Skip to Main Content
Important SNAP Updates: See what’s changing and where to get support. Learn more
Important SNAP Updates: See what’s changing and where to get support. Learn more

UPDATED ADHD GUIDANCE

Date: 06/12/24

Attention deficit hyperactive disorder (ADHD) is among the most common neurodevelopmental disorders affecting children, often persisting through adulthood.1 The symptoms of ADHD include hyperactivity, lack of ability to pay attention to detail, and impulse control challenges greater than expected for their age or developmental age.3 This can cause difficulty at school, at home, and with friends. There are three types of ADHD: inattentive, hyperactive/impulsive presentation, and a combined presentation.

Diagnosis4, 5

Listed below are the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition (DSM-5) criteria for diagnosis.

  1. Inattention

    Six or more symptoms of inattention for children up to age 16 years OR five or more for adolescents aged 17 years and older and adults; symptoms of inattention have been present for at least 6 months; and they are inappropriate for developmental level:

    • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities
    • Often has trouble holding attention on tasks or play activities
    • Often does not seem to listen when spoken to directly
    • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked)
    • Often has trouble organizing tasks and activities
    • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework)
    • Often loses things necessary for tasks and activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones)
    • Is often easily distracted
    • Is often forgetful in daily activities

        2. Hyperactivity and Impulsivity

Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years OR five or more for adolescents aged 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive; and inappropriate for the person’s developmental level: 

  • Often fidgets with or taps hands or feet, or squirms in seat
  • Often leaves seat in situations when remaining seated is expected
  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless)
  • Often unable to play or take part in leisure activities quietly
  • Is often “on the go” acting as if “driven by a motor”
  • Often talks excessively
  • Often blurts out an answer before a question has been completed
  • Often has trouble waiting their turn
  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

The following conditions must also be met:

  • Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
  • Several symptoms are present in two or more settings (such as at home, during school or work, with friends or relatives, or participating in other activities).
  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
  • The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

It is possible to diagnose ADHD in adults. The symptoms can often present as poor planning, difficulty to follow through on tasks at home or work, poor time management, or problems focusing on a task.6

Treatment

Treatment usually consists of a combination of therapy and medication. Psychostimulant medications are the recommended first-line pharmacotherapy.

The following medications are on Meridian’s Preferred Drug List. If there is a documented, national shortage of a medication, overrides are placed on a case-by-case basis.

Medication name

Status

Amphetamine/dextroamphetamine (generic Adderall®/Adderall XR®)

 

 

 

 

 

Preferred

Clonidine/Clonidine ER

Concerta®

Dexmethylphenidate tablets (generic Focalin®)

Focalin® XR

Guanfacine

Methylphenidate tablets (generic Ritalin®)

Methylphenidate ER 10mg and 20mg tablets

Strattera

Vyvanse®

Daytrana®

 

Preferred with Prior Authorization

Dyanavel® XR (Suspension)

Jornay PM®

 

Process for YouthCare HealthChoice Consents

For children in YouthCare whom the Illinois Department of Children and Family Services (DCFS) is legally responsible for, consent must be obtained prior to the administration of any psychotropic medication, a class of drugs commonly used to treat ADHD. Consent must be submitted directly to the DCFS Centralized Consent Unit (CCU) using Form CSF 431-A available below and under the Policies, Rules and Forms page at dcfs.illinois.gov.

CFS 431-A Psychotropic Medicaid Request Form

CFS 431-A Psychotropic Medication Request Cover Sheet

 

References

1.       What is ADHD? Accessed June 3, 2024.

2.       Data and Statistics on ADHD. Accessed June 3, 2024.

3.       Symptoms of ADHD. Accessed June 3, 2024.

4.       Diagnosing ADHD. Accessed June 3, 2024.

5.       American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed., Text Revision, American Psychiatric Publishing, 2022.

6.       Adult Attention Deficit/Hyperactivity Disorder. Accessed May 29, 2024.