Baldwin Discusses Treatment of Caleb, 9 Year Old With ADHD

Dawn M Baldwin, MS, LPC, discusses the next steps in the treatment of Caleb, a 9-year-old patient with ADHD.

Read the transcript:

Hi, my name is Dawn Baldwin, M.S., L.P.C. I am a licensed professional counselor in the state of Pennsylvania. I have a master's degree in clinical psychology from Millersville University of Pennsylvania. I have approximately 10 years in the field of working in outpatient psychotherapy.

I work with a lot of children and teenagers, so I suppose this is why I was chosen to do this particular section on treating pediatric ADHD.

Let's go over my recommended order from the poll that you looked at. The poll, I did it in a unique way because in mental health, there isn't necessarily a, "This is the right thing to do. This is the wrong thing to do." There's a lot of shades of grey. That's what we work in within mental health.

What I provided was a list of four things that I would certainly do, but I listed them in the recommended way, the order in which I would do such things. It'll be interesting to see what all of you come up with.

In the case of young Caleb, I had said, "With the information provided, what would be your next step in treating Caleb?" The first thing that I would do is I would educate Caleb's mother on the diagnosis. The diagnosis of F90.2 ADHD combined type or presentation.

I would provide her with a layperson explanation of ADHD and allow her to know that this is a condition that does not result from any kind of poor parenting. I would look to normalize that experience.

I would also try to assure her that I have a lot of experience working with this, and also that schools do as well, and other professionals. That would be option B.

Building off that, the next thing that I would do in discussing with mom would be option A. I would provide her contact information on a psychiatrist. That would also be understanding that in talking with the mom, that she was on board for Caleb receiving psychotropic medication.

The fact that he is nine, in my experience, parents are much more willing to consider medication at this age as opposed to if Caleb's symptoms reach the level of diagnosis at, let's say, seven.

At this point, it was very likely it wasn't indicated in the case that Caleb has been struggling with these symptoms for about three years or so, so then the parents would most likely be on track.

I would also give an explanation as to how counseling and medication work as a yin-yang together, that the medication helps calm down the frontal lobe of his brain enough for decision-making. Then, we would also work on strategies to help him in this behavior.

The third thing that I would do would be option D. Still while talking to the mother, I would obtain an informed consent form from her signing on behalf of the minor, Caleb, in order to speak with Caleb's teacher and also probably Caleb's guidance counselor.

The reason to do this, rather, would be so that there can be consistency between behavioral techniques that we may use, for example, utilizing token economy, giving positive reinforcement for positive actions and seeing that be consistent so that Caleb could have the best possible outcome.

Finally, in what I had listed, option C. I would then talk to Caleb about ADHD. This could be an unpopular choice to do so as he is nine years old.

However, I feel as though when people are educated as to what is going on with them, there is a level of relief, even in a young child so they can have an idea, "Oh, OK, there are some things that I can do about this. Professionals know what this is. I'm not some weirdo."

I would probably use terms close to what he had indicated in the session, in terms of explaining what it was when his mind was jumping around like bunnies and things like that.

Also, continue to normalize the experience for him that a lot of young people struggle with these issues and that with counseling and medication, he can improve and definitely be a happier, healthier young man. I hope that this was helpful.

In a review of treating pediatric ADHD, I value the opportunity to contribute my thoughts and experience. I wish all of you in the field happiness and healthiness as well as, hopefully, Caleb would have. Thank you so much.