2016/04/01 by Daryl Efron, Emma Sciberras, Harriet Hiscock +4
paper · doi:10.1111/jpc.13091
Aims In a sample of newly diagnosed children with attention‐deficit/hyperactivity disorder (ADHD), the aims were to examine (1) paediatrician assessment and management practices; (2) previous assessments and interventions; (3) correspondence between parent‐report and paediatrician identification of comorbidities; and (4) parent agreement with diagnosis of ADHD. Methods Design : cross‐sectional, multi‐site practice audit with questionnaires completed by paediatricians and parents at the point of ADHD diagnosis. Setting : private/public paediatric practices in Western Australia and Victoria, Australia. Main outcome measures : paediatricians: elements of assessment and management were indicated on a study‐designed data form. Parents: ADHD symptoms and comorbidities were measured using the Conners 3 ADHD Index and Strengths and Difficulties Questionnaire, respectively. Sleep problems, previous assessments and interventions, and agreement with ADHD diagnosis were measured by questionnaire. Results Twenty‐four paediatricians participated, providing data on 137 patients (77% men, mean age 8.1 years). Parent and teacher questionnaires were used in 88% and 85% of assessments, respectively. Medication was prescribed in 75% of cases. Comorbidities were commonly diagnosed (70%); however, the proportion of patients identified by paediatricians with internalising problems (18%), externalising problems (15%) and sleep problems (4%) was less than by parent report (51%, 66% and 39%). One in seven parents did not agree with the diagnosis of ADHD. Conclusions Australian paediatric practice in relation to ADHD assessment is generally consistent with best practice guidelines; however, improvements are needed in relation to the routine use of questionnaires and the identification of comorbidities. A proportion of parents do not agree with the diagnosis of ADHD made by their paediatrician.