ADHD Office Guidelines

As you are aware, ADHD is a complex, chronic disease requiring ongoing treatment, monitoring, and management. Treatment includes counseling, behavior modification, changes in school and home environments and routines, and medications. Many of the medications for ADHD are controlled substances, requiring further management to meet federal and state laws and regulations. In order to provide the very best care for your child, we follow standard expert, evidence-based guidelines and recommendations, as well as federal and state laws. We have developed the following guidelines in order to provide this care for your child.

  1. The diagnosis and treatment of ADHD is complex and controversial. Regardless, most agree that there are many things that can cause behavior problems or attention problems, including hearing or vision problems, sleep disorders, family stress, hormone problems, learning difficulties, and processing disorders. We require a complete and thorough evaluation for other medical problems prior to diagnosing ADHD, a condition for which there is no definite test or agreement on a definition.
  2. We follow standard guidelines for the diagnosis of ADHD, including parent and teacher evaluations. Children who do not meet the criteria for diagnosis of ADHD will be referred for further testing as to the cause of academic difficulties or behavior problems.
  3. Children whose evaluation suggests other mental health problems instead of or in addition to ADHD, such as depression, anxiety, or oppositional defiant disorder, will be referred to a mental health professional prior to treating ADHD. The mental health professional may treat all conditions, work with a psychiatrist, or work with us in treating all diagnosed problems. We will not treat children with multiple mental health disorders for ADHD unless the other conditions are also being treated.
  4. Children who start on medication for ADHD or change doses will require frequent follow-up visits until stable on medication, usually at least once a month.
  5. Once stable on medication, each child must be seen regularly for ADHD visits for follow-up and medication management. This is usually every 3 months.
  6. While being treated, each child will have regular follow-up input from teachers and parents.
  7. The standard of care for the treatment of children with ADHD is behavior modification counseling plus medication if needed. Standard treatment does not involve medication alone. We expect children who are taking medication for ADHD to also be in counseling.
  8. Each child must have a yearly well-child visit (aka physical or checkup). This is the only time we look at your child’s overall health and wellbeing, and is the required context for managing any chronic condition, including ADHD. If your child is stable on his ADHD medications and there are no issues, an ADHD visit may be combined with the annual well visit. Your insurance may require a separate charge for the ADHD portion of the visit. If there are any issues, it will probably be necessary to have separate visits for ADHD and the yearly well visit.
  9. Children who miss ADHD visits or well-child visits or do not turn in the required forms cannot have medication refills until the appointments are kept according to schedule and forms are up-to-date.
  10. Medication dosage increases or changes or a change in symptoms usually requires an office visit.
  11. Prescriptions for controlled substances cannot be called or faxed to a pharmacy.
  12. If a prescription for a controlled substance is lost, or medication is lost, a refill may have to wait until the next scheduled monthly refill.
  13. Parents should give out the daily dose of medications and keep them locked up.