Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Childhood Onset, Disruptive Mood Dysregulation Disorder, Oppositional Defiant Disorder in Children
Conditions
Brief summary
This small pilot study will enroll children ages 5-12 years of age with disruptive behavior problems at school. These children and their families will be offered an enhanced model of primary care, which includes pre-visit record review, standardized content of primary care visits, post-visit care coordination by the primary care team, and coordination of services between the primary care team and the school. We hypothesize that children receiving this enhanced model of care will achieve better behavioral outcomes at both school and home.
Interventions
OTHERenhanced model of primary care
The SCHOOL STARS model of care includes pre-visit planning, standardized visit content, post-visit care coordination, and coordination between primary care and school.
Sponsors
Children's Hospital Medical Center, Cincinnati
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Pre-post within-subject design
Eligibility
Sex/Gender
ALL
Age
5 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* Student at a local public school * Primary care patient at the Pediatric Primary Care Center (PPC) at CCHMC, or a CCHMC-affiliated school-based health center * School disciplinary problems defined as: (1) any suspension from school within the last 2 school months and/or (2) frequent calls to the parent from school (1+ times per week x 1 month) * Parent is in the contemplative, preparation, or action stage of readiness for starting medication or therapy if recommended by a healthcare provider for their child's behavior problems * Student may or may not have an existing diagnosis of an externalizing behavioral health disorder, such as ADHD, Oppositional Defiant Disorder, or Disruptive Mood Dysregulation Disorder.
Exclusion criteria
* Non-English-speaking parent * Enrolled in another ADHD study * Severe developmental delay or autism * Potential cardiac contraindications to starting stimulant medications without an EKG (personal or family history of heart disease in a child, family history of sudden death before age 50, family history of death due to heart disease before age 50, personal history of seizures, personal history of unexplained syncopal episodes) * Patients who have an established relationship with a PPC Care Manager * Patients who have seen the same primary care provider for the last two well child or behavior-related visits (unless approved/referred by that primary care provider)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Child Behavior Checklist scores (externalizing subscale) | at enrollment and 3 months post-intervention | parent-completed assessment of child behavior; T scores for the externalizing subscale range 0-100 with higher scores being worse |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in disciplinary referrals at school | 3 months pre-intervention to 3 months post-intervention | number of times per week child was referred for disciplinary action at school |
| Change in calls to parent from school | 3 months pre-intervention to 3 months post-intervention | number of calls per week to the parent from school about the child's behavior |
| Change in days of suspension from school | 3 months pre-intervention and 3 months post-intervention | number of days child was suspended from school |
| Change in Vanderbilt Attention Deficit Hyperactivity Disorder Rating Scale scores | all historical data and all data up to 3 months post-intervention | (for participants with ADHD); Total Symptoms Score for items 1-18 (inattentive and hyperactive symptoms); Range 0-54; Higher scores represent a worse outcome |
Other
| Measure | Time frame | Description |
|---|---|---|
| Referral adherence | from enrollment to 3 months post intervention | percentage of referrals to behavioral therapy that result in a completed appointment |
Countries
United States
Outcome results
None listed