ADHD: Case summaries
by Ellen Buikema
The following case study summaries were used as part of the research for my book, Parenting … A Work in Progress. The names have been changed to protect their privacy. I encountered Jack and Gordon as adults and Sam as a child.
Jack was an adult student in my Child Growth and Development class. He was happily married and found a job where his hyperactivity was a huge benefit – the Chicago Stock Exchange. He worked on the trading floor where his naturally high level of energy allowed him to get through each action-packed day with relative ease.
Jack had the best looking yard in his neighborhood. After a full day’s work and commute home to the northern suburbs, he spent a few hours, weather permitting, working on the yard. He did this, in part, to keep from driving his wife crazy.
When Jack was a child, his mother opted not to put him on medication for hyperactivity. As a nurse, she read studies that suggested at the time that the current medication, methylphenidate – also known as Ritalin – might cause a change in the motility of sperm. She wanted grandchildren and felt Ritalin might rob her of the chance to spoil her future grandbabies. She was also concerned for her son, as methylphenidate was thought at the time to be habit forming.
In the classroom as an adult, Jack was able to pay attention if part of his body was able to move. Frequently, he tapped a pen against his leg to keep any sound he made down so he wouldn’t disturb the other students. When necessary he’d pace in the back of the room. As long as he could move, Jack was able to concentrate. He was a superior student.
My friend Gordon asked questions by the billions, or at least that’s what his mother remembers. A high-energy child, he thrived while doing more than one activity at a time.
In elementary school, his teachers often sent him to the office to deliver notes and gave him jobs requiring physical movement. Gordon remembers banging erasers together in the hallway during the days of chalk and blackboards.
Because Gordon’s family drank coffee throughout the day, it was not unusual for his mother to give Gordon coffee topped off with milk in the mornings before school. The caffeine in his coffee may have helped Gordon be a little less energetic in class. In a hyperactive person, stimulants have a calming effect on the body.
As an adult, Gordon holds a job that requires a high level of concentration. He does this by multitasking with a light task – one that requires little thinking, and drinking coffee. Even while working on a mind-bending, computer-related task, he listens to music and doodles on paper.
Sam, born in the early 1990s, was one of my pre-K students. His was a world of privilege and high expectations. Sam was diagnosed by his pediatrician with attention deficit disorder with hyperactivity (ADHD) at age 4. According to the American Academy of Pediatrics, it is possible to diagnose a child as early as age 4 with ADHD. Not so with ADD, attention deficit disorder without hyperactivity, as inattention is harder to diagnose in preschool-aged children.
Sam was so active at home and at school that he was unable to stay still long enough to watch more than a commercial’s worth of television. He literally bounced off the walls everywhere he went.
Sam’s parents tried behavioral therapy for six months, first. The therapy was minimally beneficial. Although not recommended by the Federal Drug Administration until age 6, Sam’s parents agreed with their family pediatrician to give Sam, just under age 5, a prescription for Ritalin. This decision was made due to the severity of Sam’s symptoms.
On Ritalin, in school, we saw a much different Sam. He was subdued. A sparkle of mischief no longer shone in his eyes. He was, however, able to sit in a chair and work with a teacher on an age-appropriate task.
At home Sam’s parents noticed he was less interested in eating and had difficulty sleeping. Both are common side effects of Ritalin, as are delayed physical growth and anxiety. All these side effects disappear once the child no longer takes the medication. For this reason, some families take their kids off medication for ADHD on weekends and during the non-school months.
Several months went by before a proper dosage of Ritalin was found for Sam. Each child responds differently to medications, and doses must be carefully monitored. Sam also continued behavioral therapy, as the family believed medication alone was not enough.
According to WebMD, recent research has documented a decrease in omega-3 fatty acids and zinc in the blood of children with ADHD. As a result, supplementation with omega-3 fatty acids and zinc may be recommended for children with ADHD. Additionally, parenting classes that focus on parenting skills, child safety, and understanding the child’s behavior have been found to decrease the symptoms of ADHD.
The decision to use medication for ADHD should be a last resort.
The information provided is not meant to diagnose or treat a medical problem. Please consult your own physician. References are provided for informational purposes only.
Ellen Buikema is a writer, speaker and former teacher. A graduate of the University of Illinois at Chicago, she received her M.Ed. specializing in Early Childhood. She has extensive post-graduate studies in special education from Northeastern Illinois University. Ellen writes short stories, poetry, adult non-fiction and children’s fiction, sprinkling humor everywhere possible. Find her at EllenBuikema.com, Twitter, LinkedIn, Facebook, and Google+. Click here for Sock Puppet Tim videos, and find a podcast interview on ItMattersRadio.com.