Authors of the study compared the two type of “collaborative care,” where care managers act as intermediaries between a family and the doctor supervising the child.
The standard collaborative approach and the “enhanced” approach were compared, and care managers received several days of training to teach parents additional healthy parenting skills and interact with families of ADHD children.
“I think it’s a very powerful tool in medicine and it’s being used more and more, but it’s still not widespread in terms of how doctors interact with patients and their families,” said study author Dr. Michael Silverstein, an associate professor of pediatrics at Boston University School of Medicine.
Silverstein noted that care managers who were trained did not have advanced degrees or formal mental health education and licensing. “This could be potentially significant for how to provide care in settings or among populations who might not be able to afford or have access to Ph.D.-level psychologists,” he said.
Scientists followed 156 children in an urban setting for one year after they were referred for testing for ADHD, and were randomly assigned to receive standard collaborative care or enhanced collaborative care.
Children in the study were between 6 and 12 years of age, and had not been diagnosed with ADHD at the start of the study but were recommended for testing. At the end of the study, 40 percent of them were found to have ADHD symptoms that met rigors of a diagnosis.
Silverstein described that three factors can interfere with a child’s ability to receive successful treatment. The list includes: difficulty adhering to the therapy; a mother’s mental health problems; and other conditions the child has, such as oppositional defiance disorder, depression, anxiety, learning disabilities or even post-traumatic stress disorder.
The enhanced collaborative care approach tried to help with those factors, Silverstein said.
The findings were published in the journal Pediatrics.