The revisions most notably underscore systemic barriers to care and call on pediatricians to screen and initiate treatment for comorbidities.
, and more — if experienced in diagnosing them, or make a referral to a sub-specialist for treatment. The new KAS brings the total number of KASs to seven since the 2011 revision.
The new guidelines also come with a 10-page companion article, “Systemic Barriers to the Care of Children and Adolescents with ADHD,” that features four barriers as identified by AAP and recommendations on addressing them. The barriers include: limited access to care because of inadequate training or shortage of specialists; payer coverage limitations for services; challenges in practice organization and staffing; and fragmentation of care and communication barriers.
Other strategies to address the barriers include promoting changes in pediatric residency curricula; supporting revisions to payment systems; and implementing team-based approaches to communication. The barriers were determined, in part, as AAP reviewed the process of care algorithm , which has also been updated to assist in implementing the guideline’s recommendations.
“Evidence is clear with regard to the legitimacy of the diagnosis of ADHD and the appropriate diagnostic criteria and procedures required to establish a diagnosis, identify comorbid conditions, and effectively treat with both psychosocial and pharmacologic interventions,” AAP writes. “The steps required to sustain appropriate treatments and achieve successful long-term outcomes remain challenging, however.
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