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Boston University School of Public Health / Department of Community Health Sciences

Attention Deficit Hyperactivity Disorder (ADHD) Care Practicum

The ADHD Care Management project, located within the pediatrics department at Boston Medical Center (BMC), is a care model (based on chronic care model) that supports parents and pediatricians in determining ADHD care. Children whose pediatrician (BMC or Dorchester House) suspect ADHD refer the family to the ADHD care management team. Care managers collect information from the parents, schools, and from medical charts. This information is presented to a panel of experts (developmental specialist and pediatric psychiatrist) who make recommendations to the referring pediatrician for treatment (trial of medication, behavioral services, rule out learning disability, etc.). The care manager follows-up with the family to re-evaluate progress after services have been dispersed. The overall goal of the program is to increase ability of child to succeed, because ADHD is associated with poor academic achievement and higher unemployment rates in adulthood.

Chronic Care Model

CCM

Skills Gained

-Communication with parents and providers of ADHD services

-Patient chart dissection for ADHD indicators

-Development and presentation of professional memos

-Data analysis for research question

-Collection/Input of data

Research with ADHD Data

The ADHD program collects Vanderbilt data from parents and teachers, Vanderbilts are an assessment tool for ADHD and comorbid disorders.  I was able to complete many of these assessments during the time of my practicum and developed an interest in children who screen positive for ADHD as well as comorbid disorders.  The comorbid disorders associated with ADHD and included in the Vanderbilt assessment are: Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Anxiety/Depression (ANX/DEP).

Based on my knowledge of ADHD and of typical male/female behaviors, I made a few hypotheses of what I would find in analyzing this data: 

1.) More boys with comorbid ADHD will have ADHD+ODD/CD, and it will more commonly be ODD versus CD.

2.) More girls with comorbid ADHD will have ADHD+ANX/DEP (may not emerge since ANX/DEP is usually diagnosed later in adolescence/adulthood).

Findings:

*Based on teacher and parent Vanderbilt Assessments 23-46% of males in study and 19-27% of females in study screened + for ADHD and 1 or more comorbid disorders.

-Setting matters (school vs. home)
 
-Parent vs. Teacher self-report
In further analysis of the 14 subjects included in both teacher and parent data: 50% of parent and teacher screenings were a perfect match regarding comorbidity.
 
-Understanding of Vanderbilt questions, language or cultural differences
 
-More studies should be conducted in regards to comorbidity and ADHD

 


Findings

3/14/2014 10:45:25 AM
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Graphs-ADHD and Comorbidities

4/22/2014 10:25:33 PM
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