by Mayer, Gwendolyn ¹, Perlea, Victor ¹, Schultz, Jobst-Hendrik ¹, Hanke, Felizitas ¹

• ¹ Universitätsklinikum Heidelberg

This is the abridged version, for the extended version click here
The introduction and overview can be found here

Disclaimer: We have compiled this information to the best of our knowledge based on current scientific literature (as of May 2026). However, we do not provide diagnosis or treatment recommendations. If you notice any mental health concerns in yourself or in a child or adolescent in your care, please consult a medical doctor.

Diagnostic criteria

According to DSM-5 and ICD-11, ADHD is defined by a persistent pattern of inattention and/or hyperactivity–impulsivity with symptoms present before age 12 and in at least two settings. Symptoms must cause clinically significant impairment and not be better explained by another disorder. The DSM-5 distinguishes between predominantly inattentive, predominantly hyperactive/impulsive, and combined presentations (Eom & Kim, 2024; Warren & Arayamparambil, 2023).

The 2019 American Academy of Pediatrics guideline recommends a structured diagnostic process. This includes initial evaluation when academic or behavioural problems and ADHD symptoms are present, a thorough history and diagnostic interview, reports from school and other sources, use of DSM-5–based rating scales, confirmation of criteria across settings, exclusion of alternative explanations, screening for comorbidities, and referral if specialist care is needed (Wolraich et al., 2019).

Prevention measures

· Screening and monitoring of high-risk children, such as those with strong family history or prematurity, in primary care and school settings (AADPA, 2022)
· Parenting programs that teach positive behaviour management, classroom strategies, and educational support (Shah et al., 2019).

Risk factors

· Genetic and familial loading, prenatal exposure to tobacco, alcohol, or drugs, prematurity or very low birth weight, environmental risks such as lead exposure, brain injury, and psychosocial adversity (Patel et al., 2016).
· High rates of comorbidity with learning disorders, anxiety, depression, and autism spectrum disorder disorder (Eom & Kim, 2024; Ernstmayer et al., 2022).

Treatment approaches

· First-line treatment is multimodal and combines psychoeducation, behavioural interventions, parent training, classroom management, organizational skills training, and, when indicated, stimulant or non-stimulant medication.
· Parenting programs with positive behaviour management and educational support remain important (Eom & Kim, 2023; Jerome & Jerome, 2020, Shah et al. (2019).

References for this article are here