Question 51

Question Answered step-by-step Case Scenario:Jonathan is a 9-year-old who presents with his mother… Case Scenario: Jonathan is a 9-year-old who presents with his mother after his teacher told her to have him evaluated for ADHD. He repeated the first-grade last year and reads on a “kindergarten level.” Since the pandemic and online learning, she receives daily notes from his teacher regarding “acting out” during class, including disruptive behaviors (e.g. starting private chats with other classmates), is logged in for class, but not present during roll call, does not follow directions, and often fights with classmates during smaller online collaborate groups. When mom is with Jonathan at home he is “well-behaved” and can sit still watching TV for hours at a time. She did take him out of Little League for problems with behavior last summer.  He is now sitting quietly in front of the camera during the telehealth visit.1. Does Jonathan have ADHD? What are the criteria for diagnosis? 2. What scales are available for screening? Jonathan and both his parents return for follow-up with screening instruments. His parents and teachers rated him well above the norm for hyperactivity, inattention, and impulsiveness. In the last two months, Jonathan is failing school, is argumentative with adults, has been occasionally aggressive, and now only has a few friends. He was started on methylphenidate by his pediatrician in the last month. After a dosage increase, he began showing motor and phonic tics consisting of head jerking, facial movements, coughing, and grunting. The medication was immediately stopped and although the tics subsided, they did not go away. In hindsight, mom recalls that he had shown blinking and throat clearing before starting methylphenidate.   3. What is the diagnosis? What treatment approach would you take? Health Science Science Nursing NURS 758 Share QuestionEmailCopy link Comments (0)

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