A Pediatric Consult

Susie’s parents did not know what to expect when they arrived in my office for a pediatric consulation. They were just hoping I had a little more expertise to offer than their very young primary care pediatrician.

Susie just could not stay still. She didn’t listen to instructions. She wouldn’t do the task required even if she repeated the instruction. She constantly interjected unrelated topics. She didn’t sleep well. She leaped before she looked. She was a safety hazard to herself and didn’t know it.

Her parents had already some initial evaluations. She had tested negative for autism, positive for ADHD, and was now trying a stimulant medication that caused significant side effects and could not continue.

Susie’s mom was beginning to question whether she was just being defiant on purpose.

Susie and I talked as she bounced around the room. I asked her questions her parents had not thought to ask, but that gave them insight into her daily life. We discovered her unhappiness on the playground, her sadness at being called out in the classroom, and her eagerness to feel better. Mom and Dad felt reassured that she was not a defiant child.

I helped Susie’s parents see the larger picture of Susie. We devised a comprehensive road map of ADHD and how it plays out in the long term for children. We discussed the many medication options available to Susie, how they are subtly different and how I would approach her care if she were my pediatric patient.

We filled in the gaps in Susie’s lifestyle to take advantage of better food, quality sleep, good exercise and smiles as “medications” in Susie’s long-term plans for success.

Her parents thanked me. Children, like Susie, who have attention deficit disorder, need the support to be taught how to manage and improve their life-long challenges. And Susie needs to know what a cool, unique person she is no matter what she struggles with.