Tears quickly poured into her eyes and ran down her hands over her face. Her voice was choking with pain as she tried to answer my questions about her school performance. Although I asked the usual questions that are typical for evaluating ADHD (Attention-Deficit / Hyperactivity Disorder), Kristen's emotional response could not have been foreseen specifically for a thirteen-year high school student. Kristen believed that her problems with fragmented concentration began in fourth grade. She felt unable to control her wandering thoughts, even when involved in casual conversations with others. Despite the fact that she found it difficult to listen to auditory training in the classroom, Kristen was often too shy to ask for additional explanation or additional assistance in her assigned work. As a result, her grades suffered, as did her sense of confidence as a student.
Kristensky's tears and painful description of her academic disappointments seriously reached for my heart strings. It was rather unusual for me to hear how a teenager so frankly and plausibly speaks about his problems with attention. Kristen was convinced that she had ADHD. However, I was stuck in the lack of data support in other areas of her life. The descriptions of her behavior by her parents and teachers in the classroom could not identify Kristen with any noticeable attention deficiencies or distractions. Kristen almost finished elementary school before her teachers expressed initial concern about her inconsistent work. According to her parents, Kristen began to show home dismissal only before high school began. Neither her parents nor the elementary school teachers ever learned that Kristen was struggling with inattention or distraction. The early developmental history of Kristen and family history were equally absent with any positive factors of ADHD.
My interview with two high school teachers Kristen did not reveal any additional information that would support ADHD. Kristen has been described as a student with weak academic skills. Her classroom work was inconsistent at best. Her interest and motivation to invest her best efforts always seemed to decline in the middle of the year. At the end of the school year, she often put in a more concerted effort to improve her final level. However, her teachers never recognized Kristen as a special struggle with inattention or distraction in the classroom. However, her teachers did describe Kristen with a poor understanding and low productivity, which brought her low marks in English, math and science.
Kristen has been described as a typical teenager at home. She often needed reminders to complete her duties. She showed a lot of forgetfulness around personal responsibilities, unless she had an immediate incentive. It was not difficult for me to recognize her selective memory and convenient forgetting as typical adolescent behavior.
After analyzing all this past and current information, I felt that it was impossible to identify Kristen with ADHD. But here she sat in front of me, making sure that she had problems with attention. Emotionally distraught by this awareness, Kristen considered herself an ADHD disabled. In her opinion, her difficulties with the English language and mathematics were less important issues. Then I realized how important it is for me to give priority attention to her weaknesses of attention about her learning problems.
I presented two preliminary diagnostic statements for Kristen, which dealt with her learning problems, as well as attention deficiencies. I recommended that she receive a comprehensive assessment of education by proceeding with the trial of medicines with a stimulant. Although I could not offer a definitive diagnosis of ADHD, the most important thing is that I respond to Kristen's unshakable confidence about her poor attention. Her self-diagnosed ADHD, combined with her learning weaknesses, has already severely damaged her self-perception as a student.
Christine's parents were given the opportunity to use the stimulant test for Christine. Despite the fact that Kristen was sure that she was attentive, her parents were still worried about using medications to help her. I tried to state my personal reservations regarding the use of medications for a child with a preliminary diagnosis of ADHD. In a statement about dispelling the myth, I explained that most stimulant stimulants often increase the attention and involvement of the child, even if he is not diagnosed with ADHD. Although I would never recommend giving medication to a child not suffering from ADHD, a preliminary diagnosis of ADHD would allow us to respond to Kirsten’s beliefs about her own disabilities. In the case of Kristen, stimulant medications can easily offer some increased attention and concentration that can improve her learning. Her heightened attention would also make it possible to more reasonably evaluate possible learning opportunities that disrupt her work. Although the use of drugs should always be taken seriously and given the associated risk factors, careful monitoring of the response of the drug Kristen will reduce our remaining concerns about this intervention.
In addition to testing stimulant drugs, Kristen's parents decided to ask a special training group in her high school to undergo a training assessment. Thus, achievement and cognitive testing can provide invaluable information about Kristen's intellectual abilities, as well as her learning style. If she has to apply for programming, Kristen will kindly receive additional academic support that the school could provide to her. Parents were also ready to provide Kristen the private tuition required to remind her school years. Although Kristen's career path promised many future challenges, her parents were satisfied with the intervention plan that was formulated.
Seven days later, Kristen and her parents met a pediatrician to consider the choice of stimulant medication. Despite the fact that Kristen anxiously began to take the drug, she was largely comforted by the hope of improving concentration and mental organization. The drug seemed to give her emotional reassurance and new optimism about her future academic efforts. Her parents also informed her of their intention to request a comprehensive assessment of education in her special school. If a learning disability was identified, Kristen could then receive individual academic support. Even if a significant learning disability was not identified, she could still recognize her attention deficiencies, since this disability barrier gave her additional academic support from special education.
Kristen's story can teach an important lesson when considering the possibility of ADHD. In her case, there were many factors that could not support this diagnosis. Nonetheless, her personal conviction about her weakened attention required her to be taken into account in relation to ADHD. In this assessment, I learned to listen more carefully to the self-assessment provided by this older patient. Kristen was certainly able to accurately describe her personal experience, and her self-report justified the preliminary diagnosis of ADHD.
