title: The diagnosis of attention-deficit/hyperactivity disorder in Australian children: Current paediatric practice and parent perspective.
abstract: OBJECTIVE
  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
  
  
  
  METHODS
  cross-sectional, multi-site practice audit with questionnaires completed by paediatricians and parents at the point of ADHD diagnosis.
  
  
  METHODS
  private/public paediatric practices in Western Australia and Victoria, Australia.
  
  
  METHODS
  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.
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia.|Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.|The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Daryl
authors.initials: D
authors.lastname: Efron
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia.|Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.|The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Sciberras
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia.|Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.|The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Harriet
authors.initials: H
authors.lastname: Hiscock
authors.affiliation: Child Development Service, Joondalup, Western Australia, Australia.|The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Brad
authors.initials: B
authors.lastname: Jongeling
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia.|Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.|The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Lycett
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bisset
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Grant
authors.initials: G
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000628:therapy*; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D000072143:Pediatricians / Q000523:psychology*; D010372:Pediatrics / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014904:Western Australia
keywords: ADHD; behavioural medicine; guidline adherence; paediatrics; quality of health care