A 6-step approach developed by the researchers of the research program Reach for ADHD at Boston Medical Cente will help families of ADHD children to address the condition: “This project is family-centered, focused on breaking down the barriers that families face from before diagnosis to preparing ADHD children for the future “, said Dr. Andrea Spencer, program director.
The study was published in the scientific journal Pediatrics.
6-step approach: that’s what it consists of
“This project can help serve as a model for developing engagement interventions that will be more beneficial to families “, Spencer added in a press release from the center, explaining the purpose of the 6-step approach for families with ADHD children.
The researchers developed the new therapy based on the experiences of 41 low-income urban ethnic and racial minority families, who are more likely to experience difficulties as they transitioned from diagnosis to treatment of their children’s ADHD.
The six phases of approach or involvement identified by the researchers are:
- normalization and hesitation;
- stigmatization and fear;
- action and advocacy;
- communications and navigation;
- care and validation;
- preparation and transition.
Difficulties and conflicts can occur when parents and caregivers are at different stages in the process, which researchers call a phase discrepancy. Interventions could be offered to support families at each stage and help them successfully move on to the next, the study authors suggest.
“Parents have been successful when support has been provided in a way that matches their engagement stage“Explained Spencer, who is also an assistant professor of psychiatry at the Boston University School of Medicine.
“The use of the Six Stages framework (6-step approach), could allow the health system to better meet the needs of ADHD children whose families are at different stages in their engagement process“, Continued the expert.
Regarding the results of applying the 6-step approach, the experiment revealed that of the ADHD children, 69.2% were male, 57.7% were black or African American and 38.5 % were of Hispanic, Latino or Spanish descent. Parents were 92.7% female, 75.6% spoke English and had an average income of $ 20,000.
Parents described 6 stages of the process of involvement in their child’s ADHD care, which unfolded as a developmental process: (1) normalization and hesitation, (2) fear and stigmatization, (3) action and advocacy, (4) communication and navigation, (5) care and validation, and (6) preparation and transition.
Barriers have often arisen in moments of mismatch between parents and providers and / or systems. The difficulty of resolving an earlier stage interfered with the progression through the later stages.
The authors said future research to refine the model should examine: the experiences of families with undiagnosed and untreated children; age of diagnosis and years of treatment and how families of specific racial or ethnic groups may progress differently through the stages.
ADHD is one of the most common disorders of development neurological of childhood. It is usually first diagnosed in childhood itself and often lasts into adulthood. Children with ADHD may have difficulty paying attention, controlling impulsive behaviors (they may act without thinking about what the outcome will be), or being overly active.
It is normal for children to have difficulty concentrating and behaving in any circumstance that requires some attention. However, ADHD children don’t just grow up with these behaviors. Symptoms continue, can be severe, and can cause difficulties at school, at home, or with friends.
There are three different types of ADHD, depending on which types of symptoms are strongest in the individual:
Mostly inattentive: it is difficult for the individual to organize or complete a task, pay attention to details, or follow instructions or conversations. The person is easily distracted or forgets the details of the daily routine.
Predominantly hyperactive-impulsive: the person gets agitated and talks a lot. It is difficult to sit for a long time (e.g. for a meal or while doing homework). Younger children can run, jump or climb constantly. The individual feels restless and has problems with impulsivity. Someone who is impulsive can interrupt others a lot, grab things from people, or talk at inappropriate times. It is difficult for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
Symptoms combined: the symptoms of the two previous types are equally present in the person.
Since symptoms can change over time, the presentation can also change over time. Scientists are studying the causes and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The causes and risk factors for ADHD are unknown, but current research shows that genetics play an important role. Recent studies link genetic factors with ADHD.
Deciding if a child has ADHD is a multi-step process. There is no single test to diagnose ADHD and many other problems, such as anxiety, depression, sleep problems, and some types of learning difficulties, can have similar symptoms. One step in the process involves a medical exam, including hearing and vision tests, to rule out other problems with symptoms such as ADHD. The diagnosis of ADHD usually includes a checklist to assess the symptoms of ADHD and collect a history of the child from parents, teachers, and sometimes the child.
In most cases, ADHD is treated, in addition to the 6-step approach, at best with one combination of behavioral therapy and medications. For preschool-aged children (4-5 years old) with ADHD, behavior therapy, especially parent training, is recommended as the first line of treatment before trying medications. What works best may depend on the child and the family. Good treatment plans will include careful monitoring, follow-up and changes as needed along the way.
ADHD can last into adulthood. Some adults have ADHD but have never been diagnosed. Symptoms can cause difficulties at work, at home, or in relationships. Symptoms may appear different in old age, for example, hyperactivity can appear as extreme restlessness. Symptoms can become more severe as the demands of adulthood increase.
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