Forms for the Diagnosis and Treatment of ADHD
Tracking
Patient Log – used as a tool to track newly evaluated patients and ensure patients are receiving follow-up care at guideline recommended intervals
Vanderbilt Assessment Scales
The AAP and Cincinnati Children's Hospital Medical Center guidelines recommend that an ADHD diagnosis be DSM-based. This requires that symptoms and impairment be documented in home and school settings and that alternative diagnoses are ruled out. Use of the Vanderbilt rating scales is encouraged because they enable primary care providers to screen for symptoms, impairment, and presence of the most common psychiatric comorbidities found in elementary school aged children. The Vanderbilt scales should be used in combination with a comprehensive review of the child's medical, developmental, educational, social, and family histories.
The following Vanderbilt scales can be customized to work with your office's contact information to enable parents and teachers to mail or fax completed forms to the office.
Follow-up Vanderbilt scales enable the primary care provider to document and quantitatively track response to treatment (through the use of the TSS, Total Symptom Score) and monitor side-effects. Follow-Up Vanderbilt scales should be completed by the parent(s) and teacher(s) within 6 weeks of medication initiation.
Tools for Scoring and Interpreting Initial and Follow-up Rating Scales
Telephone Follow-Up Encounter Form
Telephone follow-up should be conducted within 7 – 14 days for all newly diagnosed ADHD patients who are started on medication. This scripted encounter form standardizes necessary follow-up questions so that phone calls can be made by non-physician staff members.
Written Care Management Plan
The purpose of the Written Care Management Plan is to help the child and family manage his or her ADHD. Recommended elements of a written care management plan include: goals, treatment plan, expectation for how follow-up will occur, and a scorecard for monitoring response to treatment.
Sample Evaluation Packet
It can be helpful to provide an information packet to families when the assessment of ADHD is initiated to ensure that offices expectations regarding diagnosing ADHD are clearly spelled out. Frequently, offices include the cover letters listed below in addition to Initial Parent and Teacher Vanderbilt Rating Scales.
Sample Treatment Packet
It can be helpful to provide an information packet to families when treatment of ADHD is initiated to ensure that offices expectations regarding treatment are clearly defined. Frequently, offices include the cover letters and resource information (see below) in addition to Follow-Up Parent and Teacher Vanderbilt Rating Scales.
