“Collaborative Care” Improves ADHD Symptoms in Children
A new model for treating ADHD in children — connecting parents to pediatricians through a “care manager” — has shown to be more effective than standard treatment approaches.
March 26, 2015
What’s the best treatment for children with ADHD? It might be a team effort.
A recent study published in the journal Pediatrics found that a “collaborative care” model, which uses a “care manager” as a liaison between parents and pediatricians, was more effective at treating ADHD in children than a standard pediatrician-centered model.
The study, published online March 23, randomly assigned 156 children who were being evaluated for ADHD — not those who were already diagnosed — to one of two care management systems: “enhanced care” or a control group. The enhanced care system included care managers, mostly bilingual young adults — primarily women — who were trained in general health care and showed a strong desire to connect to the families they work with.
The care manager was charged with getting medical histories from families, collecting symptom reports, and communicating with parents, their pediatrician, and a specialized panel of child psychiatrists and developmental pediatricians. Each care manager received a week of additional training in “motivational interviewing,” a technique that allows the manager to engage with parents and to give strategies to help manage difficult behaviors.
After one year, researchers assessed children in three categories: hyperactivity and impulsivity, oppositionality, and social skills. Families who worked with the care managers saw significant improvement in all three measures as compared with the control group. Though this collaborative care technique involved more health professionals and took more time, its cost was surprisingly low: The only additional expense was the week’s worth of training for the care managers.
Dr. Michael Silverstein, the author of the study, thinks that this method will have a powerful impact on low-income children, who often show the least improvement from ADHD treatment. Low-income families usually don’t have access to behavioral therapy or other treatment options beyond medication, and cultural differences may discourage them from going to the doctor for behavioral problems.
An effective care manager can bridge the gap by visiting parents on their own turf, explaining the ins and outs of an ADHD diagnosis and — most importantly — how proper treatment can better their child’s life.