It's All About the Children

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common mental disorders in the pediatric population. Its impact on daily living can be overwhelming and if not appropriately treated, can have lasting effects well into adulthood. Although it was first included in the Diagnostic and Statistical Manual (DSM) in 1980, reports support this diagnosis has been present throughout medical history.

Neuropsychological studies support the belief there is a neurotransmitter imbalance as it relates to executive function. And as most are aware, three basic forms of ADHD/ADD exist: hyperactivity, inattentiveness, and/or a combination of both. Symptoms certainly can appear prior to kindergarten, but often the diagnosis is made after a child has been in grade school for a few years. But unlike many other medical conditions, making the diagnosis of ADHD often leads to treatment measures not always easily accepted by patients and their families.

Nearly two years ago, a new patient to me had just completed a neuropsychological evaluation secondary to parental concerns of an inability to focus both at school and home. Unfortunately, this was leading to negative outcomes with both school work and relationships. A very complete list of recommendations were given to and followed by the family. Well, all except one. These recommendations included obtaining an educational, occupational, and psychotherapist, changing the physical environment within the classroom, home exercises, and the list goes on. The family initially wanted to try all therapies other than medication. Now jump ahead to two years of later, with both parents sitting in front of me with looks of despair and frustration and asking for something...anything that might help their child who was now getting closer to starting middle school...where things only get tougher.

We monitored the child's progress along the way and I worked with family's desire to avoid medicating. But we all felt the 100% effort being given to the behavioral therapy provided only minimal improvements. After two years, the family accepted that it was now time to begin a medication. After spending over an hour with the family discussing all issues related to the medication, I completed the prescription and asked the family for an update in 1-2 weeks. When I received the call, the parents were nearly in disbelief with the turnaround of their child. Now they were still hesitant to sing the praises of medicating, but they also realized they were maximizing the potential of their child. And that is my goal for any child I care for, to maximize his/her potential, whether it be through early intervention, immunizations or even medications.