Implementing the Key Action Statements: An Algorithm and Explanation for Process of Care for the Evaluation, Diagnosis, Treatment, and Monitoring of ADHD in Children and Adolescents

  • Published 2013

Abstract

Practice guidelines provide a broad outline of the requirements for highquality evidence-based care. In support of consistent and comprehensive care for children and adolescents with symptoms of attention and hyperactivity disorders within a typical, busy pediatric practice, the AAP has developed the following suggested process-ofcare algorithm (see Supplemental Fig 2) that provides discrete and manageable steps through which a primary care clinician can fulfill the key action statements offered in the guideline. The algorithm is entirely consistent with the practice guideline and is based on the practical experience and advice of clinicians experienced in the diagnosis and management of ADHD in children and adolescents. Because of the detail provided, the process algorithm does not have the same level of evidence base as the key action statements that are provided in the practice guideline. The steps of the algorithm are based primarily on consensus among expert clinicians. This algorithm and each of its constituent steps is not intended to be completed in any single office visit or any specific number of visits; the experience of the clinician, the volume of the practice, the longevity of the relationship between the clinician and family, the severity of the concerns, the availability of records and school input, the family’s schedule, and the reimbursement structure will all play a role in determining the pace at which a family and child/adolescent move through the process of care. Similarly, continued systematic monitoring (to include reconsideration of the diagnosis if improvements in symptoms are not apparent) is an ongoing process, to be addressed throughout the child’s/adolescent’s care within the practice, and in transition planning as the adolescent moves into the adult care system. The algorithm assumes that the primary care practice has adopted mental health surveillance and screening as described by the AAP Task Force on Mental Health.1 In light of the prevalence of ADHD, the severity of the consequences of untreated ADHD, and the availability of effective treatments for ADHD, the AAP recommends that every child/adolescent identified with signs or symptoms suggestive of ADHD be evaluated for ADHD. It is important to document all aspects of the diagnostic and treatment procedures in patients’ records. Use of rating scales for the diagnosis of ADHD, for assessment for comorbid conditions, and as a method for monitoring treatment and providing information provided to parents, such as management plans, can help facilitate a clinician’s accurate documentation of the process.

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Cite this paper

@inproceedings{2013ImplementingTK, title={Implementing the Key Action Statements: An Algorithm and Explanation for Process of Care for the Evaluation, Diagnosis, Treatment, and Monitoring of ADHD in Children and Adolescents}, author={}, year={2013} }