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Attention deficit hyperactivity disorder in children

Última revisión: 16 Jul 2025
Última actualización: 13 May 2025

Resumen

Definición

História e exame físico

Principais fatores diagnósticos

  • inability to give close attention to details or making "careless" mistakes in schoolwork, work, or other activities
  • difficulty sustaining attention in tasks or play activities
  • does not seem to listen when spoken to directly
  • does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
  • often has difficulty organizing tasks and activities
  • avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
  • often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
  • easily distracted by extraneous stimuli
  • forgetful in daily activities
  • fidgets or taps with hands or feet or squirms in seat
  • leaves seat in classroom or in other situations in which remaining seated is expected
  • runs about or climbs excessively during inappropriate situations
  • difficulty playing or engaging in leisure activities quietly
  • often "on the go" or acts as if "driven by a motor"
  • often talks excessively
  • often blurts out answers before questions have been completed
  • often has difficulty awaiting turn
  • often interrupts or intrudes on others (e.g., butts into conversations or games)
Detalhes completos

Outros fatores diagnósticos

  • mild mood symptoms (dysphoria, mood lability, irritability, boredom)
  • anxiety
  • difficulty with peer interactions
  • low self-esteem
  • working memory (i.e., short-term memory) impairment
  • processing speed impairment (i.e., the rate at which information is dealt with)
Detalhes completos

Fatores de risco

  • family history of ADHD
  • male sex
  • low birth weight
  • epilepsy
  • tic disorders
  • maternal nicotine use during pregnancy
  • maternal acetaminophen use during pregnancy
  • obstetric complications in pregnancy or labor
  • gestational exposure to stress
  • psychosocial adversity
  • lead exposure
  • traumatic brain injury
  • severe early deprivation
  • iron deficiency
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • no formal laboratory or imaging studies
Detalhes completos

Tests to avoid

  • hair analysis
Detalhes completos

Investigações a serem consideradas

  • neuropsychological testing
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

preschool-age children: 4-6 years

school-age children: 6-18 years

Colaboradores

Autores

Mark Wolraich, MD

Shaun Walters Professor Emeritus, Pediatrics

Section of Developmental and Behavioral Pediatrics

University Oklahoma Health Sciences

Oklahoma City

OK

Declarações

MW is a member of the steering committee of the REACH Institute providing CME programs on child mental health.

Agradecimentos

Dr Mark Wolraich would like to gratefully acknowledge Dr Lawrence W. Brown, Dr Kristin S. Russell, Dr Howard Y. Liu, and Dr Michael S. Jellinek, previous contributors to this topic.

Declarações

LWB was reimbursed by Sunovion for participation in a Medical Advisory Board. KSR, HYL, and MSJ declare that they have no competing interests.

Revisores

Joseph F. Hagan, Jr. MD, FAAP

Clinical Professor in Pediatrics

The Larner College of Medicine at the University of Vermont

Burlington

VT

Declarações

JFH served as Vice-Chairman of the American Academy of Pediatrics' ADHD Clinical Guidelines revision alongside the author of this topic, MW, who was Chairman. They also co-authored the book "ADHD: What Every Parent Needs to Know, 3rd. Ed.", published by the AAP.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

World Health Organization. ICD-11 International statistical classification of diseases and related health problems, 11th revision. Geneva: WHO; 2022.Texto completo

Wolraich ML, Hagan JF Jr, Allan C, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019 Oct;144(4):e20192528.Texto completo  Resumo

Faraone SV, Banaschewski T, Coghill D, et al. The world federation of ADHD international consensus statement: 208 evidence-based conclusions about the disorder. Neurosci Biobehav Rev. 2021 Sep;128:789-818.Texto completo  Resumo

Barbaresi WJ, Campbell L, Diekroger EA, et al. Society for Developmental and Behavioral Pediatrics Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents with Complex Attention-Deficit/Hyperactivity Disorder. J Dev Behav Pediatr. 2020 Feb/Mar;41 Suppl 2S:S35-S57.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Learning/language disorder
    • Oppositional defiant disorder
    • Depression
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR)
    • Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    ADHD: what is it?

    ADHD in children: what treatments work?

    Mais Folhetos informativos para os pacientes
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