October 22, 2008

Communication Interventions with Parents, Teachers, and Physicians of Children with ADHD

Principal Investigator: Mark L. Wolraich, MD

This study looked at two different interventions to help improve communication between the teachers, parents and primary care physicians of children with ADHD. Long-term results showed no significant improvement in communication due to either intervention.

It is estimated that around 3-5% of children worldwide have ADHD (Polanczyk, et al, 2007). In the U.S. in 2003, the parent-reported prevalence of ADHD in a Centers for Disease Control (CDC) study was 7.8%. A neurobehavioral diagnosis that can affect a child’s ability to learn and succeed in school, successfully treating ADHD involves close communication between parents, physicians and teachers (The Multimodality Treatment of ADHD Cooperate Group, 1999).  

Achieving communication between the physicians and the teachers and parents proved difficult in this study. There were two interventions tested in this study: a workshop approach and an individualized approach. The workshop approach was very ineffective in delivering information – with only one doctor and two teachers attending that were in the study (Wolraich, et al, 2005). The individualized approach delivered information more effectively, but the long-term impact was negligible. Despite having received information that physicians should communicate with teachers regarding a child’s ADHD, there was a very low rate of physicians communicating with teachers. It ranged from none to less than 5% (Wolraich, et al, 2005).  

The authors of the study reflected that neither a workshop approach nor a single-session individual meeting were highly effective (Wolraich, et al, 2005). They suggested that multiple-session interventions might be more effective. Also, since many of the children served were low income and on Medicaid, a school-based clinic might be more helpful.

References
Polanczyk, G., de Lima, M.S., Horta, B.L., Biederman, J., Rohde, L.A. (2007)." The worldwide prevalence of ADHD: a systematic review and metaregression analysis." American Journal of Psychiatry 164(6): 942–948.

The  Multimodality Treatment of ADHD Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit hyperactivity disorder (ADHD). Archives of General Psychiatry. 56: 1073-1086.

Visser, S.N., Lesesne, C.A. (2005, September 2). Mental health in the United States: Prevalence of diagnosis and medication treatment for Attention-Deficit/Hyperactivity Disorder.  Morbidity & Mortality Weekly Report. 54(34): 842-847

Wolraich, M.L., Bickman, L., Lambert, E.W., Simmons, T. & Doffing, M. (2005). Intervening to improve communication between parents, teachers, and primary care providers of children with ADHD or at high risk for ADHD. Journal of
Attention Disorders. 9(1): 354-368.