{"id":1695,"date":"2024-12-08T12:28:12","date_gmt":"2024-12-08T17:28:12","guid":{"rendered":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/?p=1695"},"modified":"2024-12-08T12:59:23","modified_gmt":"2024-12-08T17:59:23","slug":"asthma-and-adhd-how-do-pediatricians-approach-this-intersection","status":"publish","type":"post","link":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/biology\/asthma-and-adhd-how-do-pediatricians-approach-this-intersection\/","title":{"rendered":"Asthma and ADHD: How do Pediatricians Approach This Intersection?"},"content":{"rendered":"

According to the CDC, 11.4% of children aged 3-17 in the USA are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) (<\/span>Data and Statistics on ADHD | Attention-Deficit \/ Hyperactivity Disorder (ADHD)<\/span><\/i>, 2024). ADHD is a developmental disorder characterized by symptoms of hyperactivity, impulsivity, and inattention, as the name suggests. Treating this disorder often requires a variety of approaches including medication, psychotherapy, and workplace or school-based accommodations (<\/span>Attention-Deficit\/Hyperactivity Disorder – National Institute of Mental Health (NIMH)<\/span><\/i>, n.d.).\u00a0 Comorbidities are very common in people with ADHD, this makes it so that it is rarely the only concern during a primary care visit (Silver, 2024). Sleath et al. discuss the communication primary physicians held with families with children that have both ADHD and asthma. There has been found to be a correlation between the severity of ADHD and asthma symptoms (Blackman & Gurka, 2007). In turn, balancing treatment for both primary care visits was a driver for the paper. Asthma is a chronic lung condition that results in the narrowing of the lung pathways. Medication to alleviate symptoms of both ADHD and asthma is often prescribed at primary care visits hence the study of their intersection.\u00a0<\/span><\/p>\n

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Figure 1.<\/strong> Happy little girl and pediatrician doing high five after medical checkup. AAP Schedule of Well-Child Care Visits. (2023). Healthy Children.org. https:\/\/www.healthychildren.org\/English\/family-life\/health-management\/Pages\/Well-Child-Care-A-Check-Up-for-Success.aspx<\/figcaption><\/figure>\n

Sleath et al. approach this balance by studying the communication between patients with ADHD and asthma and pediatricians. The study focuses on the communication breakdown when the patient has ADHD during an asthma visit. All of these were pediatric visits. To measure the effectiveness of communication, the American Association of Pediatrics (AAP) guidelines for discussing ADHD were used. The percentage of adherence was measured through the visits using recordings.\u00a0<\/span><\/p>\n

Before data collection eligibility tests were conducted. This made sure that all participants in the study were 8-16 years of age, could speak English, was capable of filling out an assent form, had had at least one prior visit to the clinic, had persistent asthma, and had a guardian present who is over the age of 18 and is competent in English. After the visits concluded, guardians were provided with questionnaires, and children were interviewed. These were used to supplement the recordings.\u00a0<\/span><\/p>\n

The audio taping and coding are the backbone of the data. The audio tapes were transcribed by a coding tool that was flagged for AAP guidelines. To ensure accuracy two research assistants met twice a month to review and refine criteria. The other important aspect of the collection was a thorough socio-demographic data set: gender, age, race, insurance, and tears of asthma. All demographic data but asthma status was also recorded from guardians.\u00a0<\/span><\/p>\n

The results yielded from this were extreme. Throughout the visits 23% of the 296 children had ADHD noted in their medical chart. It was found that boys were more likely to have ADHD diagnoses. It is important to note that it is not because ADHD affects males more, but women are less likely to get diagnosed or are diagnosed later in life due to inattentive presentations (Attoe & Climie, 2023). When understanding the extent of utilization of AAP guidelines, categories were formed; functioning, outcomes, treatment plan, ADHD asthma relationship, chronic and follow-up visits. In all of these categories, the percentage of providers that used AAP guidelines never rose above 40%. In the adherence to medication, only one provider out of the 35 discusses the topic (41 providers participated, but recording forms only 35 were usable). Overall, it was shown that AAP guidelines were more likely to be followed if the visit was unrelated to asthma, highlighting providers’ tendency to neglect proper ADHD management in patients with comorbidities.\u00a0<\/span><\/p>\n

The aim was to highlight the need for better communication practices in the pediatric setting. Particularly in cases where comorbid conditions are present. Future development in this field would be understanding the reason behind the present communication pattern. Approaching the issue from the physician and patient perspective. On the other hand, research on how to remedy the disparity in guideline adherence.\u00a0<\/span><\/p>\n

 <\/p>\n

Article based on \u2018Communication about ADHD and its treatment during pediatric asthma visits\u2019<\/strong><\/p>\n

Sleath, B., Sulzer, S. H., Carpenter, D. M., Slota, C., Gillette, C., Sayner, R., Davis, S., & Sandler, A. (2014, Feb). Communication about ADHD and its treatment during pediatric asthma visits. <\/span>Community Ment Health J .<\/span><\/i>, <\/span>50<\/span><\/i>(2), 185-192. 10.1007\/s10597-013-9678-3<\/span><\/p>\n

References<\/strong><\/p>\n

AAP Schedule of Well-Child Care Visits<\/span><\/i>. (2023). Healthy Children.org. https:\/\/www.healthychildren.org\/English\/family-life\/health-management\/Pages\/Well-Child-Care-A-Check-Up-for-Success.aspx<\/span><\/p>\n

Attention-Deficit\/Hyperactivity Disorder – National Institute of Mental Health (NIMH)<\/span><\/i>. (n.d.). National Institute of Mental Health. Retrieved November 1, 2024, from https:\/\/www.nimh.nih.gov\/health\/topics\/attention-deficit-hyperactivity-disorder-adhd<\/span><\/p>\n

Attoe, D. E., & Climie, E. A. (2023, March 30). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. <\/span>J Atten Disord<\/span><\/i>, <\/span>27<\/span><\/i>(7), 645\u2013657. 10.1177\/10870547231161533<\/span><\/p>\n

Blackman, J. A., & Gurka, M. J. (2007). Developmental and Behavioral Comorbidities of Asthma in Children. <\/span>Journal of Developmental & Behavioral Pediatrics<\/span><\/i>, <\/span>28<\/span><\/i>(2), 92-99. 10.1097\/01.DBP.0000267557.80834.e<\/span><\/p>\n

Data and Statistics on ADHD | Attention-Deficit \/ Hyperactivity Disorder (ADHD)<\/span><\/i>. (2024, May 22). CDC. Retrieved November 1, 2024, from https:\/\/www.cdc.gov\/adhd\/data\/index.html<\/span><\/p>\n

Silver, L. (2024, April 3). <\/span>ADHD Symptoms Or ADHD Comorbidity? Diagnosing Related Conditions<\/span><\/i>. ADDitude. Retrieved November 1, 2024, from https:\/\/www.additudemag.com\/when-its-not-just-adhd\/<\/span><\/p>\n

Sleath, B., Sulzer, S. H., Carpenter, D. M., Slota, C., Gillette, C., Sayner, R., Davis, S., & Sandler, A. (2014, Feb). Communication about ADHD and its treatment during pediatric asthma visits. <\/span>Community Ment Health J .<\/span><\/i>, <\/span>50<\/span><\/i>(2), 185-192. 10.1007\/s10597-013-9678-3<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

According to the CDC, 11.4% of children aged 3-17 in the USA are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) (Data and Statistics on ADHD | Attention-Deficit \/ Hyperactivity Disorder (ADHD), 2024). ADHD is a developmental disorder characterized by symptoms of hyperactivity, impulsivity, and inattention, as the name suggests. Treating this disorder often requires a […]<\/p>\n","protected":false},"author":743,"featured_media":1736,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[63,68],"tags":[69],"class_list":{"0":"post-1695","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-biology","8":"category-psych-neuro","9":"tag-medicine","10":"entry"},"featured_image_src":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-content\/uploads\/sites\/35\/2024\/12\/bsj-pic-1.jpg","featured_image_src_square":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-content\/uploads\/sites\/35\/2024\/12\/bsj-pic-1.jpg","author_info":{"display_name":"Martina Tognato Guaqueta","author_link":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/author\/mtognatoguaqueta\/"},"_links":{"self":[{"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/posts\/1695","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/users\/743"}],"replies":[{"embeddable":true,"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/comments?post=1695"}],"version-history":[{"count":0,"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/posts\/1695\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/media\/1736"}],"wp:attachment":[{"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/media?parent=1695"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/categories?post=1695"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/students.bowdoin.edu\/bowdoin-science-journal\/wp-json\/wp\/v2\/tags?post=1695"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}