Improving Diagnosis and Treatment of ADHD

Opportunity

Attention-deficit hyperactivity disorder (ADHD) is one of the most common chronic childhood disorders. Historically, the assessment and management of this condition varied widely among practitioners, and the disorder was widely misunderstood by parents, teachers and other caregivers. From 2000–2003, we facilitated a learning collaborative funded by the Robert Wood Johnson Foundation and in partnership with the American Academy of Pediatrics (AAP) and Children and Adults with Attention-Deficit Hyperactivity Disorder (CHADD) to improve care and outcomes in practices across the country. The collaborative was successful in improving practices and demonstrated that implementation of the AAP Guidelines was feasible on a broad scale.

Approach

Based on this foundation, we partnered with North Carolina’s Center for Child Health Improvement and the AAP to develop Caring for Children with ADHD: A Resource Toolkit for Clinicians (1st Edition) in 2002. To create this toolkit, we applied quality improvement methods and core principles of chronic care management to ADHD cases by involving families, tracking results, using evidence and coordinating care among various caregivers.

In 2009, the AAP issued newly revised ADHD guidelines and again sought our help for its Quality Improvement Innovation Network (QuIIN) to update the toolkit. After continuous testing and rigorous updating of the content based on input from clinical experts and project team members, we finalized the 2nd edition of the toolkit in the fall of 2011. The kit is now available from the 

AAP bookstoreExternal Link. The revised toolkit is a valuable resource for many different stakeholders in advancing the understanding of, and the best treatment for, children living with ADHD.

Impact

  • The ADHD Toolkit has been widely adopted as the standard of care by nearly all pediatric clinicians in the U.S.
  • The Toolkit includes the widely used Vanderbilt Assessment Scale to assist families, caregivers, and educators in the evaluation and management of children and adolescents with ADHD.
  • Thousands of children have been appropriately diagnosed and treated for ADHD using the Toolkit.
  • According to a study in the AAP Journal, pediatricians’ use of formal diagnostic criteria increased from 67 percent in 1999 to 81 percent in 2005.
Caring for Children with ADHD: A Resource Toolkit for Clinicians (2nd Edition)

Establishing National Standards

NICHQ worked with the AAP to develop Caring for Children with ADHD: A Resource Toolkit for Clinicians. It includes the NICHQ Vanderbilt Assessment Tool and scoring instructions. An updated second edition is available for purchase from the AAP BookstoreExternal Link.