Attention‑Deficit / Hyperactivity Disorder in Children: Overcoming Diagnostic Challenges and Exploring Modern Treatment Approaches

Attention-Deficit / Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder with significant functional impact. It is characterized by inattention, hyperactivity, and impulsivity. Its diagnosis remains challenging due to informant discrepancies, developmental variations, and gender- or culture-related biases. Disparities in healthcare access and stigma further contribute to under- and over-diagnosis, particularly in marginalized populations. This narrative review synthesizes recent literature on advances in ADHD assessment and management. Structured diagnostic tools, digital health innovations, and equity-aware algorithm design are emerging as promising solutions to improve accuracy and reduce bias. In Europe, methylphenidate remains the most commonly prescribed first-line treatment, supported by robust evidence for symptom reduction. Non-stimulant options, such as atomoxetine, guanfacine, and clonidine, provide alternatives for patients with contraindications or poor tolerance to stimulants. Beyond pharmacology, evidence-based psychosocial interventions; including Parent Management Training (PMT) and Cognitive Behavioral Therapy (CBT), play a critical role in promoting long-term functional outcomes. Lifestyle modifications, particularly structured physical activity and dietary interventions, e.g., balanced nutrition, omega-3 supplementation, show benefits in symptom management. The expansion of telemedicine and digital platforms has enhanced care delivery, enabling remote monitoring, parent training, and behavioral support in underserved areas. Effective ADHD care requires an individualized, developmentally sensitive, and culturally competent approach that integrates medical, psychological, and social dimensions. Continued research into digital diagnostics, bias mitigation, and personalized treatment pathways will be essential to ensure equitable, accessible, and comprehensive care.