Ben’s mother acknowledges that his behavior is pretty difficult to control. She is ready to consider all the different treatment options, if they are safe.
Below are some aspects of Ben’s history and physical examination you may want to consider before initiation of medication. Click on the “+” signs below for clinical pearls associated with the various aspects of the history and physical exam.
Ben’s mother is open to looking into behavioral techniques, and she is starting to ask a question about medication, when Ben’s father arrives at the visit. He explains that he got caught up trying to finish something for a deadline at work and almost forgot about Ben’s appointment altogether.
You catch Ben’s father up on the visit, explaining that Ben meets diagnostic criteria for ADHD, combined type and you were just about to discuss possible medication treatments with Ben’s mother.
At this, Ben’s father says, “Whoa, wait a minute. I don’t think Ben needs medication. He is just like me when I was a kid, and I turned out just fine!”
Ben’s mother shoots his father a dirty look, and then they both look back to you.
Ben’s parents do not agree about the treatment course for their child’s medical condition. From your view point, there are multiple treatment options that could be suitable for Ben. This can be a common, but difficult, clinical scenario.
Together, you and Ben’s parents eventually decide to try behavior management/parent training first. Ben’s father just can’t get behind the idea of medications. You make a plan to see Ben in 3 months to discuss how things are going.