Pediatrics – Peer Response – Ly
Peer Responses:
Citations: At least two high-level scholarly reference in APA per post from within the last 5 years
- Relate to another journal reading
- Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavior disorders in children. The condition if goes untreated can affects the child’s social interactions, academic goals, and their quality of life (Wolraich, et al., 2019). According to the clinical practice guideline (CPG) from the American Academy of Pediatrics (AAP), children from 6 to 12 years old with diagnosis with ADHD should be manage with pharmacological and non-pharmacological treatments (Wolraich, et al., 2019). The article advise that for this age group, if only psychological therapies are implemented, “a high level of family and/or school involvement and may lead to increased family conflict, especially if treatment is not successfully completed.” (2019). However, the parents of the child in the case study separated and it would be more risky than normal when parents cannot fully commit to the child’s therapy plan. In addition, medications in conjunction with cognitive-behavior therapy has been proven to produce positive health outcomes for children with ADHD in this age group (Wolraich, et al., 2019). Moreover, the nurse practitioner should educate the parents that even though consistent behavior therapy benefit the child, the positive effectiveness of these therapy may stop when the child is not on medications; hence, to produce the most health outcomes for the child, both medications and psychological therapy should be applied (Wolraich, et al., 2019). Also, the NP should advise the parents that ADHD is a chronic condition, discontinuance of medication treatment abruptly can put the children at high risks for adulthood impairment (Wolraich, et al., 2019). Moreover, some medications used to treat ADHD should be tapper down or serious health effects can occur to the child (Wolraich, et al., 2019). The article by Lohr and their co-author regarding the Intentional Discontinuation of Psychostimulants Used to Treat ADHD in Youth: A Review and Analysis highlights that for children who were stopped the stimulant and put con placebo-controlled, “76% of boys had a significant worsening in behavioral problems either at home or at school.” (Lohr, et al., 2021). The NP should explain to the parents the risks and help them coordinate the weaning off medications phase with the child’s school activities when they want to stop the medication treatment for the children. I would expect the weaning-off medication phase would last from 3 months to 1 year so I have enough time to monitor the child’s performance in social and school and the re-emergence of ADHD (Lohr, et al., 2021). I would connect with teachers and parents closely in order to help the child achieve the best result of care.
- References
Lohr, W. D., Wanta, J. W., Baker, M., Grudnikoff, E., Morgan, W., Chhabra, D., & Lee, T. (2021). Intentional Discontinuation of Psychostimulants Used to Treat ADHD in Youth: A Review and Analysis. Front Psychiatry.
Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., . . . Frost, J. (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. FROM THE AMERICAN ACADEMY OF PEDIATRICS.
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