ADHD in Preschool: A Narrative Review.

Abstract

Attention Deficit Disorder (ADHD) is a very heterogeneous and highly prevalent neurodevelopmental disorder in children and adolescents. The detection of ADHD in the preschool stage (between 3 and 5 years of age) would allow early intervention, reducing its symptoms and modifying the course of the disorder. The present study aims to review in a narrative way the concept of ADHD in preschool population, its characteristics, the instruments that allow its detection and the available treatments. The clinical symptoms of ADHD in preschoolers are not as frequent as traditionally thought and present a high predictive validity, being frequently maintained over the years. The most common presentation of ADHD at this stage is hyperactive/impulsive and inattentive-dominant presentations occur infrequently. The evaluation of ADHD includes the detection of general psychopathology that may be comorbid to ADHD or that allows a correct differential diagnosis. Several ADHD symptom assessment scales are reliable for the clinical detection of the disorder and should be combined with measures that assess possible associated difficulties. Family interventions are the most frequently used, and pharmacological treatment is not recommended until 6 years of age. However, the results of treatment effectiveness are not very robust. Early preventive intervention is needed in the preschool stage with cases that present or are at risk of presenting ADHD and not “sit and wait”, although more effective interventions need to be found.