Reilly Marie, Fogler Jason, Selkie Ellen, Augustyn Marilyn
*Boston Children's Hospital, The Developmental Medicine Center; †Department of Pediatrics, University of Michigan, Ann Arbor, MI; ‡Department of Pediatrics, Boston University School of Medicine, Boston, MA.
J Dev Behav Pediatr. 2016 Jul-Aug;37(6):511-3. doi: 10.1097/DBP.0000000000000308.
Sarah is a 13-year-old eighth grader who was recently diagnosed for the first time with attention-deficit/hyperactivity disorder (ADHD)-inattentive type, and the family elected to treat her with behavioral interventions to help her organization and attention. She had struggled with distractibility and disorganization since the fourth grade. At home, Sarah's mother described her as "spacey" and unable to complete the morning routine without constant supervision. Over time, her mother observed that it seemed as if Sarah had given up on school.As Sarah became an adolescent, her self-esteem suffered because of her academic struggles, and she placed increasing emphasis on her appearance, including focus on remaining thin and refusing to leave the house without makeup. It was in this context that Sarah recently posted photographs of herself in various stages of undress and/or drinking alcohol on Snapchat, a photograph-sharing application in which users can send "snaps"-photographs that disappear soon after opening. However, snap recipients can take a screenshot or photograph of the snap, thereby saving the image. For unknown reasons, Sarah's close female friend took screenshots of these provocative photographs and sent them to their classmates and Sarah's older brother.Sarah's family contacted the police and has been working with her school to address this incident. This experience resulted in significant family stress and distrust of Sarah. For example, her mother took away her cell phone and laptop and has "grounded her" for a month from all out of school activities.Sarah's family seeks guidance regarding teaching Sarah about using social media responsibly and preventing this from happening again. Sarah's mom comes to your urgent care session asking for help because she does not feel that Sarah has "learned her lesson." What would you do next?
莎拉是一名13岁的八年级学生，最近首次被诊断患有注意力缺陷/多动障碍（ADHD）注意力不集中型，家人选择通过行为干预来帮助她提高组织能力和注意力。自四年级以来，她一直受注意力分散和做事无条理的困扰。在家中，莎拉的母亲形容她“迷迷糊糊的”，如果没有持续监督，就无法完成早晨的日常事务。随着时间的推移，她的母亲发现莎拉似乎已经对学业放弃了。随着莎拉进入青春期，由于学业上的困难，她的自尊心受到了伤害，她越来越注重自己的外表，包括专注于保持苗条身材以及不化妆就不出门。正是在这种情况下，莎拉最近在Snapchat（一款照片分享应用程序，用户可以发送“快拍”——照片在打开后很快就会消失）上发布了自己不同程度脱衣和/或饮酒的照片。然而，快拍接收者可以对快拍进行截图或拍照，从而保存图像。出于不明原因，莎拉亲密的女性朋友对这些具有挑衅性的照片进行了截图，并将其发送给了她们的同学和莎拉的哥哥。莎拉的家人报了警，并一直在与她的学校合作处理这起事件。这段经历给家庭带来了巨大压力，也让家人对莎拉产生了不信任。例如，她的母亲没收了她的手机和笔记本电脑，并让她“禁足”一个月，禁止她参加所有校外活动。莎拉的家人寻求关于教导莎拉负责任地使用社交媒体并防止此类事件再次发生的指导。莎拉的妈妈来到您的紧急护理咨询时段寻求帮助，因为她觉得莎拉“没有吸取教训”。接下来您会怎么做？
