Many Children with ADHD Receive Inadequate Care

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The treatment of children with

ADHD in community based pediatric settings is lacking and does not comply with guidelines, reports a recent study published in Pediatrics.  Researchers found the diagnosis and treatment of ADHD deficient in several areas including:

• Over reliance on drugs to treat ADHD without any behavioral or psychotherapy
• Lack of timely follow-up when children start medications for the treatment of ADHD
• Lack of interaction with children’s parents and their schools about children’s daily activities and the effects of any prescribed therapies
• Failure to consult the Diagnostic and Statistical Manual of Mental Disorders when making an ADHD diagnosis
• Failure to review “behavioural rating scales” from parents and schools when making an ADHD diagnosis

"The quality of care seems to be very low and not in accord with American Academy of Pediatrics guidelines," said lead author Jeffery Epstein, director of the Center for ADHD, Behavioral Medicine and Clinical Psychology at Cincinnati Children's Hospital.

The American Academy of Pediatrics recommends that physicians look at the

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following factors when considering an ADHD diagnosis:

• Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,
• Reports from parents
• Input from teachers including a complete “validated ADHD instrument” or behavioral scale
• Information on the child’s behaviour among peers and in the presence of authority figures
• Interview with the child
• Results of a comprehensive physical and neurological examination
• Other possible causes

Once a diagnosis of ADHD is made, physicians should:

• Educate the child and family about ADHD
• Provide information to the child’s school on the ADHD diagnosis and child’s needs (after obtaining parental permission)
• Develop an ADHD management plan that includes a care plan for the family and a follow-up plan
• Monitor progress during treatment including a four week follow-up visit if medication is started

Epstein advises parents with any concerns about their children's diagnoses or treatment to talk with their doctors.

Sources:

Implementing the Key ActionStatements:  AnAlgorithm and Explanationfor Process of Care for theEvaluation, Diagnosis, Treatment, and Monitoring of ADHDin Children and Adolescents

ADHD: Clinical Practice Guidelinefor the Diagnosis, Evaluation, and Treatment of Attention-Deficit/HyperactivityDisorder in Children and Adolescents

Typical ADHD Care Leaves Room forImprovement, Study Finds

Variability in ADHD Care inCommunity-Based Pediatrics

©Mary M Conneely T/A Advocacy in Action