Working With Pediatric ADHD, Advice from Stacy Doumas, MD, MBA

In this interview, Stacy Doumas, MD, MBA, chair of psychiatry at Jersey Shore University Medical Center, discussed updates in the understanding and management of pediatric attention deficit hyperactive disorder (ADHD). She emphasized that current guidelines promote earlier recognition of ADHD’s nuanced presentations, with a stronger focus on functional impairment across home, school, and social environments rather than solely on checklist-based criteria.

Doumas noted a shift toward developmentally appropriate and multidisciplinary approaches, prioritizing behavioral interventions and parent education as first-line treatments for younger children. She highlighted the continued underdiagnosis of ADHD in girls, who often present with inattentive symptoms, disorganization, and emotional sensitivity rather than hyperactivity. Broader clinical inquiry into organization, self-esteem, and emotional regulation can aid earlier detection and prevent secondary issues such as anxiety and depression, she said.

Addressing lifestyle factors, Doumas underscored the importance of adequate sleep, nutrition, and exercise as adjuncts to treatment.¹ While no specific “ADHD diet” is supported by evidence, omega-3 supplementation may modestly aid focus, she noted. She also referenced emerging evidence for mindfulness practices, while cautioning clinicians to ensure complementary therapies are safe and integrated within a comprehensive treatment plan.²

Finally, Doumas emphasized the need to view pediatric ADHD within the family and school systems, fostering collaboration and reducing parental guilt. She noted increasing recognition of emotional dysregulation as a core feature of ADHD linked to executive dysfunction.

Dr Doumas is chair of psychiatry at Jersey Shore University Medical Center and a pediatric psychiatrist.

References

1. Lange KW, Lange KM, Nakamura Y, et al. Nutrition in the management of ADHD: a review of recent research. Curr Nutr Rep. 2023;12(3):383-394.

2. Modesto-Lowe V, Farahmand P, Chaplin M, et al. Does mindfulness meditation improve attention in attention deficit hyperactivity disorder?. World J Psychiatry. 2015;5(4):397-403.