Approach to Attention Deficit Disorder (ADD)

First Neurological Visit

Objective: Gather a complete medical history, assess habits, and family context.

Personal and family medical history.

Family, school, and work context.

Daily habits (sleep, diet, activities).

General Neurological Examination:

Exclude signs of other neurological disorders.

Tests for Differential Diagnosis

Objective: Rule out other neurological or functional pathologies

Test Purpose:

Electroencephalogram (EEG):

Rule out brain electrical abnormalities.

Cognitive Evoked Potentials (P300): Evaluate attentional and cognitive processes.

Brain MRI:

Rule out structural brain lesions.

Neurovisual Assessment: Identify central visual dysfunctions.

Central Auditory Assessment Rule: out auditory processing disorders.

In-Depth Neuropsychological Cognitive Assessment

Objective: Explore cognitive functions to identify specific deficits.

Main Tests:

Sustained and selective attention.

Executive functions (cognitive flexibility, planning).

Working memory

Processing speed

Second Neurological Visit

Objective: Integrate the medical history, diagnostic tests, and neuropsychological
assessment.

Activities:

Discussion of test results.

Formulation of the final diagnostic hypothesis.

Formulation of Therapy

Possible Therapies:

Follow-Up

Timelines:

1 month →

Initial evaluation of therapeutic response.

3 months →

Monitoring of effectiveness and safety.

6 months →

Consolidation of therapy.

Annually →

Stable evaluation of progression.

A

Behavioral:

Interventions to manage habits and behavior.

B

Psychological:

Psychotherapeutic support (e.g., cognitive-behavioral therapy).

C

Pharmacological:

Use of psychostimulants (e.g., methylphenidate, atomoxetine).

D

If pharmacological therapy → Required monitoring:

Electroencephalogram (EEG) if not already performed.

E

24-Hour Holter Cardiac Monitoring:

Exclude cardiac rhythm abnormalities or
long QT syndrome.

F

Neurofeedback:

Training to improve self-regulation of cognitive functions.
Specific school recommendations and behavioral strategies will also be provided to support the
patient in their academic and daily activities.

Possible Follow-Up Controls:

• Cardiac: 24-hour Holter monitoring if on psychostimulant therapy

• Neurophysiological: EEG and evoked potentials to monitor progression.

• Neuropsychological: Repetition of tests to assess cognitive improvements.