TABLE 4

KAS 3: In the evaluation of a child or adolescent for ADHD, the PCC should include a process to at least screen for comorbid conditions, including emotional or behavioral conditions (eg, anxiety, depression, oppositional defiant disorder, conduct disorders, substance use), developmental conditions (eg, learning and language disorders, autism spectrum disorders), and physical conditions (eg, tics, sleep apnea). (Grade B: strong recommendation.)

Aggregate evidence qualityGrade B
BenefitsIdentifying comorbid conditions is important in developing the most appropriate treatment plan for the child or adolescent with ADHD.
Risks, harm, costThe major risk is misdiagnosing the comorbid condition(s) and providing inappropriate care.
Benefit-harm assessmentThere is a preponderance of benefits over harm.
Intentional vaguenessNone.
Role of patient preferencesNone.
ExclusionsNone.
StrengthStrong recommendation.
Key referencesCuffe et al51; Pastor and Reuben52; Bieiderman et al53; Bieiderman et al54; Bieiderman et al72; Crabtree et al57; LeBourgeois et al58; Chan115; Newcorn et al60; Sung et al61; Larson et al66; Mahajan et al65; Antshel et al64; Rothenberger and Roessner63; Froehlich et al62