The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder.

OBJECTIVE: The objective of this article was to provide an overview of the development and recommendations from the Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). The guideline aims to promote accurate and timely identification and diagnosis, and optimal and consistent treatment of ADHD. METHODS: Development integrated the best available evidence with multidisciplinary clinical expertise and the preferences of those with lived experience, underpinned by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The 23 guideline development group members included psychiatrists, paediatricians, general practitioners, psychologists, speech pathologists, occupational therapists, educators, Indigenous psychologists, and people with a lived experience; with two independent chairs and a methodologist. Where appropriate, evidence reviews from the National Institute for Health and Care Excellence (NICE) 2018 'Attention Deficit Hyperactivity Disorder: Diagnosis and Management' guideline were updated. Fifty prioritised clinical questions were addressed in 14 systematic reviews (new and updated from NICE 2018) and 28 narrative reviews. RESULTS: The 113 clinical recommendations apply to young children (5 years and under), children, adolescents and adults. They provide guidance for clinicians on identification, screening, diagnosis, multimodal treatment and support, including pharmacological and non-pharmacological interventions. The guideline and supporting information are available online: https://adhdguideline.aadpa.com.au/. CONCLUSIONS: The guideline was approved by the National Health and Medical Research Council (NHMRC) of Australia and relevant medical and allied health professional associations. It is anticipated that successful implementation and uptake of the guideline by organisations, health care providers and other professionals will increase delivery of evidence-based treatment and improve health outcomes for the more than 800,000 Australians with ADHD.

Safe transport of children with disabilities and medical conditions: Caregiver experiences.

BACKGROUND: Road vehicle transportation is essential to support community access and participation for all children. However, little is known about the transport patterns of children with disabilities and medical conditions and their caregivers' experiences supporting them to be transported safely in road vehicles in Australia. AIM: To understand the transport needs of children with disabilities and medical conditions and the transport needs of their caregivers. MATERIALS AND METHODS: A large-scale national survey was undertaken online to explore the experiences and perspectives of 193 caregivers, identifying the challenges and needs associated with providing and supporting safe road transportation for their children. RESULTS: Caregivers believed their child was missing out on participating in everyday life due to their transportation needs, with caregivers experiencing multiple challenges and barriers to transporting their child safely. CONCLUSIONS AND SIGNIFICANCE: There is a need to provide knowledge and support to caregivers who are primarily responsible for the safe transportation of their children with disabilities and medical conditions.

Restraint of children with additional needs in motor vehicles: knowledge and challenges of paediatric occupational therapists in Victoria, Australia.

AIM: This research project aimed to understand the challenges faced by occupational therapists when making recommendations regarding the restraint of children with additional needs in motor vehicles in Victoria, Australia. METHODS: A cross-sectional survey design was used to explore current practice in relation to the prescription of motor vehicle restraints in Victoria, Australia. An electronic survey was sent to occupational therapists working with children aged from birth to 18 years in early intervention services, hospitals, schools, community services or private practice. RESULTS: Challenges faced by occupational therapists related to a lack of knowledge of relevant standards and legal requirements, issues seating children with behavioural difficulties, families' inability to purchase recommended equipment and constraints as a result of funding issues. CONCLUSION: Further work is required to develop appropriate resources which support occupational therapists to make car seating recommendations for children with additional needs which comply with Australian legal requirements and standards.