Academic journal article International Journal of Psychology Research

Adam: Case Study of a Ten-Year-Old Undiagnosed Boy *

Academic journal article International Journal of Psychology Research

Adam: Case Study of a Ten-Year-Old Undiagnosed Boy *

Article excerpt

Introduction

When attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder is diagnosed, the model of therapeutic intervention is predefined by our knowledge of the condition. However, when faced with unpredictable or difficult behavior from a child who has not been examined previously by a neurologist or a psychiatrist, the course of action may not be obvious, since there are many possible reasons for behavioral problems. It is important, in such cases, to examine the family situation, and not just the child in isolation. Usually, however, parents who report behavioral disorders of their children do not raise issues of family structure and communication spontaneously. They focus on the disruptive behavior, which seems to isolate the child from the other family members. They do not treat the child as a part of a system, but rather as a separate unit, violating the norms and disturbing the balance of family life.

When I met the mother of Adam, a boy of almost 10, for the first time, she spoke initially of his behavioral problems and related difficulties. Later, the conversations turned towards the relationship between the spouses, and their difficulties in understanding each other. It became clear that the wife was considering ending the relationship. She claimed that she did not know how to talk to her husband, and that they often had different views on how to raise their children. Her husband mostly used injunctions and penalties, and often undermined her decisions. Although the husband had some experience of parenting, having raised his older son, he did not engage in the children's education, nor care for them even when the mother was sick. He only required that the children not disturb him. In the mother's opinion, the husband was very strict and organized family life to best satisfy his own needs and preferences. To pacify and placate the children and compensate for her husband's high-handed parenting style, the mother indulged them.

Adam's family was a patchwork family consisting of Adam's mother a nd father, a sister, Ania, almost eight years old, and a half-brother from his father's previous relationship, seventeen-year-old Jurek. The family lived in good material conditions. They owned their own home, in which only the younger siblings shared a room. The parents were sociable, meeting regularly with friends who also played with the children. Sometimes, the siblings stayed with their grandmother (if the parents needed to go somewhere), which they enjoyed. It might seem that these would be favorable conditions in which to raise calm and happy children. Yet, in this case, a nuclear family with the assistance of grandparents did not provide an environment in which Adam received the emotional support he needed for healthy personality development.

Adam

Adam was attending the 3rd grade at elementary school and was almost 10 years old. He was an intelligent boy, who upon first impressions displayed no serious behavioral issues. However, his mother reported escalating uncontrolled emotional outbursts (explosions of vulgarisms, screaming, stuttering). These had begun at the start of the previous year, occurring initially around once a month, increasing to once a week in the past half a year. Such situations were usually triggered by a dispute between the siblings or with his class colleagues. Sometimes, Adam would run out of the classroom when he became upset. Sometimes he would remove all his clothes and run from the house, or from the playground. His lack of control was so extreme that on one occasion he ran onto the road, ignoring the red light, and was almost hit by a vehicle. On holiday in a foreign city, he ran away suddenly, disappearing from his parents' sight. On family trips, Adam had fled from the beach on several occasions. Nothing seemed able to prevent his fits of crying and anger, which occurred both in public, such as when he was in a restaurant and something displeased him, or in private, when he went outside and was alone, with nobody watching him. …

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