Toward a Comprehensive Life-Course Model of Care for Youth with Attention-Deficit/Hyperactivity Disorder

Abstract

Students with attention-deficit/hyperactivity disorder (ADHD) exhibit developmentally inappropriate levels of inattention and/or hyperactivity-impulsivity on a chronic basis across settings. In part due to their high rates of disruptive, noncompliant, and intrusive social behavior, students with ADHD also experience significant difficulties building positive relationships with peers and adults. In spite of the availability of evidence-based practices for youth with ADHD, many do not receive them. Furthermore, many of the best practice guidelines and models of care tend to be based on short-term benefit and focused on keeping service delivery costs at a minimum. In this chapter, we propose and describe an alternative model of care for children and adolescents' with ADHD that emphasizes a lifecourse perspective, that is, a framework that carefully considers the long-term implications and outcomes of early life experiences on the health and developmental outcomes of individuals across the entire life span. We apply this model to the process of making decisions about treatment and service delivery for the developing child; the implication for treatment decision making is that clinicians need to consider the long-term effect on the child and family when making recommendations. We propose this model for care of children with ADHD; however, it may be applicable to most youth with emotional and behavioral problems as many of the issues that support our proposal are similarly relevant for all children. Although the life-course model is grounded in empirical evidence, we acknowledge that a substantial body of research is needed lo fully test some of the articulated hypotheses. The goal of this chapter is to describe the model and its rationale as means of stimulating research designed to test the hypotheses within