Academy of Pediatrics (AAP) provides physicians with evidence-based guidelines for managing common pediatric
conditions. The AAP has established an organizational process and methodology for the development, implementa-
tion, and improvement of these clinical practice guidelines.
synthesizing the literature to provide the scientific basis for guideline recommendations. Clinical practice guideline
dence, risk, benefits, patient and caregiver preferences, and effect on equity, diversity, and inclusion. Each clinical
practice guideline undergoes a thorough peer-review process before publication. The AAP supports efforts to imple-
5 years, each clinical practice guideline and the scientific literature are ideally reevaluated by the subcommittee to
ensure that the recommendations are based on the most up-to-date science.
American Academy of Pediatrics clinical practice guidelines are designed to provide physicians with an analytic
framework for evaluating and treating common pediatric conditions and are not intended as an exclusive course of
treatment or standard of care. The AAP recognizes circumstances in which there is a lack of definitive data and relies
on expert consensus in cases in which data do not exist. American Academy of Pediatrics clinical practice guidelines
allow for flexibility and adaptability at the local and patient levels to address unique circumstances and should not
replace sound clinical judgment.
Clinical Practice Guideline for the
Diagnosis, Evaluation, and Treatment of
Attention-Deficit/Hyperactivity
Disorder in Children and Adolescents
Attention-deficit/hyperactivity disorder (ADHD) is 1 of the most common abstract
neurobehavioral disorders of childhood and can profoundly affect children’s
academic achievement, well-being, and social interactions. The American Academy
of Pediatrics first published clinical recommendations for evaluation and
diagnosis of pediatric ADHD in 2000; recommendations for treatment followed
in 2001. The guidelines were revised in 2011 and published with an accompanying
process of care algorithm (PoCA) providing discrete and manageable steps by
which clinicians could fulfill the clinical guideline’s recommendations. Since the
release of the 2011 guideline, the Diagnostic and Statistical Manual of Mental
Disorders has been revised to the fifth edition, and new ADHD-related research
has been published. These publications do not support dramatic changes to
the previous recommendations.
Therefore, only incremental updates have been
made in this guideline revision, including the addition of a key action statement
related to diagnosis and treatment of comorbid conditions in children and
adolescents with ADHD. The accompanying process of care algorithm has also
been updated to assist in implementing the guideline recommendations.
Throughout the process of revising the guideline and algorithm, numerous
systemic barriers were identified that restrict and/or hamper pediatric clinicians’
ability to adopt their recommendations. Therefore, the subcommittee created
a companion article (available in the Supplemental Information) on systemic
barriers to the care of children and adolescents with ADHD, which identifies the
major systemic-level barriers and presents recommendations to address those
barriers; in this article, we support the recommendations of the clinical practice
guideline and accompanying process of care algorithm.
