title: Diagnosis of attention-deficit/hyperactivity disorder by developmental pediatricians in academic centers: A DBPNet study.
abstract: OBJECTIVE
  To describe the developmental-behavioral pediatricians (DBPs), patients, and clinical practices used in the diagnostic assessments of attention-deficit/hyperactivity disorder (ADHD) within all 12 academic medical centers comprising Developmental-Behavioral Pediatrics Research Network (DBPNet).
  
  
  METHODS
  Between December 2011 and June 2012, all DBPs who evaluated children with ADHD or autism spectrum disorders were asked to complete a diagnostic encounter survey form for up to 10 consecutive new cases that resulted in the diagnosis of ADHD or autism spectrum disorder. Fifty-two clinicians returned one or more forms for children diagnosed with ADHD (n = 211).
  
  
  RESULTS
  DBPs were generally experienced full-time academics. Children were 76.3% male, 62.3% white, 24.5% African American, and 20.7% Hispanic. Mean child age was 8.0 + 3.1 years. DBPs reviewed parent ratings of behavior in 84.4% and teacher ratings in 69.2% of cases. They reviewed or completed at least one developmental assessment in 79.2% of cases: intelligence (60.2%), academic (57.8%), fine motor or visual motor (39.3%), speech/language (34.6%), or adaptive skills (28.9%). They made the diagnosis of coexisting conditions in 82.7% of cases, including learning disabilities (31.8%), speech/language disorders (31.8%), anxiety (14.2%), externalizing disorders (10.9%), and sleep disorders (9.5%). Among 146 children not medicated before the visit, stimulant medications were initiated in 15 children (10.2%).
  
  
  CONCLUSIONS
  Within DBPNet, DBPs were highly likely to complete comprehensive assessments of ADHD that went beyond the requirements of primary care practice guidelines. They typically identified coexisting developmental and learning conditions. They did not typically prescribe medication at the end of diagnostic encounters.
authors.affiliation: Department of Pediatrics, Stanford University, Palo Alto, Calif. Electronic address: hfeldman@stanford.edu.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Feldman
authors.affiliation: Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Blum
authors.affiliation: Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Gahman
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa.
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
mesh_terms: D000046:Academic Medical Centers; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine / Q000379:methods*; D010372:Pediatrics / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'
keywords: DBPNet; attention-deficit/hyperactivity disorder; comorbidity; developmental-behavioral pediatrics; diagnosis; stimulants