Using data from the National Survey of Children with Special Health Care Needs, this study compared parent perceptions about receipt of Shared Decision Making (SDM) during pediatric medical visits for a physical health condition (asthma) relative to a behavioral condition (Attention Deficit / Hyperactivity Disorder- ADHD).
Parents were less likely to perceive high levels of SDM in the care of their children with more complex developmental behavioral conditions associated with greater diagnostic and treatment complexity as well as greater functional impairments. Compared to parents of children with asthma, those with ADHD had lower odds (0.73) of reporting consistent SDM. Compared to parents of children with ADHD, those with ASD reported even lower odds of consistent SDM (0.59). This study suggests that disease type, complexity, and need for specialty care may present challenges to implementing SDM.