What is ADHD? Attention-deficit/hyperactive disorder is a chronic condition that encompasses hyperactivity, impulsiveness, and difficulty maintaining attention. It normally emanates from early childhood, and it can also extend to adulthood. The disorder is characterized by trouble multitasking, problems focusing on a task, poor time management skills, disorganization, and difficulty prioritizing.
What is ADHD?
It also demonstrated low frustration tolerance, restlessness, and impulsiveness (Punja, Shamseer, Hartling, Urichuk, Vandermeer, Nikles, & Vohra, 2016). The
condition affects the child's self-esteem, influences troubled relationships, and contributes to
various atrocities at school. The development of ADHD is not associated with a clear cause;
however, research has indicated that genetics, the environment, and complication in the central
nervous system could be significant contributing factors.
In the case study, Katie presents with absolute symptoms of ADHD. The symptoms are
evident objectively and subjectively. The parents report normal developmental milestones, but
she was born with a low 5 minutes Apgar score, had difficulty with sleep during the preschool
stage, which could probably contribute to the problem. They equally reported that Katie has
problems socializing with peers. On interaction with Katie, she attributes limited attention and
concentration on the short questions asked.
Decision point one: based on the assessment of Katie's scenario and evidence collected,
it confirmed Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation. It
is the decision that stood out regarding other considerations.
The decision was selected concerning Katie's symptoms. Her behavior utterly indicates
limited concentration and distraction. She lacks focus on something, and she fond of losing
interest in difficult tasks or uninteresting subjects. Katie is inattentive, easily distracted, makes
Careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling,
reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to
things she is interested in. She has difficulty interacting with peers in the classroom and likes to
play by herself at recess. These attributes conform to the DSM5 criteria in the diagnosis of
ADHD.
By making this decision, I was targeting to achieve evidence-based management of
Katie's condition. Determination of the exact diagnosis of the disorder based on the symptoms
could welcome the best evidence-based interventions that impact the patient positively.
Knowledge of the condition being treated promotes collaborative practices involving family,
such as the introduction of psychotherapy (Tegtmejer, Hjörne, & Säljö, 2018). The decision
could also inform effective pharmacological approaches to handling ADHD. The integration of
psychotherapy, in this case, could enhance behavior change and improve attention skills while
the child is advancing to adulthood.
The client still demonstrated an insignificant improvement regarding the decision. She
was expected to show some behavioral changes; however, the difference in expectation against
the results presented due to the non-integration of pharmacological measures to compliment the
already set practices.
Decision point two: Begin Adderall XR 10 mg orally daily
The decision was selected because the client did not register improvement, and the
symptoms persist. The decision involved the correct choice of medication that is Adderall XR, in
the management of ADHD. The drug is a combination of amphetamine and dextroamphetamine
hence its effectiveness. It changes the number of certain substances in the brain, thereby
What is ADHD?
increasing the ability to pay attention, control behavior problems, and improves concentration. It
also promotes listening skills and organization of tasks (Bélanger, Andrews, Gray, & Korczak,
2018).
Under this decision, I was hoping to attain an appropriate behavior of the client mainly to
enhance her attention in school and focused concentration on particular activities. The drug
Adderall XR is a central nervous system stimulant that affects chemicals in the brain and nerves,
which control hyperactivity and impulsivity. The use of this medication targeted to minimize
hyperactivity and impulsiveness simultaneously improves attention and focused concentration in
handling tasks.
The client demonstrated significant improvement with the application of the decision.
Katie started paying more attention to school, which was a good sign. However, she was
experiencing daydreams in the afternoon, which interfered with her concentration. The
difference in the expectation and the outcomes could be referenced to the dosage of the
medication accompanied by adherence to psychotherapy. The concentration of the drug in the
body might be taking a limited amount of time, especially in the morning. This could prompt the
revision of the dosage and the intervals of taking the medication.
Decision point three: Add a small dose of immediate-release Adderall in the early
afternoon
The decision was selected because the client experienced a loss of attention in the
afternoon, indicating imbalances in the dosage. The first dose registered an improvement on the
client's concentration, which elapses a few hours after consumption (Hall et al., 2016). Thus, the
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decision to revise the dosage and add a small amount in the early afternoon to sustain throughout
the lesson.
Under this decision, the main object was to attain full day attention and concentration of
Katie in the classroom. The afternoon classes are short hence the small doses addition. There
were concerns about her decreased appetite since the start of medication, which informed the
decision to add a small quantity. Adding a small dose of immediate relate Adderall in the
afternoon can help Katie to maintain attention throughout the afternoon and into the early
evening when she must do homework.
The client is expected to attain full day attention after the intervention. The difference in
expectation and results could be minimal. However, the slight flashes of relapses could be
registered due to her development. At her age, she is still growing, and with time the dose of the
drug could not be balanced to her body requirement. Therefore, there could be a need to revise
the quantity progressively.
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References
Bélanger, S. A., Andrews, D., Gray, C., & Korczak, D. (2018). ADHD in children and youth:
Part 1—Etiology, diagnosis, and comorbidity. Paediatrics & Child Health, 23(7), 447-
453.
Hall, C. L., Valentine, A. Z., Groom, M. J., Walker, G. M., Sayal, K., Daley, D., & Hollis, C.
(2016). The clinical utility of the continuous performance test and objective measures of
activity for diagnosing and monitoring ADHD in children: a systematic review. European
child & adolescent psychiatry, 25(7), 677-699.
Punja, S., Shamseer, L., Hartling, L., Urichuk, L., Vandermeer, B., Nikles, J., & Vohra, S.
(2016). Amphetamines for attention deficit hyperactivity disorder (ADHD) in children
and adolescents. Cochran
Tegtmejer, T., Hjörne, E., & Säljö, R. (2018). Diagnosing ADHD in Danish primary school
children: a case study of the institutional categorization of emotional and behavioural
difficulties. Emotional and Behavioural Difficulties, 23(2), 127-140.
