Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Winter;19(4):357-368.
doi: 10.31486/toj.18.0103.

Pediatric Attention-Deficit/Hyperactivity Disorder in Louisiana: Trends, Challenges, and Opportunities for Enhanced Quality of Care

Rohail Kumar  1 , Mary Margaret Gleason  2   3
Affiliations
Review

Pediatric Attention-Deficit/Hyperactivity Disorder in Louisiana: Trends, Challenges, and Opportunities for Enhanced Quality of Care

Rohail Kumar et al. Ochsner J. 2019 Winter.

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common pediatric condition with significant developmental, social, educational, and safety implications. The American Academy of Pediatrics has developed guidelines to support quality care of children with ADHD, but studies demonstrate that the guidelines are variably followed. Methods: This review highlights patterns of diagnosis and treatment of children with ADHD nationally and in Louisiana and provides examples of system- and practice-level opportunities to improve adherence to quality standards. Results: Possible contributors to the higher prevalence of ADHD and medication use in Louisiana compared to the nation are specialty workforce shortages, factors in the educational system, and factors associated with race and geography. Innovative system approaches have been developed to address workforce shortages and training limitations. Practice-level innovations include improving the use of validated measures, offering adequate scheduling, and identifying relevant resources and sharing the information with families. Conclusion: Despite the availability of evidence-based recommendations and resources, significant opportunities exist to provide enhanced ADHD care at the primary care level, especially in Louisiana where the high prevalence of some risk factors for ADHD and the high rates of ADHD and medication prescriptions have been noted nationally and at the state level. Attention to these factors can potentially help address these disproportionalities. Additionally, innovative models of training and collaboration in pediatrics are imperative. Pediatric clinicians, mental health providers, and families can work together to increase awareness about the needs of children and families affected by ADHD in medical, educational, and policy arenas and move the system forward for children.

Keywords: Attention deficit disorder with hyperactivity; Louisiana; pediatrics; primary health care.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Overview of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria for attention-deficit/hyperactivity disorder.1
Figure 2.
Figure 2.
Key action statements from the American Academy of Pediatrics attention-deficit/hyperactivity disorder guidelines.8 DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
Figure 3.
Figure 3.
Attention-deficit/hyperactivity disorder prescription rates in Louisiana (2013) by age, sex, and ethnicity.7
Figure 4.
Figure 4.
Attention-deficit/hyperactivity disorder (ADHD) prescription rates in Louisiana (2013) by geographic region.7 DHH, Department of Health and Hospitals; Rx, prescription.
Figure 5.
Figure 5.
Summary of the American Academy of Pediatrics (AAP) attention-deficit/hyperactivity disorder (ADHD) toolkit (second edition). AHA, American Heart Association; CRAFFT, Car, Relax, Alone, Forget, Family/Friends, Trouble; NICHQ, National Initiative for Children's Health Quality; PHQ-9, Patient Health Questionnaire-9.
Figure 6.
Figure 6.
Approaches to enhanced attention-deficit/hyperactivity disorder (ADHD) care. AAP, American Academy of Pediatrics.
Figure 7.
Figure 7.
Point of care attention-deficit/hyperactivity disorder (ADHD) and child development educational resources for caregivers and healthcare professionals. CHADD, Children and Adults with Attention-Deficit/Hyperactivity Disorder.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed Arlington, VA: American Psychiatric Publishing; 2013.
    1. Visser SN, Danielson ML, Bitsko RH, et al. . Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. J Am Acad Child Adolesc Psychiatry. 2014. January;53(1):34-46.e2. doi: 10.1016/j.jaac.2013.09.001. - DOI - PMC - PubMed
    1. Danielson ML, Bitsko RH, Ghandour RM, Holbrook JR, Kogan MD, Blumberg SJ. Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016. J Clin Child Adolesc Psychol. 2018. Mar-Apr;47(2):199-212. doi: 10.1080/15374416.2017.1417860. - DOI - PMC - PubMed
    1. Sayal K, Prasad V, Daley D, Ford T, Coghill D. ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. 2018. February;5(2):175-186. doi: 10.1016/S2215-0366(17)30167-0. - DOI - PubMed
    1. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015. March;56(3):345-365. doi: 10.1111/jcpp.12381. - DOI - PubMed

LinkOut - more resources