Challenges and Opportunities in Attention Deficit Hyperactivity Disorder in Developing Countries.

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Pieter Rousseau Fourie Julia C Armstrong


In the developing country a physician is faced with many challenges when seeing patients on the neurodiverse spectrum. Despite many well-known tools available, time restraints and lack of resources often results in sub-par diagnoses and continuation of care. Fortunately, with modern technology and the ever growing fields of machine learning and artificial intelligence, new developments have the possibility to ensure wider access to simplified and efficient tools with decreased need for specialist referral, helping to facilitate diagnosis, to reduce consultation time and costs and to simplify follow-up and monitoring.

Keywords: Attention Deficit Hyperactivity Disorder, Developing Countries, Neurodiverse Spectrum, Diagnostic Challenges, Resource Constraints, Machine Learning, Artificial Intelligence, Simplified Diagnostic Tools

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How to Cite
FOURIE, Pieter Rousseau; ARMSTRONG, Julia C. Challenges and Opportunities in Attention Deficit Hyperactivity Disorder in Developing Countries.. Medical Research Archives, [S.l.], v. 12, n. 6, june 2024. ISSN 2375-1924. Available at: <>. Date accessed: 22 july 2024. doi:
Review Articles


1. Still G. Some abnormal psychical conditions in children: excerpts from three lectures. American Psychological Association. 2006. Accessed September 7, 2023.

2. Koutsoklenis A, Honkasilta J. ADHD in the DSM-5-TR: What has changed and what has not. Frontiers in psychiatry. January 10, 2023. Accessed September 7, 2023.

3. Connors C. Conners 3 Comparative Report. Multi-Health Systems Inc. 2014. Accessed September 7, 2023.

4. Brites C, Salgado-Azoni CA, Ferreira TL, Lima RF, Ciasca SM. Development and applications of the Swan Rating Scale for assessment of attention deficit hyperactivity disorder: A literature review. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas. November 2015. Accessed September 7, 2023.

5. Hall C, Guo B, Valentine A, et al. The validity of the SNAP-IV in children displaying ADHD symptoms. National Library of Medicine. September 2016. Accessed September 7, 2023.

6. Wolraich M, Lambert W, Doffing M, Bickman L, Simmons T, Worley K. Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. Journal of pediatric psychology. December 2003. Accessed September 7, 2023.

7. Freismuth D, TaheriNejad N. On the treatment and diagnosis of attention deficit hyperactivity disorder with EEG Assistance. MDPI. February 16, 2022. Accessed September 7, 2023.

8. Chen H, Yang Y, Odisho D, Wu S, Yi C, Oliver B. Can biomarkers be used to diagnose attention deficit hyperactivity disorder? Frontiers in psychiatry. March 8, 2023. Accessed September 7, 2023.

9. Chinawa JM, Odetunde OI, Obu HA, Chinawa AT, Bakare MO, Ujunwa FA. Attention deficit hyperactivity disorder: A neglected issue in the developing world. Behavioral neurology. June 25, 2014. Accessed September 7, 2023.

10.Chet et al

11. Pies R. How “objective” are psychiatric diagnoses?: (guess again). Psychiatry (Edgmont (Pa. : Township)). October 2007. Accessed September 7, 2023.

12. Lohani DC, Rana B. ADHD diagnosis using structural brain MRI and personal characteristic data with machine learning framework. Psychiatry Research: Neuroimaging. July 20, 2023. Accessed September 7, 2023.

13. Young S. Failure of healthcare provision for attention-deficit/hyperactivity disorder in the United Kingdom: A consensus statement. Frontiers in psychiatry. 2021. Accessed September 7, 2023.

14. Mueller AK, Fuermaier ABM, Koerts J, Tucha L. Stigma in attention deficit hyperactivity disorder. Attention deficit and hyperactivity disorders. September 2012. Accessed September 7, 2023.

15. Schoeman R, Voges T. Attention-deficit hyperactivity disorder stigma: The silent barrier to care. South African Journal of Psychiatry. 2022. Accessed September 7, 2023.

16.Muhammad N, Murugesan BG, Singal P, Antai A, Jain L. Diagnostic Dilemma of Differentiating Attention-Deficit/Hyperactivity Disorder (ADHD) From Mood Disorders and Other Common Psychiatric Illnesses in Substance Use Patient Population. Cureus. 2023;15(4):e37372. Published 2023 Apr 10. doi:10.7759/cureus.37372

17.Rommelse N, Visser J, Hartman C. Differentiating between ADHD and ASD in childhood: Some directions for practitioners. European child & adolescent psychiatry. May 12, 2018. Accessed September 7, 2023.

18.Oliva F, di Girolamo G, Salerno L, Pallanti S, Wilson L, Philipsen A. Editorial: Adult ADHD and other psychiatric disorders. Frontiers. October 3, 2022. Accessed September 7, 2023.

19. Montano C, Weisler R. Distinguishing symptoms of ADHD from other psychiatric disorders in the adult primary care setting. Postgraduate medicine. 2011. Accessed September 7, 2023.

20. Tobin C. Home - goldilocks and the Bear Foundation. Goldilocks and the Bear Foundation. 2021. Accessed September 8, 2023.

21.Meyer JC, Matlala M, Chigome A. Mental health care - a public health priority in South Africa. South African Family Practice. 2019. Accessed September 7, 2023.

22. Not Disclosed ND. Beyond unemployment – Time-Related Underemployment in the SA labour market. May 16, 2023. Accessed September 7, 2023.

23.Lola HM, Belete H, Gebeyehu A, Zerihun A, Yimer S, Leta K. Attention deficit hyperactivity disorder (ADHD) among children aged 6 to 17 years old living in Girja District, rural Ethiopia. Behavioural Neurology. April 14, 2019. Accessed September 7, 2023.

24. Amod Z, Vorster A, Lazarus K. Attention-deficit/hyperactivity disorder (ADHD) as a barrier to learning and development within the South African context: The perspective of teachers. IntechOpen. June 27, 2013. Accessed September 7, 2023.

25. Cedergren K, Östlund S, Âsberg Johnels J, Billstedt E, Johnson M. Monitoring medication response in ADHD: What can continuous performance tests tell us? European archives of psychiatry and clinical neuroscience. August 21, 2021. Accessed September 7, 2023.

26. Chan A, Ma T-T, Lau W, et al. Attention-deficit/hyperactivity disorder medication consumption in 64 ... The Lancet. March 20, 2023. Accessed September 7, 2023.

27. Sampaio F. The cost-effectiveness of treatments for attention deficit-hyperactivity disorder and autism spectrum disorder in children and adolescents: A systematic review. European child & adolescent psychiatry. 2021. Accessed September 7, 2023.

28. Chen T, Antoniou G, Adamou M, Tachmazidis I, Su P. Automatic diagnosis of attention deficit hyperactivity disorder using ... Applied Artificial Intelligence. June 2, 2021. Accessed September 7, 2023.

29. Loh HW, Ooi CP, Barua P, Palmer E, Molinari F, Acharya UR. Automated detection of ADHD: Current trends and future perspective. Computers in biology and medicine. 2022. Accessed September 7, 2023.

30. Cao M, Martin E, Li X. Machine learning in attention-deficit/hyperactivity disorder: New approaches toward understanding the neural mechanisms. Nature News. July 1, 2023. Accessed September 7, 2023.

31. Javed AR. Artificial Intelligence for Cognitive Health Assessment: State-of-the ... Cognitive Computation. 2023. Accessed September 7, 2023.

32. Braverman ER. Test of variables of attention (Tova) as a predictor of early attention complaints, an antecedent to dementia. Neuropsychiatric disease and treatment. 2010. Accessed September 7, 2023.

33. Elbaum T, Braw Y, Lev A, Rassovsky Y. Attention-deficit/hyperactivity disorder (ADHD): Integrating the moxo-dcpt with an eye tracker enhances diagnostic precision. Sensors (Basel, Switzerland). November 9, 2020. Accessed September 7, 2023.

34. Ortiz D. New Clinical Study shows home-based Cogo attention training programme as effective as in clinic settings. The New Technology of Brain Computer Interface. February 28, 2023. Accessed September 7, 2023.

35. Mwamba HM, Fourie PR, van den Heever D. Pandas: Pediatric Attention-Deficit/Hyperactivity Disorder Application Software. MDPI. April 20, 2019. Accessed September 7, 2023.

36. Botha N. How to create a supportive home environment for you and your family. Tracto. August 30, 2023. Accessed September 7, 2023.

37. Mechler K, Banaschewski T, Hohmann S, Häge A. Evidence-based pharmacological treatment options for ADHD in children and adolescents. Pharmacology & Therapeutics. June 23, 2021. Accessed September 7, 2023.

38. Sonuga-Barke E. Nonpharmacological Interventions for ADHD: Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. The American journal of psychiatry. March 2013. Accessed September 7, 2023.

39. Davico C, Secci I, Vendrametto V, Vitiello B. Pharmacological treatments in autism spectrum disorder: A narrative review. Journal of Psychopathology. April 7, 2023. Accessed September 7, 2023.

40. Brentani H, Paula CS, Bordini D, et al. Autism spectrum disorders: an overview on diagnosis and treatment. Braz J Psychiatry. 2013;35 Suppl 1:S62-S72. doi:10.1590/1516-4446-2013-S104

41. Enriquez-Geppert S, Smit D, Pimenta MG, Arns M. Neurofeedback as a treatment intervention in ADHD: Current evidence and practice. Current psychiatry reports. May 28, 2019. Accessed September 7, 2023.

42. Oliveira J, Pellow J, Tsele-Tebakang T, Solomon EM. Experiences of neurofeedback therapists in treating attention-deficit hyperactivity disorder. Health SA = SA Gesondheid. July 28, 2022. Accessed September 7, 2023.

43. Yeo PS, Nguyen TN, Ng MPE, et al. Evaluation of the implementation and effectiveness of community-based brain-computer interface cognitive group training in healthy community-dwelling older adults: Randomized controlled implementation trial. JMIR Formative Research. 2021. Accessed September 7, 2023.

44. Alves RM. Download PDF | Mobile Devices and systems in ADHD treatment. Sciences and Technology Publications. 2020. Accessed September 7, 2023.

45. Hollis C. The impact of a computerized test of attention and activity (qbtest) on ... Europe PMC Funders Group. 2018. Accessed September 7, 2023.