Receipt of Behavioral Therapy in Preschool-Age Children with ADHD and Coexisting Conditions: A DBPNet Study.

IF 1.8 3区 医学 Q3 BEHAVIORAL SCIENCES Journal of Developmental and Behavioral Pediatrics Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI:10.1097/DBP.0000000000001216
Shruti Mittal, Ami Bax, Nathan J Blum, Justine Shults, William Barbaresi, Jaclyn Cacia, Alexis Deavenport-Saman, Sandra Friedman, Angela LaRosa, Irene M Loe, Shelby Tulio, Douglas Vanderbilt, Elizabeth Harstad
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Abstract

Objective: Practice guidelines from the American Academy of Pediatrics and Society for Developmental and Behavioral Pediatrics recommend evidence-based behavioral therapy (BT) as first-line treatment for preschool-age children with ADHD, prior to medication initiation. Thus, this study's objective is to present the frequency of physician-documented receipt of BT in preschool-age children with ADHD prior to medication initiation and to determine factors associated with receipt BT receipt.

Methods: This retrospective medical record review was conducted across 7 Developmental Behavioral Pediatrics Research Network (DBPNet) sites. Data were abstracted for children <72 months old seen by a DBP clinician and initiated on ADHD medication between 1/1/2013-7/1/2017. From narrative text of the medical records, BT receipt was coded as: parent training in behavior management (PTBM), Applied Behavior Analysis (ABA), other, or did not receive.

Results: Of the 497 children in this study; 225 children (45%) had reported receipt of any BT prior to ADHD medication initiation, with 15.9% (n = 79) receiving PTBM. Children with co-existing diagnoses of ASD or disruptive behavior disorder were more likely to receive BT than children without co-existing conditions (59.3% vs 69.0% vs 30.6%). There was significant site variability in reported receipt of BT, ranging from 22.4% to 74.1%, and sex and insurance were not associated with BT rates.

Conclusion: The percentage of children with documented receipt of any BT, and particularly PTBM, was low across all sites and co-existing conditions. These findings highlight the universal need to increase receipt of evidence-based BT for all young children with ADHD.

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学龄前多动症儿童接受行为治疗和共存条件:DBPNet研究。
目的:美国儿科学会和发育与行为儿科学会的实践指南建议,在开始用药之前,循证行为疗法(BT)是学龄前多动症儿童的一线治疗方法。因此,本研究的目的是介绍医生记录的ADHD学龄前儿童在用药前接受BT的频率,并确定与接受BT相关的因素。方法:这项回顾性医疗记录审查在7个发育行为儿科研究网络(DBPNet)网站上进行。结果:在本研究的497名儿童中;225名儿童(45%)报告在ADHD药物治疗开始前接受过任何BT,15.9%(n=79)接受过PTBM。患有ASD或破坏性行为障碍合并诊断的儿童比没有合并疾病的儿童更有可能接受BT治疗(59.3%vs69.0%vs30.6%)。报告的接受BT治疗存在显著的位点变异性,从22.4%-74.1%不等,性别和保险与BT发病率无关。结论:在所有地点和共存条件下,有记录的接受任何BT,特别是PTBM的儿童比例都很低。这些发现强调了增加所有患有多动症的幼儿接受循证BT的普遍必要性。
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来源期刊
CiteScore
3.10
自引率
8.30%
发文量
155
审稿时长
6-12 weeks
期刊介绍: Journal of Developmental & Behavioral Pediatrics (JDBP) is a leading resource for clinicians, teachers, and researchers involved in pediatric healthcare and child development. This important journal covers some of the most challenging issues affecting child development and behavior.
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