Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder (NDD) that affects 5% of children and adolescents in the world. But today, diagnosis and access to care are complicated. The recommendations published by the High Authority for Health (HAS) on Monday, September 23 aim to enable early treatment. Because, as the HAS specifies, “The diagnosis of a person with ADHD is made in the presence of symptoms of inattention, accompanied or not by hyperactivity and impulsivity, which vary from one person to another, last over time and cause a harmful impact on the school, social and family level.” Remember that this disorder is often complex to diagnose before the child is 3 or 4 years old because before this age, children’s mobility needs are very important. However, some signs can be spotted earlier by observing the child.
Early diagnosis
In these recommendations, the HAS emphasizes that “The diagnosis is based on an interview with the child and his parents in order to assess the child’s development in all its dimensions (neurological, psychomotor, emotional, etc.).” A specific interview is then conducted with the child, focusing on their perception and how they overcome difficulties. The HAS specifies that the diagnosis must be accompanied by a clinical examination and also rely on discussions with the child’s entourage (family, school, extracurricular, etc.). And insists: “Time spent talking with the child and their parents is essential to help them decide on the therapeutic interventions and thus encourage their adherence to the therapeutic project.”
Train more professionals
Currently, only pediatricians, psychiatrists and child neurologists can make a diagnosis and are authorized to initiate drug treatment. The HAS is campaigning for the long term, primary care physicians (pediatricians and general practitioners)) may be able to diagnose a simple disorder, “or, in the event of suspicion of a complex disorder, to redirect the patient to a doctor or a specialized structure, if they have not followed second-line training.” To strengthen their skills, doctors “will then follow structured and qualifying training, in conjunction with the relevant National Professional Colleges.” Furthermore, “a standard examination grid, listing various reference diagnostic scales, is made available.”
Make way for telediagnosis
The High Authority for Health advocates for the development of telemedicine which “can also help improve the journey of people with ADHD by facilitating access to medical expertise.” And adds in his document: “While it is recommended that the diagnosis of ADHD be based on at least one face-to-face consultation, particularly for carrying out the clinical examination of the child or adolescent, teleconsultation can make it possible to organize remote monitoring of the patient.”
