ayano, G., Demelash, S., Gizachew, Y., Tsegay, L., & Alati, R. (2023). The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. Journal of affective disorders, 339, 860–866. doi.org/10.1016/j.jad.2023.07.071
Bellato, A., Perrott, N. J., Marzulli, L., Parlatini, V., Coghill, D., & Cortese, S. (2025). Systematic Review and Meta-Analysis: Effects of Pharmacological Treatment for Attention-Deficit/Hyperactivity Disorder on Quality of Life. Journal of the American Academy of Child and Adolescent Psychiatry, 64(3), 346–361. doi.org/10.1016/j.jaac.2024.05.023
Bitsko, R. H., Holbrook, J. R., O’Masta, B., Maher, B., Cerles, A., Saadeh, K., ... & Kaminski, J. W. (2024). A systematic review and meta-analysis of prenatal, birth, and postnatal factors associated with attention-deficit/hyperactivity disorder in children. Prevention Science, 25(Suppl 2), 203-224. doi.org/10.1007/s11121-022-01359-3
Bolea-Alamañac, B., Nutt, D. J., Adamou, M., Asherson, P., Bazire, S., Coghill, D.,…& British Association for Psychopharmacology (2014). Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: update on recommendations from the British Association for Psychopharmacology. Journal of psychopharmacology (Oxford, England), 28(3), 179–203. doi.org/10.1177/0269881113519509
Catalá-López, F., Hutton, B., Núñez-Beltrán, A., Page, M. J., Ridao, M., Macías Saint-Gerons, D.,…& Moher, D. (2017). The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. PloS one, 12(7), e0180355. doi.org/10.1371/journal.pone.0180355
Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2019). Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Molecular psychiatry, 24(3), 390–408. doi.org/10.1038/s41380-018-0116-3
Cénat, J. M., Kokou-Kpolou, C. K., Blais-Rochette, C., Morse, C., Vandette, M. P., Dalexis, R. D.,…& Kogan, C. S. (2024). Prevalence of ADHD among Black Youth Compared to White, Latino and Asian Youth: A Meta-Analysis. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 53(3), 373–388. doi.org/10.1080/15374416.2022.2051524
Centers for Disease Control and Prevention (CDC) (2024). Attention-Deficit/Hyperactivity Disorder (ADHD). (Accessed on 13/10/2025 from adress https://www.cdc.gov/adhd/index.html).
Chan, Y. S., Jang, J. T., & Ho, C. S. (2022). Effects of physical exercise on children with attention deficit hyperactivity disorder. Biomedical journal, 45(2), 265–270. doi.org/10.1016/j.bj.2021.11.011
Faraone, S.V., Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24, 562–575. doi.org/10.1038/s41380-018-0070-0
Grigore, M., Ionică, M. V., Pătru, L., Gheorman, V., & Wagner, A. P. (2025). Recent Advances in the Etiology and Neural Pathways Underlying Attention-Deficit and Hyperactivity Disorder. Current health sciences journal, 51(1), 14–25. doi.org/10.12865/CHSJ.51.01.02
Hakim Shooshtari, M., Shariati, B., Kamalzadeh, L., Naserbakht, M., Tayefi, B., & Taban, M. (2021). The prevalence of attention deficit hyperactivity disorder in Iran: An updated systematic review. Medical journal of the Islamic Republic of Iran, 35, 8. doi.org/10.47176/mjiri.35.8
Kleve, L., Vårdal, L., & Elgen, I. B. (2022). The Nurse Role in the Management of ADHD in Children and Adolescent: A Literature Review. Frontiers in psychiatry, 13, 676528. doi.org/10.3389/fpsyt.2022.676528
Millichap J. G. (2008). Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics, 121(2), e358–e365. doi.org/10.1542/peds.2007-1332
NICE guideline (2018). Attention deficit hyperactivity disorder: diagnosis and management. (Accessed on 12/10/2025 from adress https://www.nice.org.uk/guidance/ng87/resources/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933).
Norman, L. J., Sudre, G., Price, J., & Shaw, P. (2024). Subcortico-Cortical Dysconnectivity in ADHD: A Voxel-Wise Mega-Analysis Across Multiple Cohorts. The American journal of psychiatry, 181(6), 553–562. doi.org/10.1176/appi.ajp.20230026
Ogundele, M. O., & Ayyash, H. F. (2023). ADHD in children and adolescents: Review of current practice of non-pharmacological and behavioural management. AIMS public health, 10(1), 35–51. doi.org/10.3934/publichealth.2023004
Özbay, A., & Kayhan, Z. (2024). Dikkat eksikliği ve hiperaktivite bozukluğunun (dehb) nedenleri ve tedavi yöntemleri. Elektronik Sosyal Bilimler Dergisi, 23(89), 394-406. doi.org/10.17755/esosder.1283141
Qiu, H., Liang, X., Wang, P., Zhang, H., & Shum, D. H. (2023). Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: a systematic review and meta-analysis. Asian journal of psychiatry, 87, 103692. doi.org/10.1016/j.ajp.2023.103692
Thapar, A., Cooper, M., & Rutter, M. (2017). Neurodevelopmental disorders. The lancet. Psychiatry, 4(4), 339–346. doi.org/10.1016/S2215-0366(16)30376-5
Westwood, S. J., Aggensteiner, P. M., Kaiser, A., Nagy, P., Donno, F., Merkl, D., …& European ADHD Guidelines Group (EAGG) (2025). Neurofeedback for Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. JAMA psychiatry, 82(2), 118–129. doi.org/10.1001/jamapsychiatry.2024.3702
Wolraich, M. L., Hagan, J. F., Jr, Allan, C., Chan, E., Davison, D., Earls, M.,…& Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 144(4), e20192528. doi.org/10.1542/peds.2019-25
AlAzzam, M., Suliman, M., & ALBashtawy, M. (2017). School Nurses' Role in Helping Children With Attention-Deficit/Hyperactivity Disorders. NASN school nurse (Print), 32(1), 36–38. doi.org/10.1177/1942602X16648192
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). doi.org/10.1176/appi.books.9780890425756
Ayano, G., Demelash, S., Gizachew, Y., Tsegay, L., & Alati, R. (2023). The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. Journal of affective disorders, 339, 860–866. doi.org/10.1016/j.jad.2023.07.071
Bellato, A., Perrott, N. J., Marzulli, L., Parlatini, V., Coghill, D., & Cortese, S. (2025). Systematic Review and Meta-Analysis: Effects of Pharmacological Treatment for Attention-Deficit/Hyperactivity Disorder on Quality of Life. Journal of the American Academy of Child and Adolescent Psychiatry, 64(3), 346–361. doi.org/10.1016/j.jaac.2024.05.023
Bitsko, R. H., Holbrook, J. R., O’Masta, B., Maher, B., Cerles, A., Saadeh, K., ... & Kaminski, J. W. (2024). A systematic review and meta-analysis of prenatal, birth, and postnatal factors associated with attention-deficit/hyperactivity disorder in children. Prevention Science, 25(Suppl 2), 203-224. doi.org/10.1007/s11121-022-01359-3
Bolea-Alamañac, B., Nutt, D. J., Adamou, M., Asherson, P., Bazire, S., Coghill, D.,…& British Association for Psychopharmacology (2014). Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: update on recommendations from the British Association for Psychopharmacology. Journal of psychopharmacology (Oxford, England), 28(3), 179–203. doi.org/10.1177/0269881113519509
Catalá-López, F., Hutton, B., Núñez-Beltrán, A., Page, M. J., Ridao, M., Macías Saint-Gerons, D.,…& Moher, D. (2017). The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. PloS one, 12(7), e0180355. doi.org/10.1371/journal.pone.0180355
Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2019). Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Molecular psychiatry, 24(3), 390–408. doi.org/10.1038/s41380-018-0116-3
Cénat, J. M., Kokou-Kpolou, C. K., Blais-Rochette, C., Morse, C., Vandette, M. P., Dalexis, R. D.,…& Kogan, C. S. (2024). Prevalence of ADHD among Black Youth Compared to White, Latino and Asian Youth: A Meta-Analysis. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 53(3), 373–388. doi.org/10.1080/15374416.2022.2051524
Centers for Disease Control and Prevention (CDC) (2024). Attention-Deficit/Hyperactivity Disorder (ADHD). (Accessed on 13/10/2025 from adress https://www.cdc.gov/adhd/index.html).
Chan, Y. S., Jang, J. T., & Ho, C. S. (2022). Effects of physical exercise on children with attention deficit hyperactivity disorder. Biomedical journal, 45(2), 265–270. doi.org/10.1016/j.bj.2021.11.011
Faraone, S.V., Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24, 562–575. doi.org/10.1038/s41380-018-0070-0
Grigore, M., Ionică, M. V., Pătru, L., Gheorman, V., & Wagner, A. P. (2025). Recent Advances in the Etiology and Neural Pathways Underlying Attention-Deficit and Hyperactivity Disorder. Current health sciences journal, 51(1), 14–25. doi.org/10.12865/CHSJ.51.01.02
Hakim Shooshtari, M., Shariati, B., Kamalzadeh, L., Naserbakht, M., Tayefi, B., & Taban, M. (2021). The prevalence of attention deficit hyperactivity disorder in Iran: An updated systematic review. Medical journal of the Islamic Republic of Iran, 35, 8. doi.org/10.47176/mjiri.35.8
Kleve, L., Vårdal, L., & Elgen, I. B. (2022). The Nurse Role in the Management of ADHD in Children and Adolescent: A Literature Review. Frontiers in psychiatry, 13, 676528. doi.org/10.3389/fpsyt.2022.676528
Millichap J. G. (2008). Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics, 121(2), e358–e365. doi.org/10.1542/peds.2007-1332
NICE guideline (2018). Attention deficit hyperactivity disorder: diagnosis and management. (Accessed on 12/10/2025 from adress https://www.nice.org.uk/guidance/ng87/resources/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933).
Norman, L. J., Sudre, G., Price, J., & Shaw, P. (2024). Subcortico-Cortical Dysconnectivity in ADHD: A Voxel-Wise Mega-Analysis Across Multiple Cohorts. The American journal of psychiatry, 181(6), 553–562. doi.org/10.1176/appi.ajp.20230026
Ogundele, M. O., & Ayyash, H. F. (2023). ADHD in children and adolescents: Review of current practice of non-pharmacological and behavioural management. AIMS public health, 10(1), 35–51. doi.org/10.3934/publichealth.2023004
Özbay, A., & Kayhan, Z. (2024). Dikkat eksikliği ve hiperaktivite bozukluğunun (dehb) nedenleri ve tedavi yöntemleri. Elektronik Sosyal Bilimler Dergisi, 23(89), 394-406. doi.org/10.17755/esosder.1283141
Qiu, H., Liang, X., Wang, P., Zhang, H., & Shum, D. H. (2023). Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: a systematic review and meta-analysis. Asian journal of psychiatry, 87, 103692. doi.org/10.1016/j.ajp.2023.103692
Thapar, A., Cooper, M., & Rutter, M. (2017). Neurodevelopmental disorders. The lancet. Psychiatry, 4(4), 339–346. doi.org/10.1016/S2215-0366(16)30376-5
Westwood, S. J., Aggensteiner, P. M., Kaiser, A., Nagy, P., Donno, F., Merkl, D., …& European ADHD Guidelines Group (EAGG) (2025). Neurofeedback for Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. JAMA psychiatry, 82(2), 118–129. doi.org/10.1001/jamapsychiatry.2024.3702
Wolraich, M. L., Hagan, J. F., Jr, Allan, C., Chan, E., Davison, D., Earls, M.,…& Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 144(4), e20192528. doi.org/10.1542/peds.2019-25
Pages
247-260
Published
June 30, 2026
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