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I'm going to leave my clothes on when we go
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I'm Dr. Arias. Thank you. I'm Sarah, and this is
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my son, Andrés. Thank you for coming
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today, Sara. Hi, Andrés.
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Hi, how can I help you? Andrés
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started school this year. I've been
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called several times because he's
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causing problems in class. He spends all his time
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talking to other children when
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the teacher is speaking, and when he's asked to
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behave, he doesn't seem to listen. I
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was worried he was going to have
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problems at school. He
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has so much energy; it seems like nothing
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catches his attention for more than a few minutes, and it's been like this
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since he was 2 or 3 years old.
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I thought this behavior was
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normal, but my sister's children behave the same way.
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Andrés, it's true that you
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spend all your time talking in class, even though you should
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be listening to your teacher. Yes, but
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sometimes I start talking and I forget about
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the teacher. I see. You have problems with
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your teacher. Yes, but I don't want to. Well, let's see
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if we can understand what's
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happening at school. Andrés, do you want to
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draw while I talk to your mom? Yes. Andrés, thank you. Excuse me, you should
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n't behave like this. He
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does everything. He takes too long to do things, he
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runs, he interrupts others when they
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speak as if they are not thinking.
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What are the symptoms that Andrés
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Andrés's symptoms so far
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are: excessive hyperactivity,
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serious difficulty sitting still,
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excessive impulsivity, frequently doing things
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without thinking, and a reference to
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Before asking about the
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behavioral problem in more detail, what should you ask?
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Ask about the child's school performance and
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daily routines. Are they
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affected by hyperactivity and
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understand that you feel frustrated.
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It seems that Andrés has had this
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behavior for some time.
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Tell me, has he been able to finish his homework? I
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thought he did, but the
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teachers told me that it is never
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completed. He is very intelligent, but they told me that he
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may not have achieved the
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necessary grades to pass the
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year. Mom, today at school he drew
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our family and the teacher said it
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was very good. Andrés, I'm talking to you
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because you can't finish your drawing. I ca
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n't sit still for more than five
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minutes. I get distracted easily and always
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have to go see what is happening.
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It seems that he draws very well. What else do you do well? He
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is very active and good at
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sports. Andrés, what sport do you like to
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play? He likes soccer and wants to play it.
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Everything is excellent, and how does he behave at
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home? Normally, my husband and I are
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tired at the end of the day. I feel like we're
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nagging him all the time. Every morning I
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have to remind him to get dressed, to eat
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breakfast, to finish his work, to have his
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backpack, to brush his teeth.
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What else should we explore?
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Explore the impact of
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environmental factors, including fear or trauma,
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medical problems, and rule out other
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priority disorders. Have there been any
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recent changes at home or in the
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family? No, not really. What do
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you and your husband do when he doesn't listen to you?
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Sometimes my husband and I don't
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agree on how to discipline Andrés. My
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husband says I scold him too much, that's why he does
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n't listen to me anymore. He thinks I should
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punish him for misbehaving and give him more
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things to do. Sometimes he can barely
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finish one thing because I
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should give him more chores. We try to
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talk to him and explain what he shouldn't
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We exhaust all resources until we
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hit him. Andrés, Andrés,
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please stop moving around. Look
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in my bag. Come on, pick up your
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And we go outside. We do this a lot because I just do
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n't know what to do. I don't know if we
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can really be... Quiet, Andrés, you were
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drawing very well. Can you finish your
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drawing and then write your name?
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I see it keeps you very busy. Can I
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ask you a few questions? Of course. How has
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your son's development been? Does he have a
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health card? Yes. Have
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you ruled out any medical conditions or other
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priority disorders? Does he have
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a complete health record? Is he
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growing well and has he reached all
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developmental milestones? Is he walking
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very early today? Has he ever had
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seizures or lost consciousness for
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any reason? No. In general, he is
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and is always smiling. He is playful,
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very playful. I would say, "
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Andrés, don't touch that!" "Carry the pot!" "Excuse me." Okay,
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Anyway, I'm glad you brought him. It's
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helpful to be able to observe his behavior, such as
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his behavior with other children. Does he fight
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with them? Do you get the impression that he is
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cruel or that he lies? Does he have
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difficulty getting along with other children? But he
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is not selfish and doesn't fight, and he
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never actually tells lies, even knowing that he will get
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is not a bad child, but I think that's what
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others think when he causes so much
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Based on the symptoms presented
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by Andrés, what behavioral disorder
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should you consider? Symptoms
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persist in multiple settings (home,
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school, doctor's office, etc.),
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exceed those of other children of the
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intelligence level, began before age 6, lasted for at
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least 6 months, and caused
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significant impairment in the child's functioning.
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attention deficit hyperactivity disorder (ADHD).