Timing of ADHD Diagnosis and Medication Initiation in Preschoolers

In U.S. primary care, many preschool-age children who receive diagnoses of attention-deficit/hyperactivity disorder (ADHD) begin pharmacologic treatment soon after diagnosis, despite guidelines emphasizing parent-focused behavioral therapy as the preferred initial approach for young children (age, 4–5 years). Medication is considered to be a second-line treatment when symptoms are severe or behavioral strategies are ineffective. Researchers examined real-world patterns of ADHD diagnosis and medication timing by evaluating 8 years of electronic primary care health records for 700,000 children (age range, 3–5 years) from eight large U.S. pediatric health systems.