Division of General Academic Pediatrics, University of California San Diego, CA, USA.
J Dev Behav Pediatr. 2010 Apr;31(3 Suppl):S64-7. doi: 10.1097/DBP.0b013e3181d83215.
Casey is a first grader who is brought to the pediatrician for consideration of ADHD. His mother is concerned that he is very difficult to focus at home when asked to do anything and gets so distracted at meals that he eats very little. The teachers last year and this year say that Casey is very distracted, always "in a fog" and just can't seem to get his work done. "He's in his own world." His report card has several unsatisfactory marks because of poor completion of work, doing things other than the assignment and talking too much to the kids around him. The parents are very upset as they see their son as very bright. His advanced vocabulary, early reading skills and his extensive knowledge of engines, machines and aircraft were all noted in his medical chart in the past as part of his health supervision visits. He has lots of friends, mostly third graders and plays soccer with moderate success. The paternal grandmother says Casey is just like his dad who is now a biochemical geneticist. He too had a hard time getting his work in as a child and "always talked back" to the teacher. Casey's mother would like him on medication before the Iowa Basics come around. The Vanderbilt rating scales by both teacher and parent are positive for inattention and borderline for hyperactivity. Casey took it upon himself to speak to the principal about how bored he was with the classroom work. She agreed that he could have some special assignments. In the pediatrician's office, Casey is a delightful, verbal, thin boy who has about 100 things to talk about, from train engines to the sports scores, acquired from the television sports channel, to what should be done to "fix" his school. He said he was bored and knew more about volcanoes than the science teacher. He just wanted to get home each day and work on his elaborate train setup. He doesn't seem overly active, distractible, anxious, inattentive or oppositional. Testing by the school psychologist showed him to have an IQ of 138 with an even verbal/performance profile. Sam is a 4-year old whose parents brought him to the local private school for application to kindergarten. The admission requirements consisted of a group "developmental" test, given to groups of 20 youngsters at a time. Sam failed the test. The report said that he was too immature, talked out of turn and generally wasn't ready for the vigorous academic program planned at that school. He asked too many questions and argued with the admissions person. They suggested he might need medication before he attempted school. His parents asked their pediatrician for an opinion on the school report. They asked for a referral for testing as they could not believe their son was a preschool failure. The psychologist reported that his IQ was 142 (verbal 146 and performance 136).
凯西是一名一年级学生，他因注意力缺陷多动障碍（ADHD）而被带到儿科医生处就诊。他的母亲担心他在家中做任何事情时都很难集中注意力，而且在吃饭时会非常分心，以至于吃得很少。去年和今年的老师都说凯西非常分心，总是“在雾中”，似乎无法完成作业。“他活在自己的世界里。”他的成绩单上有几个不令人满意的成绩，因为他的作业完成得不好，做的是与作业无关的事情，而且和他周围的孩子说话太多。父母非常沮丧，因为他们认为自己的儿子很聪明。他的高级词汇、早期阅读技能以及他对发动机、机器和飞机的广泛了解，都在他过去的医疗图表中作为他健康检查的一部分被记录下来。他有很多朋友，大多是三年级的孩子，他踢足球踢得还不错。父亲的祖母说，凯西就像他现在是生物遗传学家的父亲一样。他小时候也很难完成作业，“总是跟老师顶嘴”。凯西的母亲希望在爱荷华基础考试之前给他用药。老师和家长用范德比尔特量表对他的注意力不集中和多动边缘进行了评估。凯西主动向校长谈论他对课堂作业感到多么无聊。她同意给他一些特殊任务。在儿科医生的办公室里，凯西是一个健谈、瘦弱的男孩，他有大约 100 件事情要谈，从火车引擎到他从电视体育频道上获取的体育比分，再到应该如何“修复”他的学校。他说他很无聊，对火山的了解比科学老师还多。他只是想每天回家，致力于他精心搭建的火车模型。他看起来并不过于活跃、分心、焦虑、注意力不集中或逆反。学校心理学家的测试显示，他的智商为 138，言语/表现能力均衡。
山姆是一个 4 岁的孩子，他的父母带他到当地的私立学校申请上幼儿园。入学要求包括一组 20 名孩子同时进行的“发展”测试。山姆没有通过测试。报告称，他太不成熟，抢答问题，而且还没有为该校计划的激烈学术课程做好准备。他问了太多问题，还和招生人员争论。他们建议他在尝试上学之前可能需要药物治疗。他的父母向儿科医生征求对学校报告的意见。他们要求进行测试转诊，因为他们无法相信他们的儿子是一个学前教育的失败者。心理学家报告说，他的智商为 142（言语智商 146，操作智商 136）。
