A Systematic Review and Evaluation of Clinical Practice Guidelines for Children and Youth with Disruptive Behavior: Rigor of Development and Recommendations for Use

Abstract

Clinical practice guidelines (CPG) provide a framework for evidence-based practice; however, few studies have assessed the methodological quality of CPGs relevant to child and youth mental health. This study was a systematic review of CPGs for the assessment, prevention and treatment of disruptive behavior, including attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD) and aggression in children and youth. Systematic review identified 29 CPGs meeting inclusion criteria that were appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) validated tool. Twenty-two guidelines addressed ADHD, 2 CD, 1 ODD, 2 for Behavior Disorders collectively and 2 for Aggression. Among the 29 guidelines, two that were developed for ADHD (NICE 2013a; Spanish Ministry of Health, 2010) and one practice guideline developed for CD (NICE 2013b) met high quality criteria; one guideline for behavior disorders (Gorman et al. 2015), two for ADHD (AAP 2011a, b; SIGN 2009a, b, c, d, e), and two for aggression (Knapp et al. 2012; Scotto Rosato et al. 2012a, b) met minimum quality criteria. Findings from this review provide important information for clinicians and organizations who want to utilize guidelines to implement best-practice clinical services for children and youth with disruptive behavior.