Table 2.

AAP ADHD Treatment Guidelines³

Preschool	First line: PTBM, behavioral classroom interventions If behavioral interventions ineffective after ≥3-month trial and if, moderate-severe disturbance in functioning: MPH If MPH is used, start and target small doses and use short-acting product; this age group metabolizes the medication more slowly
Elementary and Middle School	First line: medication and behavioral interventions Behavioral interventions: PTBM, behavioral classroom interventions, educational interventions, individualized instructional support (i.e., IEP, 504 plan) Medication: MPH considered first line, consider short- or long-acting product
High School	First line: medication and behavioral interventions Behavioral interventions: PTBM, behavioral classroom interventions, educational interventions, individualized instructional support (i.e., IEP, 504 plan) Medication: MPH considered first line, consider long-acting product to minimize need for afternoon doses

AAP, American Academy of Pediatrics; ADHD, attention-deficit/hyperactivity disorder; IEP, individualized education plan; MPH, methylphenidate; PTBM, parent training in behavior management