Deficits in Diagnosis, Treatment and Continuity of Care in African-American Children and Adolescents with ADHD. METHODS

Using the mean age of diagnosis (9.2 ± 1.8) and the mean age of symptom impairment (3.5 years) in other reports, our biostatistician recommended >28 subjects in each group to demonstrate statistical significance in age points for our study. We reconfirmed statistical power for the mean length of time between sessions for the two groups to assure an appropriate confidence interval. Over a one-month period, we age-matched charts of 5-17-year-old African Americans until we had met that number.

One biracial female was excluded. The sample consisted of 29 Caucasian and 28 African-American males.

The average age in years at the time of selection was 10.86 for the African-American group and 10.66 for the Caucasian group. The Department of Child and Adolescent Psychiatry provided 75% of the African-American charts and 90% of the Caucasian charts reviewed, and neurology 25% and 10%, respectively. Get smart and save money! Buy viagra oral jelly online

Data Collection

By retrospective chart review, we identified each child’s criteria for diagnosis, symptoms reported in home and school, the age of onset of symptoms, the age of actual diagnosis, the initial therapy plan, perceived patient compliance, effectiveness of treatments and whether medication was used. We also collected existing comorbidities, developmental milestones and family history, particularly of ADHD, substance abuse and psychosis. Temper tantrums, acts of aggression, self-injury, depression, general anxiety, separation anxiety, impulsiveness and hyperactivity were noted as well. Can’t afford your medication? Buy female pink viagra

Data Analysis

Compliance was gathered from medical progress notes on medication adherence and attendance at follow-up sessions. Whether a patient or a parent actually complied could not be confirmed, but the doctor’s belief was noted. Compliance was divided into three categories: consistently compliant, episodic compliance or consistently noncompliant. Charts consistently indicating compliance had no evidence of children deviating from the prescribed therapy in frequency or dosage. The episodically noncompliant subjects took occasional unadvised drug holidays or changed frequency or dosage of medication. The consistently noncompliant had regular problems adhering to the prescribed therapy as indicated by the physician of record. Your life is worth living. Buy Levaquin 500 mg online

The age of onset of symptoms was reported in the patient’s history. When a parent indicated that the symptoms seemed always to have been present, the study defined the age of onset as 2. An individual symptom may be noted as early as age 1, but it will not be enough to make a diagnosis. Age 3 72 was the mean age of symptom impairment in one study. We chose lend credence to particular mothers’ observations and beliefs that their children were having significant difficulties with ADHD at an earlier age. The age of diagnosis was the first documentation of ADHD in the patient’s diagnosis list or the age the parent reported that a physician or psychologist had confirmed ADHD. Physician notations reported the response to therapy as a patient feeling improvement, no improvement or worsening of symptoms; or patient (or family) choosing not to take (give) medication. Save on your pharmacy bills. Buy omnicef antibiotic online

An average time-interval score was determined for each patient over the two-year span after diagnosis. From this information, a mean was determined for each of the two groups to compute the t value. The initial therapy given at the time of diagnosis was documented, as well as whether or not the patient remained on medication for ADHD over the next two years. All data were assessed using Chi-squared analysis, with the exception of time intervals between sessions.

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Tags: ADHD, children/adolescents, racial differences

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