Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children, which affected approximately 11% of children aged 4 to 17 years of age (6.4 million) in 2011.1 ADHD is often diagnosed in childhood and lasts into adulthood in approximately 65% to 75% of cases.2 A recent systematic literature review suggests that the annual incremental costs for the disorder in the United States are between $143 and $266 billion dollars.3
Despite improvements with the drug delivery systems of ADHD medications, early morning functioning (EMF) remains an issue in many children with ADHD. According to a recent survey, the majority of caregivers reported early morning ADHD symptoms (74%) and EMF impairment (76%) as moderate to severe (ADHD symptom score: 5-10).4 Parents reported that they often: felt overwhelmed and exhausted (41%); raised their voice more (37%); and felt constantly stressed (30%) as a result of their child’s ADHD symptoms during the EMR.4 It was also noted that 79% of caregivers had discussed early morning impairments with their child’s physician.4 In light of these figures, a number of coping strategies, including nonpharmacologic and pharmacologic interventions, have been developed. Therefore, it is important for healthcare professionals to become more aware that the early morning is problematic for children with ADHD and their families.
1. Visser SN, Danielson ML, Bitsko RH, Holbrook JR, Kogan MD, Ghandour RM, Perou R, Blumberg SJ. Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003–2011. J Am Acad Child Adolesc Psychiatry. 2014;53(1):34-46.
2. Wilens TE, Faraone SV, Biederman J. Attention-deficit/hyperactivity disorder in adults. JAMA. 2004;292(5):619-623.
3. Doshi JA, Hodgkins P, Kahle J, Sikirica V, Cangelosi MJ, Setyawan J, Erder MH, Neumann PJ. Economic impact of childhood and adult attention-deficit/hyperactivity disorder in the United States. J Am Acad Child Adolesc Psychiatry. 2012;51(10):990-1002.
4. Sallee FR. Early morning functioning in stimulant-treated children and adolescents with attention-deficit/hyperactivity disorder, and its impact on caregivers. J Child Adolesc Psychopharmacol. 2015;25(7):558-565.