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Attention & Substance Related Disorders

Answer the questions below based on the following case study.
An 8-year-old boy is repeatedly in trouble at school. He has been threatened with suspension after he was verbally and physically aggressive to his teacher. The school has suggested that he has a problem with his concentration and advised his parents to seek help. The school also referred him to the school child psychologist. He keeps wriggling in his seat. His mother says his concentration is fine when he is playing on his computer. What worries her is that he does not seem to think before he does things and will run out across the road without looking.

  1. Summarize the clinical case.

  2. What is the DSM 5-TR diagnosis based on the information provided in the case?

  3. Which pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment.

  4. Which non-pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment excluding a psychotherapeutic modality.

  5. Include an assessment of the treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence to the chosen medication. Use a local pharmacy to research the cost of the medication and provide the most cost-effective choice for the patient. Use great detail when answering questions 3-5.
    Submission Instructions:
    • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

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Sample Answer

 

 

 

1. Clinical Case Summary

An 8-year-old boy is exhibiting behavioral difficulties at school, including aggression towards his teacher and difficulty concentrating. His mother reports similar concerns at home, including impulsivity and a lack of foresight. The school psychologist has recommended further evaluation for potential attention-deficit/hyperactivity disorder (ADHD).

2. DSM-5-TR Diagnosis

Based on the information provided, the boy’s symptoms are consistent with a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). The DSM-5-TR criteria for ADHD include:

Full Answer Section

 

 

 

 

  • Inattention: Difficulty paying attention, easily distracted, forgetful  
  • Hyperactivity: Excessive fidgeting, restlessness, impulsivity  
  • Impulsivity: Difficulty waiting turn, interrupting others  

3. Pharmacological Treatment

Given the boy’s symptoms and the recommendation from the school psychologist, a stimulant medication would be appropriate. Methylphenidate (Ritalin, Concerta) is a commonly prescribed stimulant for ADHD. It can help improve attention, focus, and reduce hyperactivity.  

Rationale: Stimulants work by increasing levels of dopamine and norepinephrine in the brain, which can help to improve attention and reduce impulsivity. They have been shown to be effective in treating ADHD symptoms in many children.  

4. Non-Pharmacological Treatment

In addition to medication, non-pharmacological interventions can also be beneficial for children with ADHD. These may include:  

  • Behavioral therapy: Behavioral therapy can help children learn coping skills and strategies for managing their symptoms.  
  • Parent training: Parents can be taught strategies for managing their child’s behavior at home.  
  • Educational accommodations: The school can provide accommodations, such as extended time for assignments or preferential seating, to help the child succeed in the classroom.  

5. Treatment Assessment

Appropriateness: Stimulant medication is generally considered appropriate for children with ADHD. However, it is important to monitor for side effects and adjust the dosage as needed.  

Cost: The cost of medication can vary depending on the specific medication and the patient’s insurance coverage. It is important to consider the cost-effectiveness of the medication and explore options for reducing costs, such as generic alternatives or patient assistance programs.  

Effectiveness: Stimulant medications have been shown to be effective in improving symptoms of ADHD in many children. However, the response to medication can vary, and it may take time to find the optimal dosage.  

Safety: Stimulant medications can have side effects, such as decreased appetite, insomnia, and headaches. It is important to monitor for these side effects and adjust the dosage as needed.  

Patient Adherence: Adherence to medication can be challenging for some children and their families. It is important to discuss the benefits and risks of medication with the patient and their family and to provide ongoing support and monitoring.

References

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