Over 6.1 million children have been diagnosed with ADHD in the U.S. to date, according to the CDC. As physicians continue to learn about attention deficit hyperactivity disorder, its comorbidities, and effective long term care, early and accurate diagnosis remains as relevant as ever. As this disorder affects many kids’ daily life and learning, a refocus on practice resources and patient advocacy can help children adjust with resiliency to changes in life, school, and play.
Children with chronic diagnoses that affect the way they learn, work, and play will need support as schools across the U.S. transition back to in-person learning post-pandemic. This is in addition to the fact that boys are nearly twice as likely to be diagnosed as girls are -- 12.9% compared to 5.6% according to the CDC. Accurate and early diagnosis can help patients find treatment and support that works for their needs.
Ongoing supportive care, patient recall, behavioral health visits, and controlled substance visits are also important visits for pediatric practices’ revenue and continued patient support. These visits are also crucial for maintaining the relationships with families necessary for excellent care, since 6 in 10 ADHD patients have a comorbid mood or behavioral disorder. The latest guidance from the AAP supports that “the complex care of patients with ADHD occurs best in the patient-centered medical home”.
Attention deficit hyperactivity disorder is classified as a chronic illness, which means that continued support from a trusted pediatrician is integral to managing the disorder over the long term. The latest guidelines from the AAP emphasize evaluating patients for signs of other mood disorders. With revisions to the DSM-5 in 2011, treatment remains largely the same. The AAP noted that for preschool and adolescent patients, behavioral intervention was effective, especially when parents were trained in behavior management. For treatment and clinical information, please visit the AAP’s Caring for Children with ADHD Toolkit.
A popular narrative is that common symptoms of hyperfocus, resilience, and creativity make this diagnosis a superpower. This metaphor can be empowering and fun for certain kids, and a useful way to help them think positively about their diagnosis.
For example, a physician could offer this metaphor to help a young child better understand why they can’t seem to follow expectations like sitting still. It’s also a great tool to help parents reframe a child’s “misbehavior” so that at home, they can offer calmer, more constructive support and enable a child’s learning and growth in ways that work for everyone, such as taking frequent breaks or using tactile learning tools.
Focusing on strengths is an empathetic way to connect to patients and it’s just as important to acknowledge the daily struggles and frustrations of living with a disorder that affects so many aspects of a child’s life. Another positive way to talk about ADHD is to acknowledge how other people with the disorder have both struggled and succeeded, like this story about Olympian Michelle Carter.
Since the initial treatments for attention deficit hyperactivity disorder are stimulant medications, it’s important to educate patients and families about using and storing controlled substances properly. Ongoing conversations about which medications work for each individual as well as education on the risks of medication misuse and abuse can be useful for families and pediatricians. Set a reminder to discuss responsible medication use with kids and teens, and provide resources for education and for support on your practice website.
Your practice may also require patients and parents to sign a policy form that states that they understand the importance of proper medication use and regular controlled substance visits. This is both useful as a legal protection for your practice, as well as an important way for a family to indicate that they understand and are prepared for important medical responsibilities. For an example, take a look at this policy from Tamalpais Pediatrics in California.
At the practice level, there is plenty for pediatricians and administrators to keep track of to continue to provide excellent care for ADHD patients. As well as regular screenings, behavioral health visits, and controlled substance visits, your practice might choose to begin a focused patient recall campaign to make sure patients are on track and how your practice might provide support.
Wondering how to handle the behavioral health visits your patients need? Consider a behavioral health integration for your practice. We’ve got plenty of resources on our blog, plus an ebook explaining exactly how your practice can integrate behavioral health at any size and any budget.
Advocacy helps patients feel recognized and comfortable with their diagnosis and helps connect families to the care and resources that they need. Whether you want to offer focused support for patients via a social media campaign or patient email, or simply offer options for behavioral care on your practice website, here are some resources to get you started:
Physicians can also advocate on a personal or community level by informing others about learning differences, highlighting each patient’s “superpowers,” advocating for policies that help children get supportive resources at school, and even offering classes and other resources so that parents can better support their kids at home.
Supporting children as they adjust to changes in learning and living due to the COVID-19 pandemic can help them respond with resiliency and thrive in school and at home. To help get patients the resources they need at a scale your practice can handle, be sure to check out our ebook, Behavioral Health Integration: A Guide for Expanding Access.