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While 5% of children worldwide are affected by attention disorders, their management and timeframe are not yet up to par. The High Authority for Health has published new recommendations on Monday to speed things up.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder (NDD) that affects 5% of children and adolescents worldwide. Better understood and better apprehended today, it still suffers from a delay in diagnosis that can disrupt schooling in particular and the child’s social life.
3 to 6 years of diagnostic wandering
According to the HAS, 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. But in reality, this diagnosis can take a long time, because the family and medical entourage is not trained. Or they only see an “agitated” child.
“The average time before the correct diagnosis is currently estimated at between 3 and 6 years”recalls Olivier Bonnot, professor of child and adolescent psychiatry at the University of Paris Saclay, who chaired the HAS working group, in 20 Minutes.
“The waits are so long to get an appointment with a psychologist that parents, helpless, often spend astronomical sums to have all kinds of assessments done that are not necessarily useful”warns Christine Gétin, director of the HyperSupers-TDAH France association. However, the earlier the disorder is treated, the less impact it has on the child’s schooling.
A diagnosis that is now more structured
The HAS thus recalls the procedure to follow for the diagnosis, which should be the same everywhere. This is based on
- An interview with the child and his/her parents in order to assess the child’s development in all its dimensions (neurological, psychomotor, emotional, etc.).
- A specific interview with the child, focusing on their perception and how they overcome difficulties;
- The diagnosis also includes a clinical examination and the gathering of information from the child’s entourage (family, school, extracurricular activities, etc.);
- Non-drug interventions are recommended as a first-line treatment, such as psychoeducation which helps the child and their parents to understand the disorder and manage its impact or academic support with advice on implementing specific arrangements.
- In addition, if necessary and depending on the severity of the disorder, drug treatment may be prescribed.
In order to support professionals in their practice, the HAS also publishes a summary of the recommendations, including decision trees on the choice of interventions and their relevance, and two practical sheets:
- One provides a framework for conducting the diagnostic interview and the other concerns monitoring drug treatment.
- The HAS also lists existing assessment tools (questionnaires, interview assistance, etc.).
More doctors will also be trained
To facilitate care, many doctors will also be trained, the press release promises. Currently, only pediatricians, psychiatrists and child neurologists can make a diagnosis and are authorized to initiate drug treatment.
“With the aim of expanding the provision of care in the territory, the HAS is today calling on the public authorities to extend these skills to other doctors (general practitioners in particular): the latter will then follow structured and qualifying training, in conjunction with the relevant National Professional Colleges.”
The use of assisted teleconsultation (during which a healthcare professional or a local psychologist is present alongside the child and their family in order to assist the specialist doctor remotely) is also now a possibility.
New recommendations regarding “adult” ADHD should also be made at the end of 2025.