“Extremely High Adherence” to AAP Guidelines Reported by ADHD Telemedicine Clinics

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About 6 million children in the United States suffer from attention-deficit and hyperactivity disorder (ADHD). Seventy-seven percent of these children require medication or behavioral intervention. During the COVID-19 shutdown, telehealth psychiatry clinics emerged as a safe, effective, and convenient alternative for ADHD online diagnosis and treatment. A recent study By Eve-Lynn Nelson, Ph.D. and colleagues highlights high adherence by ADHD telemedicine clinics to the American Academy of Pediatrics (AAP) diagnosis guidelines for this childhood neurodevelopment disorder.

The Telehealth ADHD Online Diagnosis and Treatment

Telemedicine and pediatrics researchers conducted a telehealth ADHD pilot study at the University of Kansas Medical Center. They assessed the feasibility of adherence to the AAP’s evidence-based ADHD evaluation guidelines by telehealth mental health providers. Specialists proficient in AAP guidelines, child psychology, and childhood development investigated an ADHD telemedicine model that took into account the communication across three levels – family, school, and telehealth mental health providers. The following publication was published in Psychological Services, an American Psychological Association journal.
The team selected 20 male and two female patients with an average age of 9.3 years from 18 schools and 2 area health education centers. Thirty-six percent were of Caucasian origin, and 32% were African and Hispanic. While 36% had no insurance, the rest had private insurance or Medicaid coverage. They were from diverse residential, ethnic, and socioeconomic backgrounds. The study involved the participation of students in 69 telemedicine visits across 13 different school-related sites.
Researchers used the school-based telehealth ADHD protocol. The school nurses office coordinated the virtual consultation linking patients, their guardians, and the clinical team before, during, and after telehealth sessions. A research assistant, who was not part of the clinical team at telemedicine psychiatry clinics, tracked the adherence to the AAP’s ADHD diagnosis guidelines. The study measured a telehealth psychiatrist’s adherence to all 6 points of the AAP protocol using both behavioral rating scales and a questionnaire.

Telehealth ADD Study Report

The ADHD telemedicine study was the first such research to explore the adherence of telehealth mental health providers to the AAP guidelines. It found “extremely high adherence” between 95% and 100% for all 6 AAP guidelines. Researchers also discovered that no inherent aspect of virtual healthcare delivery obstructed telemedicine psychiatry clinics from adhering to these guidelines.
A significant outcome of this ADHD online diagnosis and treatment study was the influential role played by the school-based ADHD telemedicine clinic. It facilitates better communication between the family of a patient and the clinical team. Researchers, therefore, posited the feasibility of more comprehensive ADHD evaluation, the prevention of overdiagnosis, and improved treatment efficacy. Involving the child’s academic setting enables more significant numbers and quality of inputs and ultimately can lead to more timely intervention.
For other TBHI Telehealth.org blog posts related to delivering telehealth services to children and their families, see:

Pediatric Telemedicine, Telehealth & Teletherapy: Practicing with Children & Adolescents

This workshop aims to bring the pediatric telemedicine and telehealth evidence base to you in ways that are practical, predictable, and doable.

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