.

Most chil­dren with ADHD receive their care from com­mu­ni­ty-based pedi­a­tri­cians, so it is espe­cial­ly impor­tant for that care to be con­sis­tent with best-prac­tice guide­lines.

Unfor­tu­nate­ly, all too often it is not.

The guidelines

Here is a brief sum­ma­ry of some key ADHD guide­lines pub­lished by the Amer­i­can Acad­e­my of Pedi­atrics Read the rest of this entry »

In 2005 the Amer­i­can Acad­e­my of Pedi­atrics (AAP) began an ini­tia­tive to pro­mote an approach to care among its mem­bers in which “…the pedi­atric team works in part­ner­ship with a child and a child’s fam­i­ly to assure that all of the med­ical and non-med­ical needs of the patient are met.” A crit­i­cal­ly impor­tant focus of this approach is the role of the fam­i­ly and child — as devel­op­men­tal­ly appro­pri­ate — in the devel­op­ment of an over­all plan of care.

This shared deci­sion-mak­ing approach is espe­cial­ly impor­tant for con­di­tions like ADHD where there is not a sin­gle treat­ment that is the most appro­pri­ate and pre­ferred option for all patients. How­ev­er, Read the rest of this entry »

Like all psy­chi­atric dis­or­ders, ADHD is diag­nosed based on the pres­ence of par­tic­u­lar behav­ioral symp­toms that are judged to cause sig­nif­i­cant impair­ment in an indi­vid­u­al’s func­tion­ing, and not on the results of a spe­cif­ic test. In fact, recent­ly pub­lished ADHD eval­u­a­tion guide­lines from the Amer­i­can Acad­e­my of Pedi­atrics (AAP) explic­it­ly state that no par­tic­u­lar diag­nos­tic test should be rou­tine­ly used when eval­u­at­ing a child for ADHD.

While most ADHD experts would agree that no sin­gle test could or should be used in iso­la­tion to diag­nose ADHD, there are sev­er­al impor­tant rea­sons why the avail­abil­i­ty of an accu­rate objec­tive test would be use­ful.

First, many chil­dren do not receive a care­ful and com­pre­hen­sive assess­ment for ADHD but are instead diag­nosed with based on eval­u­a­tion pro­ce­dures that are far from opti­mal.

Sec­ond, although AAP guide­lines indi­cate that spe­cif­ic diag­nos­tic tests should not be rou­tine­ly used, many par­ents are con­cerned about the lack of objec­tive pro­ce­dures in their child’s eval­u­a­tion. In fact, many fam­i­lies do not pur­sue treat­ment for ADHD because the the absence of objec­tive eval­u­a­tion pro­ce­dures leads them to ques­tion the diag­no­sis. You can read a review of an inter­est­ing study on this issue at www.helpforadd.com/2006/january.htm

For these rea­sons an accu­rate and objec­tive diag­nos­tic test for ADHD could be of val­ue in many clin­i­cal sit­u­a­tions. Two impor­tant con­di­tions would have to be met for such a test to be use­ful.

First, it would have to be high­ly sen­si­tive to Read the rest of this entry »