A team from St. Jude Children’s Research Hospital in Memphis, Tennessee, and Vanderbilt University Medical Center in Nashville, Tennessee, have developed an approach to help identify children with hemophilia at risk for attention-deficit/hyperactivity disorder (ADHD).

“A reliable method of screening that leads to early identification of [inattention (IN)]/[hyperactivity/impulsivity (HI)] can facilitate early intervention in the school and home setting vital to the long-term success of a child with a chronic illness,” the team explained in Haemophilia.

More than half of the study cohort of children with hemophilia (N=44) was found to have a mental health diagnosis. Eleven participants had a pre-existing mental health diagnosis, whereas 13 received a new one. Of those newly diagnosed, 8 had ADHD. The rate of ADHD in the study cohort was 29.5%, which was significantly higher than that of the general US population or other hemophilia populations.


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Participants without a pre-existing mental health diagnosis enrolled in the Quality Improvement initiative during their clinic visit, which combined the standard psychosocial assessment, conducted by a social worker and the school advocacy coordinator, with the Conners 3rd Edition, a questionnaire to assess for IN/HI symptoms.

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“The addition of the Conners 3rd Edition assessment and a triaging approach to the screening process proved useful to confirm clinical concern, pursue comprehensive psychological testing, and bring a level of objectivity to a sensitive and complicated topic,” the team wrote.

Based on the findings, participants were offered interventions, such as a psychology consult and/or psychological testing for at-risk patients, referrals to community-based mental health professionals, and/or in-person meetings among family and staff in the community schools. Most participants (95%) took advantage of the intervention offered by the school advocacy coordinator aiming to improve school services.

Reference

Boggs JE, Pullen A, Molnar Jr. AE, Hodges J, Reiss UM. Screening for inattention, hyperactivity and impulsivity in children with haemophilia: a quality improvement intervention. Haemophilia. Published online September 16, 2022. doi:10.1111/hae.14656