title: Management of Attention-Deficit/Hyperactivity Disorder by Developmental-Behavioral Pediatricians: A DBPNet Study.
abstract: To describe practice patterns for developmental-behavioral pediatricians (DBPs) practicing within Developmental-Behavioral Pediatrics Research Network (DBPNet) academic medical centers providing follow-up for children with attention-deficit/hyperactivity disorder (ADHD) and determine how well they adhere to American Academy of Pediatrics ADHD Clinical Practice Guidelines.
  
  
  
  Seventy-eight DBPs at 12 academic medical centers participating in the DBPNet were asked to complete follow-up encounter surveys for patients with ADHD or autism spectrum disorder seen from 12/2011 through 6/2012. Data regarding patient characteristics, comorbid conditions, and medication management were obtained at the time of each visit.
  
  
  
  Fifty-seven DBPs completed 301 ADHD follow-up encounter surveys; 75.3% of patients were male with mean age 9.57 years (SD = 3.3). Race/ethnicity was primarily white/non-Hispanic with similar numbers on private insurance (41.5%) versus Medicaid (45.5%). DBPs identified comorbid learning disorders in 27.6% of children ≥6 years. Only 58.3% of children <6 years received counseling/behavioral therapy or had it recommended during the visit. DBPs primarily (90.6%) prescribed medications FDA-approved for ADHD treatment and growth was monitored for >98% of visits during which stimulants were prescribed. Parent- and teacher-completed rating scales were reviewed/completed during 43.9% and 37.8% of visits, respectively. There were no child or physician factors consistently associated with variation in practice patterns.
  
  
  
  Developmental-behavioral pediatricians practicing within DBPNet medical centers adhere to the recommended medication prescribing practices for ADHD, including use of FDA-approved medications and monitoring growth. However, DBPs within DBPNet do not consistently review ADHD rating scales or recommend behavioral counseling for children <6 years of age as recommended.
authors.affiliation: *Division of Developmental Medicine, Boston Children's Hospital, Boston, MA; †Behavioral Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; ‡Division of Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Harstad
authors.forename: Nathan
authors.initials: N
authors.lastname: Blum
authors.forename: Amy
authors.initials: A
authors.lastname: Gahman
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
authors.forename: Eugenia
authors.initials: E
authors.lastname: Chan
authors.forename: William
authors.initials: W
authors.lastname: Barbaresi
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D000067877:Autism Spectrum Disorder / Q000453:epidemiology / Q000628:therapy; D001521:Behavior Therapy / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology / Q000628:therapy; D008297:Male; D000072143:Pediatricians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*