Pediatric Annals最新文献

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric psychiatric disorders and is frequently diagnosed and treated by pediatricians. Stimulant medications are the first-line treatment for ADHD but may not be a good fit for many patients due to side effects, inadequate treatment response, or family preference. Non-stimulant ADHD medications provide a useful alternative for patients that cannot tolerate stimulants, have an incomplete treatment response to stimulants, are at risk for stimulant diversion, or whose family prefers to avoid stimulants. Nonstimulant ADHD medications can be used as monotherapy or added to a stimulant as an augmentation strategy. The recommended nonstimulant ADHD medications include alpha agonists (eg, guanfacine extended-release [ER], clonidine ER) and norepinephrine reuptake inhibitors (eg, atomoxetine, viloxazine). Other nonstimulant medications (eg, buproprion, tricyclic antidepressants, polyunsaturated fatty acids) have been used off-label for ADHD but are not recommended and should only be considered as a third-line option. [Pediatr Ann. 2025;54(1):e27-e33.].

Clinicians caring for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) must be prepared to answer questions about the disorder and its treatment from parents who are unfamiliar with ADHD, as well as those who have been exposed to information and misinformation about it. In this article, we provide evidence-based responses to common questions and concerns that parents and guardians have about their child's ADHD diagnosis and treatment options. [Pediatr Ann. 2025;54(1):e18-e21.].

Attention-deficit/hyperactivity disorder (ADHD) is a treatable pediatric condition, but children with racial-ethnic minority backgrounds often do not receive timely or consistent treatment. Understanding how systemic racism impacts care and learning from families of color about their experiences can provide critical insights for improving clinical practice and engaging patients equitably in ADHD care. We interweave a mother's experience navigating ADHD care for her son with commentary from an interprofessional team about what clinicians can do for families to reduce the impact of systemic racism on care. [Pediatr Ann. 2025;54(1):e12-e17.].

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that typically presents in childhood and can cause significant impairment from youth into adulthood across multiple settings (eg, school, home). Pediatricians are the most likely health professionals to identify and treat ADHD. However, ADHD symptoms often overlap with other common mental health disorders, making accurate identification challenging. The diagnosis of ADHD relies on a combination of history gathering, screening tools, and clinical judgment. In this article, we review tools and strategies for ADHD identification, assessment, and treatment monitoring in primary care pediatrics. [Pediatr Ann. 2025;54(1):e6-e11.].

Pediatricians are often the first providers to assess and treat attention-deficit/hyper-activity disorder (ADHD) in youth. While a variety of pharmacological and psychosocial interventions exist for ADHD, stimulants remain the first-line medication treatment. Many stimulant formulations now exist, providing the pediatric prescriber with a diverse repertoire of treatment options. This article is tailored to the pediatric prescriber in the primary care setting and discusses stimulant management, with emphasis on dosing equivalencies, common stimulant-dosing strategies, and newer stimulants. [Pediatr Ann. 2025;54(1):e22-e26.].

From the 12th Century, when the word referred to taking religious vows, to its present meaning as a constellation of organized practices requiring special training, legal liability, and covenants with individual patients and society, professionalism has played an important role in the practice of medicine. Until relatively recently, the concepts of professionalism and professional behavior were rooted in timeless ideals that individual physicians were expected to achieve in training and practice. As an ideal type, professionalism was seen as a quality or characteristic residing in the individual physician. By the same measure, the period of rapid technological and social change that marked the early to mid-20th Century made clear that timelessness, as it applied to professionalism, had its limitations. Where once sharing bad or sad news with patients was viewed as harmful, the right to know one's diagnosis is now enshrined in law and taken for granted in education and practice. Moreover, research shows that knowing one's diagnosis is often beneficial, not harmful, to individuals and families. In response to changing norms and technological advances, medical educators have introduced new models of professionalism that stress the role of social context and relationships in training and practice. One innovative approach is based on the concept of professional identity formation, the moment-by-moment process of becoming and being a physician. Identity formation occurs primarily through story-telling and other forms of self-expression in the context of a community of peers who learn to practice medicine with technical proficiency, kindness, and self-awareness together. [Pediatr Ann. 2024;53(12):e440-e445.].

Pediatric advocacy is an effort to champion the well-being of children and adolescents, ensuring access to quality health care and addressing socioeconomic issues linked to adverse health. This article explores pediatricians' responsibilities in advocating for their patients within the health care system and in broader societal contexts. Models of physician advocacy and the concept of advocacy as a fundamental professionalism responsibility, grounded in ethical principles and societal obligations, are introduced. As providers for patients who lack the capacity to advocate for themselves, the unique role of the pediatrician is examined. The improving landscape of advocacy education in undergraduate and graduate medical training programs is presented, and the concept that engaging in advocacy can help physicians battle burnout is raised. Barriers to advocacy for pediatricians are addressed. Pediatricians should leverage their expertise and influence to advance the health and rights of patients and their families. [Pediatr Ann. 2024;53(12):e452-e457.].