Success Story 1
Frances first came to our clinic last July as a five year old presenting with multiple problems. Her mother reported that she was worried about her readiness for kindergarten because of her high distractibility, poor attention span, poor eye contact, and difficulty following day care routines. Frances did not speak during her visits and remained unable to greet the doctors or engage them in any kind of meaningful social interaction. Her mother had taken her to the kindergarten screening and Frances had surprisingly not been flagged as a child in need of extra help.
After gathering information from her daycare provider and her mother, and from careful observation of her behavior in the office over a couple of visits, we began to have questions about the extent of her disability. She was very restless and unable to focus. Dr. Moran thought that a trial of Ritalin may be beneficial to see the extent of the inattention and hyperactivity on her current behavior. The medication was successful in decreasing her motor activity and increasing her ability to focus, but her developmental issues became even more prominent once these symptoms decreased. Her eye contact was poor, she exhibited a lot of self-stimulatory behaviors, played with toys in a repetitive manner without any trace of imagination or make-believe. At this point both Dr. Romero and Dr. Moran encouraged her mother to take her concerns back to the school and contest the previous evaluation. We also recommended that she get a comprehensive developmental evaluation at the Floating Hospital in Boston so as to rule out a diagnosis of autism. In subsequent visits to monitor the medication, her mother received much needed support from us as her family in general was not pleased with her quest to seek adequate services for her daughter. The mother actually said “This is the only place that I have felt heard. You took Frances’ problems seriously”. She was truly grateful for all our assistance. Because of our continued encouragement, Frances was re-evaluated in the school and found to have significant disabilities which are presently being addressed. She is still on a waiting list for a comprehensive evaluation in Boston.
Success Story 2
JS is a 9 year old boy who was brought to the ADHD clinic in late April 2007. His family was at the end of their rope. His teachers were calling home constantly. He wouldn’t pay attention, he was aggressive, and bothering the other students. His academic performance was poor overall. His highest grade was a C. His parents have been hearing this since kindergarten.
They weren’t surprised, at home he was much the same; he was nervous, fidgety, “he bit the tips of his fingers off”. Everything was a battle. He was aggressive with his siblings and always on the go. Other doctors had sent the entire family to family therapy but no improvements were made. JS has a 12 y/o brother who has learning difficulties, and an 11 y/o male cousin who is much the same as JS. He comes from an intact household, although mom stated his “father is never there”, meaning literally absent for days or weeks at a time. So potentially there is some stress there. \
Vanderbilt assessment scales rated JS as inattentive and hyperactive, as well as positive for oppositional defiant disorder and conduct disorder ~ loosely translated: out of control and bad. When his mother was asked to rate her perceived ability to manage his behavior on a 1-5 scale with 1 being the worst, she said it was a 1.
At that point we thought that he was mostly in need of more family therapy and perhaps a CORE evaluation at school to look into learning disabilities (like his brother). We were assuming that it was his bad behavior that made him seem like a child with ADHD. In other words that he wasn’t paying attention or sitting still when asked because he didn’t want to, not that he wasn’t able to.
Before he could get into the counselors office, he was back into ours. Teachers were going crazy. He couldn’t concentrate unless an aid was seated next to him and he was separated from the other students. At that point we decided to start him on methylphenidate, the active ingredient in Ritalin. He was seen back in 1 week and the change was dramatic. He was “getting prizes” in school per his mother. She was very happy and told us he the teachers were happy as well. He was playing well now at home but still active, “not a zombie” and was still eating well and gaining weight. He reported some mild headaches but overall didn’t mind taking the medication. He liked being in control of himself more. His story is a typical success story and taught us that rather than bad behavior rendering a picture consistent with ADHD, sometimes it’s the ADHD that renders the picture of a misbehaving child. In his case treating the ADHD took care of everything.