Introduction

The consequences of persistent, pervasive, and disabling hyperactivity, impulsivity, and inattentiveness on a child's development and functioning are serious. The presence of attention deficit hyperactivity disorder (ADHD) or hyperkinetic disorder predicts a wide range of negative outcomes. These include poor self esteem, academic achievement, occupational status, peer relationships, and family functioning and increased injury rates, disruptive and antisocial behaviour, substance misuse, and mood and anxiety disorders.1 As treatment can restore healthy functioning to many of these children and young people, a reluctance to diagnose ADHD seems unreasonable and withholding effective treatments from those who have had the condition diagnosed is unjustifiable.

Opponents of the validity of ADHD as a diagnosis cite our incomplete understanding of its precise biological basis. Sensationalist journalism has often caught public, and at times professional, attention by delivering negative messages about the “dangers” of stimulants such as methylphenidate and the sharp increases in use over the past decade. It is important, however, to examine this …