Abstract

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood, characterised by a persistent pattern of inattention, hyperactivity and impulsivity that interferes with the child’s functioning or development. Globally it affects an estimated 5–8% of school-aged children, and Indian school-based studies report a comparable, and at times higher, prevalence. If left unrecognised and unmanaged, ADHD jeopardises the child’s academic achievement, peer relationships, self-esteem and family harmony, and it carries a substantial risk of comorbid conduct, mood and learning difficulties extending into adolescence and adulthood. Current best practice favours a multimodal approach in which non-pharmacological interventions—behaviour therapy, parent training in behaviour management, classroom interventions and psychosocial support—form the foundation of care, with stimulant and nonstimulant medication added for school-aged children with moderate-to-severe impairment. The nurse occupies a pivotal position across this continuum: as an assessor, educator, behaviour-therapy facilitator, medication monitor, counsellor and advocate, and as the professional who links the child, family, school and health system. This review article describes the epidemiology, aetiology, clinical features and assessment of ADHD, and then provides a structured account of evidencebased nursing interventions for affected children, including a sample nursing care plan and a discussion of the Indian context. It is intended as a practical resource for nurses, nursing students and allied child-health professionals.

• 1.   American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5). Arlington, VA: American Psychiatric Publishing; 2013.
• 2.   Wolraich ML, Hagan JF, Allan C, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attentiondeficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528.
• 3.   National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: diagnosis and management. NICE guideline NG87. London: NICE; 2018 (updated 2019).
• 4.   Sayal K, Prasad V, Daley D, Ford T, Coghill D. ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. 2018;5(2):175–186.
• 5.   Catherine TG, Robert NG, Mala KK, Kanniammal C, Arullapan J. Assessment of prevalence of attention deficit hyperactivity disorder among school children in selected schools. Indian J Psychiatry. 2019;61(3):232– 237.
• 6.   Joshi HM, Angolkar M. Prevalence of attention deficit hyperactivity disorder in primary school children in Belagavi city, India. J Atten Disord. 2021;25(2):154–160.
• 7.   Arora NK, Nair MKC, Gulati S, et al. Neurodevelopmental disorders in children aged 2–9 years: population-based burden estimates across five regions in India. PLoS Med. 2018;15(7):e1002615.
• 8.   Centers for Disease Control and Prevention. Behavior therapy and parent training in behavior management for ADHD. Atlanta, GA: CDC; 2024.
• 9.   Daley D, van der Oord S, Ferrin M, et al. Behavioral interventions in attention-deficit/ hyperactivity disorder: a meta-analysis of randomized controlled trials. J Am Acad Child Adolesc Psychiatry. 2014;53(8):835–847.
• 10.   The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 1999;56(12):1073–1086.
• 11.   Evans SW, Owens JS, Bunford N. Evidencebased psychosocial treatments for children and adolescents with attention-deficit/ hyperactivity disorder. J Clin Child Adolesc Psychol. 2014;43(4):527–551.
• 12.   Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894–921.
• 13.   Faraone SV, Banaschewski T, Coghill D, et al. The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neurosci Biobehav Rev. 2021;128:789–818.
• 14.   World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 11th Revision (ICD- 11). Geneva: WHO; 2019.
• 15.   Sreevani R. A Guide to Mental Health and Psychiatric Nursing, 4th ed. New Delhi: Jaypee Brothers Medical Publishers; 2016.
• 16.   Townsend MC, Morgan KI. Psychiatric Mental Health Nursing: Concepts of Care in EvidenceBased Practice, 9th ed. Philadelphia: F.A. Davis; 2018.
• 17.   Stuart GW. Principles and Practice of Psychiatric Nursing, 10th ed. St. Louis: Elsevier Mosby; 2013.
• 18.   Ministry of Health and Family Welfare, Government of India. Rashtriya Bal Swasthya Karyakram (RBSK): operational guidelines. New Delhi: MoHFW; 2013.

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