For decades, attention-deficit/hyperactivity disorder (ADHD) has been the most common chronic psychiatric disorder of childhood. More recent population studies indicate that ADHD rivals asthma as one of the most commonly diagnosed chronic conditions in children. Yet despite its prevalence, little formal training is available to pediatricians in the effective and efficient office management of affected children. Indeed, approaching ADHD with a chronic disease model is a relatively new concept.

Finding a proven evidence-based approach to the assessment and management of ADHD has long been considered a priority for many pediatricians. In the past decade, the American Academy of Pediatrics (AAP) led the charge to develop a standardized toolkit for the assessment, diagnosis, and ongoing management of ADHD in the primary care setting. Still, little is known about the long-term safety and efficacy of currently available medical and behavioral treatments for ADHD, or their appropriate application to preschool children. The advent of newer and longer acting pharmaceutical agents has also placed a further burden of proof on accepted standard treatment paradigms.

This issue of Pediatric Annals provides five timely discussions of ADHD using a chronic disease model. Safety and efficacy of standard and new treatment modalities are presented and current knowledge of side effects discussed. A unique model of ADHD as a disturbance of functioning is also presented to give a different viewpoint of this common disorder. After reviewing this issue, the participant will have a more complete view of ADHD as a chronic condition.