A recently issued federal report found that 500,000 children who were treated with ADHD medication did not receive appropriate follow-up care per the recommendations outlined by the American Academy of Pediatrics. Specifically, these children did not attend a follow-up doctor’s appointment within one month of starting their medication and 1 in 5 children did not attend additional follow-up appointments within one year as recommended.
While this report focused on children enrolled in Medicaid, the follow-up care likely reflects typical care for most children who receive their medication from pediatricians or other primary care practitioners. The report did not identify the reasons why follow-up care was poor for so many children, but the findings do highlight the need for parents to advocate for their children.
As a parent, what type of follow-up care should you expect for your child after they start an ADHD medication? The American Academy of Pediatrics guidelines include four key points related to ADHD treatment:
In addition to following these guidelines, parents should expect to complete symptom rating scales at follow-up visits. Ideally, teacher rating scales should be collected as well. The provider should review these completed rating scales at each visit and consider the responses when determining whether a medication adjustment is needed.
Follow-up care is particularly important for kids with ADHD because every child responds to ADHD medication differently. Some have a great response to the first medication they try. Others need to try two or three medications before finding one that works well. Medication dose also needs to be adjusted somewhat regularly, both when a medication is initially started and as a child grows and gains weight over time. Lastly, ADHD medications can cause side effects, many of which can be addressed with medication adjustments.
Unfortunately, as the recent federal report highlights, not all practitioners adhere to the recommended ADHD treatment guidelines. Parents should feel confident asking for regular follow-up visits and to have access to ratings scales that can be completed by parents and teachers. ADHD medication can be a very powerful treatment tool, and it’s important to work with a provider who will provide follow-up care that optimizes medication response in order to help your child reach their full potential.
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
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