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Jonathon is an engaging and rambunctious 8-year-old white boy, "smart as a whip but a real handful" according to his mother. Jonathon's preschool and first-grade teachers both suspected that Jonathon suffered from attention-deficit/hyperactivity disorder (ADHD). He was evaluated in first grade by the school psychologist.
Psychological testing, behavioral observations, and record review supported a diagnosis of ADHD (Mixed type) and mild to moderate oppositional defiant disorder (ODD) accompanied 12 Clinician's Guide to Evidence-Based Practices by family tensions. Jonathon is the second of three children, ranging in age from 3 to 10 years, born to working parents (With health insurance) who frequently separate and reconcile. The local pediatrician treats Jonathon's asthma with albuterol and offered to prescribe a psycho-stimulant for the ADHD as well, but Jonathon's father firmly resists any psychotropic medication at this time. Both parents are genuinely concerned about Jonathon and willing to participate in a few family meetings. However, their demanding work schedules and marital conflicts prevent extensive outpatient treatment.
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