Welcome to the Online Access page for Caring for Children With ADHD: A Resource Toolkit for Clinicians, 2nd Edition
Also available: The NEW 3rd edition of Caring for Children With ADHD: A Practical Resource Toolkit for Clinicians has been completely updated and revised for new diagnostic criteria. This toolkit provides practical guidance and fillable forms to help you turn your practice into a medical home for children with ADHD. For more information, visit shop.AAP.org.
Introduction
Introduction to Caring for Children With ADHD: A Resource Toolkit for Clinicians, 2nd Edition
Overview of the ADHD Care Process
Assessment and Diagnosis
Initial Assessment and Diagnosis
NICHQ Vanderbilt ADHD Primary Care Initial Evaluation Form
Intended for use by the clinician, this tool helps organize the various pieces of information needed to make a diagnosis of ADHD—patient history of presenting symptoms; relevant past and family medical history; a pertinent review of systems to consider other conditions that can look like or coexist with ADHD; physical examination, including vision, hearing, and neurologic; and a review of validated assessment scales, including a comorbidity screen. This form also can serve to organize the child’s treatment plan, including making appropriate referrals, identifying target symptoms, and scheduling appropriate follow-up and parent education.
NICHQ Vanderbilt Assessment Scale: Parent Informant
This tool is a validated, parent-completed questionnaire that obtains information needed for diagnosis from a parent about core symptoms of ADHD and areas of functional impairment. It includes a screen for comorbidities including externalizing disorders (oppositional-defiant and conduct) and internalizing disorders (depressive and anxiety).
Sample Scored NICHQ Vanderbilt Assessment Scale: Parent Informant
This tool, intended for the clinician and parent, illustrates how the scale is completed and scored.
NICHQ Vanderbilt Assessment Scale: Teacher Informant
This tool is a teacher-completed, validated questionnaire that obtains information needed for diagnosis from a teacher about core symptoms of ADHD and areas of functional impairment. It includes a screen for comorbidities including externalizing disorders (oppositional-defiant and conduct) and internalizing disorders (depressive and anxiety). The review of functional impairments can be used to help identify children who require additional screening for learning disabilities.
Scoring Instructions for NICHQ Vanderbilt Assessment Scales
This tool reviews for the clinician how to score and interpret the NICHQ Vanderbilt parent and teacher assessment and follow-up scales.
Sample Cover Letter to Teachers From Clinicians PDF | Word
Intended for use by the clinician, this letter serves as an introduction that may accompany the assessment scale requested from a teacher. It is suggested that a Release of Information Form, signed by the parent, accompany the letter. This sample is provided as a template; clinicians can adapt it to fit their own practice approach.
Assessment and Diagnosis With Comorbidities
Clinician Tool for Screening
Pediatric Symptom Checklist-17 English | Scoring Instructions
A parent-completed questionnaire that screens children for behavioral disorders, this tool has internalizing, externalizing, and attention subscales. The screening may be used as part of an annual evaluation of children with ADHD to identify those who may have significant comorbidity. The screen and its attention subscale can also be used to identify children from the general population for further evaluation of possible ADHD.
Clinician Tools for Further Evaluation
PHQ-9 English | Scoring and Instructions
Depression can complicate ADHD or present with similar symptoms. The PHQ-9 is a patient-completed questionnaire that screens for depressive disorders. It can be used to identify or follow patients with comorbid depressive disorders.
CRAFFT Provider Guide
This guide outlines a clinician approach to evaluating and treating adolescents for substance abuse concerns.
The CRAFFT Screening Questionnaire
Substance abuse can complicate ADHD or present with similar symptoms. CRAFFT can be given as a written questionnaire or asked of patients to screen for substance abuse disorders.
Screen for Child Anxiety Related Disorders (SCARED) Child Version
Anxiety disorders can present with inattention and can also be comorbid with ADHD. This questionnaire can be used to identify patients who require further evaluation or treatment for anxiety disorders.
Guidance for Primary Care Clinicians: Managing Common Mental Health Symptoms in Children and Adolescents: Background
This tool from the AAP Addressing Mental Health Concerns in Primary Care: A Clinician’s Toolkit provides information on a general approach to addressing mental health symptoms in a primary care setting. It includes suggestions on building a therapeutic alliance, and the role of primary care clinicians in the evaluation of children younger than 5 years and in the treatment of children who present with more severe problems.
Recommendations for Cardiovascular Evaluation and Monitoring of Children and Adolescents Receiving Medications for ADHD
This tool reviews recommendations for cardiovascular screening and monitoring during medication treatment of ADHD. These recommendations are based on a joint statement by the AAP and American Heart Association (AHA) following the AHA scientific statement of April 21, 2008.
Parent Tools
The following parent-directed handouts from Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) discuss approach to treatment of ADHD and other comorbidities:
ADHD and Coexisting Disorders (Overview)
ADHD and Depression
ADHD and Disruptive Behavior Disorders
ADHD and Sleep Disorders
ADHD and Tics and Tourette Syndrome
Treatment and Medication
Clinician Tools
ADHD Medication Management Plan (English) PDF | Word
This document is intended to be filled out by the clinician and given to the parent to provide a written ADHD management plan. It includes prompts to identify target symptoms for improvement and explicit instructions on when medication is given, and also lists side effects that require immediate follow-up, instructions for further evaluation, and follow-up plans. This tool is provided as a template; clinicians can adapt it to meet their own practice needs.
ADHD Medication Guide
Produced by the North Shore-Long Island Jewish Health System, Inc., this guide is a visual aid for professionals caring for individuals with ADHD. It provides full-color, actual-size images of stimulant and non-stimulant medications indicated for the treatment of ADHD by the US Food and Drug Administration. In clinical practice, the guide may be used to assist patients in identifying medications previously tried and clinicians in identifying medication options for the future. The guide identifies all available dose formulations and indicates how each medication can be given and when a generic formulation is available.
What Every Pediatrician Needs to Know About ADHD and School
This tool summarizes the process of obtaining school evaluations and accommodations for children with ADHD. Eligibility requirements and typical accommodations for 504 plans and special education services are reviewed.
Working With Families Interested in Complementary and Alternative Medicine for ADHD
This tool outlines a general approach to working with families interested in treatment with complementary and alternative medicine (CAM). References are given for more detailed information about CAM and ADHD.
Behavior Modification Treatment for Children With ADHD
This tool explains the basic principles of behavior modification treatments for children with ADHD. Behavior modification is the best evidenced-based psychosocial treatment for ADHD.
Parent Tools
Managing Medicine for Children and Teenagers with AD/HD
This tool includes basic information about the diagnosis of ADHD and outlines the role of medication in ADHD treatment, different classes of medication used for ADHD treatment and possible side effects, and dose-adjustment process.
Homework Tips for Parents
Intended for parents to understand and assist their child in completing homework, this tool identifies common problems, outlines helpful solutions, and suggests when additional resources might be useful.
Monitoring and Follow-up
Clinician Tools
NICHQ Vanderbilt Assessment Follow-up: Parent Informant
This is a validated questionnaire for parents to fill out that organizes information needed to follow a child’s response to treatment. It asks parents about a child’s core symptoms of ADHD and functional status, as well as side effects of the most frequently used medication treatments.
NICHQ Vanderbilt Assessment Follow-up: Teacher Informant
This is a validated questionnaire for teachers to fill out that organizes information needed to follow a child’s response to treatment. It asks teachers about a child’s core symptoms of ADHD and functional status at school, as well as side effects of the most frequently used medication treatments.
Basic Facts: What Every Clinician Should Know Before Starting a Patient on Medication
This tool outlines factors a clinician should consider before initiating medication treatment, including setting treatment goals, criteria to use in selecting appropriate medication, and follow-up plans.
Medication Titration Monitoring Tool (Excel)
This Excel file can be used and modified by the clinician to follow the effectiveness and side effects of medication in a simple flow sheet.
Parent Tools
Basic Facts: What Every Parent Should Know Before Starting a Child on Medication
This tool explains important information for parents about medication treatment for ADHD, including the role of medication, side effects, dose titration, and follow-up.
The Use and Abuse of Psychostimulant Medication: Tips for Parents and Teens
This tool outlines the risks of medication abuse and best practices to minimize this risk.
Additional Parent Tools
ADHD Parents Medication Guide
This guide offers a detailed review of diagnosis and treatment of ADHD, including information about selecting a medication, combined treatment, and managing medication side effects.
Why Is My Child Having Trouble in School?
This tool explains common problems children with ADHD have at school and suggests practical approaches to management.
Why Am I Having So Much Trouble With School?
Intended for the older child or teenager, this tool explains common difficulties children with ADHD have at school and suggests practical approaches to self-management.
Parent-Teen Driving Agreement and A Message to Parents of Teen Drivers
Pediatrician Implementation Guide
Teen drivers with ADHD are at increased risk of crashes and citations when they begin to drive. The Parent-Teen Driving Agreement is intended to be completed through discussion between parents and their teens about appropriate rules and expectations for safe driving. A Message to Parents of Teen Drivers outlines how parents can set rules that decrease a child’s risk of crashes during the early driving years.
Health Care Financing
ADHD Coding Fact Sheet for Primary Care Pediatricians
This tool contains detailed information about how to bill for attention-deficit/hyperactivity disorder (ADHD) care using evaluation and management codes and how to use modifier 25 to bill for ADHD care when it is offered as part of routine well-child care. A comprehensive listing of Current Procedural Terminology and International Classification of Diseases, Ninth Revision, Clinical Modification codes commonly reported by pediatric health care practitioners in providing ADHD-related services is also included.
Additional Physican Resources
ADHD Internet Resources
The Internet is a valuable source of information for parents and clinicians about attention-deficit/hyperactivity disorder (ADHD) care. This tool lists current Internet sites that are credible sources of information about ADHD care.
Technical Support
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