Posted: February 24th, 2025

Assessment and Management of ADHD in an 8-Year-Old Boy: A Clinical Case Study

Module 7 Discussion – NUR 520: Attention & Substance Related Disorders

Answer the questions below based on the following case study.

An 8-year-old boy is repeatedly in trouble at school. He has been threatened with suspension after he was verbally and physically aggressive to his teacher. The school has suggested that he has a problem with his concentration and advised his parents to seek help. The school also referred him to the school child psychologist. He keeps wriggling in his seat. His mother says his concentration is fine when he is playing on his computer. What worries her is that he does not seem to think before he does things and will run out across the road without looking. This behavior suggests potential underlying neurodevelopmental issues that require further evaluation.

Summarize the clinical case.
The case involves an 8-year-old boy exhibiting behavioral and concentration issues at school, including verbal and physical aggression toward his teacher. His mother reports that he struggles with impulsivity, such as running across the road without looking, but can concentrate well during activities he enjoys, like playing on his computer. The school has recommended professional help, and he has been referred to a child psychologist. These symptoms may indicate a neurodevelopmental disorder, such as ADHD, which requires a comprehensive assessment.

What is the DSM 5-TR diagnosis based on the information provided in the case?
Based on the DSM-5-TR criteria, the most likely diagnosis is Attention-Deficit/Hyperactivity Disorder (ADHD), predominantly hyperactive-impulsive presentation. The boy’s symptoms, including difficulty concentrating, impulsivity, and physical aggression, align with the diagnostic criteria for ADHD. Further evaluation is necessary to confirm the diagnosis and rule out other potential conditions.

Which pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment.
According to clinical guidelines, a first-line pharmacological treatment for ADHD in children is stimulant medications, such as methylphenidate or amphetamine-based drugs. These medications are effective in reducing core symptoms of ADHD, including inattention, hyperactivity, and impulsivity. The rationale for prescribing stimulants is their well-documented efficacy, rapid onset of action, and extensive research supporting their use in pediatric populations. Non-stimulant options, such as atomoxetine, may be considered if stimulants are contraindicated or poorly tolerated.

Which non-pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment excluding a psychotherapeutic modality.
A non-pharmacological treatment option for ADHD is behavioral interventions, such as parent training programs and school-based interventions. These programs focus on teaching parents and teachers strategies to manage the child’s behavior, improve organizational skills, and reinforce positive behaviors. The rationale for this approach is that it addresses environmental factors contributing to the child’s difficulties and provides long-term coping mechanisms without relying on medication.

Include an assessment of the treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence to the chosen medication. Use a local pharmacy to research the cost of the medication and provide the most cost-effective choice for the patient. Use great detail when answering questions 3-5.
Stimulant medications like methylphenidate are generally appropriate for treating ADHD in children due to their high efficacy and safety profile when monitored closely. The cost of methylphenidate varies, but generic versions are typically more affordable, with prices ranging from $20to$50 per month at local pharmacies. This makes it a cost-effective choice for most families. The medication’s effectiveness is well-supported by clinical trials, showing significant improvement in ADHD symptoms. Common side effects include decreased appetite and insomnia, but these are usually manageable. Patient adherence is generally good, especially when combined with behavioral interventions and regular follow-ups to monitor progress and adjust dosages as needed.

Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources within the past 5 years.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. (150 Words each reply) You need at least 1 academic sources within the past 5 years for each reply. (I WILL SEND YOU 2 POST AFTER I SUBMIT MY WORK FOR YOU TO COMPLETE THIS STEP)
All replies must be constructive and use literature where possible.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.

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Study Title:
Assessment and Management of ADHD in an 8-Year-Old Boy: A Clinical Case Study

 References:

1. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., Text Revision). Arlington, VA: American Psychiatric Publishing.
2. Wolraich, M. L., et al. (2019). “Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.” Pediatrics, 144(4), e20192528.

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