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Department of Health and Human Services

Topic Suggestion Description

View Topic Suggestion Disposition (PDF) 146 kB

Date submitted: August 26, 2009

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
For adopted and foster children, what is the effectiveness of training adoptive and foster parents in attunement parenting in reducing problem behaviors?
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
Children 5-12 years who are currently in foster care or in adoptive homes
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
Subgroups divided by severity of behaviors.
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
Improvements in mental health, family attachment, self-esteem, and socially appropriate behaviors.
Describe any health-related risks, side effects, or harms that you are concerned about.
Temporary worsening of behaviors as subjects are initially encouraged to express the pain of their past experiences.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
Which priority area(s) and population(s) does this topic apply to? (check all that apply)
EHC Priority Conditions (updated in 2008)
  • Developmental delays, attention-deficit hyperactivity disorder, and autism
AHRQ Priority Populations
  • Children
Federal Health Care Program


Describe why this topic is important.
Children who have been in foster care and/or have been adopted exhibit disproportionate problem behaviors, including criminal behavior as teens and young adults.
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
Current brain research indicates that trauma increases likelihood of chronic state of stress, which I believe may set up the probability of severe behaviors. I have special training and am currently working with families and children in this population group and who have experienced success with an attunement parenting model
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)
If yes, please explain:
Variations in recommended care for this population of children; use of traditional parenting models, including use of consequences and rewards, commonly prescribed do not appear to be effective with this population.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?
If objective research proves the effectiveness of an attunement model of parenting, care for children and outcomes for children in the population will improve. My practice, and others will have evidence-based methods to inform the standard of care.
Describe the timeframe in which an answer to your question is needed.
Two year study (follow subjects for two years).
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Nominator Information

Other Information About You: (optional)
Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
  • Other Health Care Professional
Are you making a suggestion as an individual or on behalf of an organization?