ADHD Diagnostic Evaluation
Scenario: A 13 year old boy is accompanied by his parents into the community mental health clinic for the evaluation of Attention Deficit Hyperactivity Disorder (ADHD). Both parents are impatient, demanding and requesting for you to start their child on a CNS stimulant medication.
Based on this scenario, respond to the following prompts:
- Which neurotransmitter(s) are involved in ADHD? How will you approach this clinical case?
- According to the DSM V-TR, what is the criteria for this condition? What is the NICHQ Vanderbilt Assessment Scale and how will you apply it to this case study?
- If the child meets diagnostic criteria for ADHD, what diagnostic(s) or lab(s) will you order prior to prescribing a CNS stimulant drug? Why is it important to assess and monitor a child’s weight and height once you start treatment for ADHD?
must be written in APA format.
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Neurotransmitters Involved in ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is primarily associated with dysregulation of the neurotransmitters dopamine and norepinephrine. These chemicals play key roles in attention, impulse control, and executive functioning. CNS stimulant medications like methylphenidate and amphetamines work by increasing dopamine and norepinephrine levels in the brain. Understanding this neurochemical imbalance guides pharmacological treatment decisions (Rosenthal & Burchum, 2021).
Clinical Approach and Assessment
In this case, a thorough clinical interview and history-taking are essential before initiating any medication. I would begin by interviewing both the child and parents to assess behavioral concerns at home and school. Additionally, I would gather information from teachers using validated scales. Rushing to medication without confirming diagnosis and considering comorbidities would be inappropriate and against evidence-based practice.
DSM-5-TR Criteria and Vanderbilt Scale
According to the DSM-5-TR, ADHD diagnosis requires at least six symptoms of inattention or hyperactivity-impulsivity lasting for six months and present before age 12, occurring in two or more settings (APA, 2022). The NICHQ Vanderbilt Assessment Scale is a standardized tool used to collect teacher and parent observations. It helps evaluate symptom severity and rule out alternative diagnoses like anxiety or learning disorders.
Diagnostics and Monitoring
Stimulants can suppress appetite and slow growth, so regular monitoring ensures safe and effective treatment.
