Given Andrew’s presentation, I believe he meets diagnostic criteria for Attention Deficit/Hyperactivity Disorder (ADHD). He is displaying disruptive behavior, such as getting out of his chair during class instruction, wandering around the room, and speaking out of turn. These symptoms are consistent with diagnostic criteria such as difficulty sustaining attention, easily distractible, blurting out answers, and impulsivity, all of which are associated with an ADHD diagnosis (Mash & Wolfe, 2018). He appears to display both inattention and hyperactivity/impulsivity traits and therefore may qualify for a combined presentation. He is also within the developmentally expected age range for ADHD, which is before age 12 (Mash & Wolfe, 2018). It also appears his symptoms interfere with his ability to function in school given that he is currently experiencing problems with his teacher. Finally, it appears there may be a genetic component to his inattention given his mother’s report that his brothers displayed similar symptoms at Andrew’s age. However, I would want to know more about whether or not his symptoms show up in settings other than school, such as at home or with his friends, given that diagnostic criteria for ADHD requires symptoms be present in two or more settings (Mash & Wolfe, 2018).
Regarding cultural factors, Andrew is a boy, which consistent with that fact that boys are diagnosed with ADHD 6x more often than girls (Mash & Wolfe, 2018). However, this may be due to referral biases as opposed to actual differences in pathology (Mash & Wolfe, 2018). It would be important to investigate if Andrew’s symptoms are truly pathological or if he is being over-pathologized by his teacher for behavior that is developmentally appropriate. Also, it appears his mother is very stressed from working a demanding job. Therefore, Andrew may be displaying his disruptive behavior as a way of eliciting attention from his mom. His mom may also need support in being able to manage her son’s behavior given her high levels of stress. Therefore, treatment should consider finding ways to support his mom so she can better support Andrew.
Treatment for ADHD often includes stimulant medication and individual counseling (Mash & Wolfe, 2018). Stimulants can help increase sustained attention and improve impulse control, which Andrew could benefit from (Mash & Wolfe, 2018). Individual therapy would allow Andrew a space to learn successful coping skills so he would be able to avoid acting on impulses that may get him into trouble at school. It would be important to consider if Andrew’s mother can afford weekly therapy sessions and what the family’s stance on medications are before making these suggestions. Most importantly, it would be important to relay to Andrew, his mother, and his teacher that he is not a “problem child” and instead focus on his strengths, such as his passion for Pokémon and sociable nature.
References
Mash, E. J., & Wolfe, D.A. (2018). Abnormal child psychology (7th Ed.). Belmont: Cengage
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