Attention-Deficit / Hyperactivity Disorder (ADHD)

Background

5-year-old boy, K3. Teachers reported he constantly left his seat, copied slowly, gripped his pencil too tightly, and couldn't finish homework in 3 hours. Parents initially suspected laziness or inattention.

Evaluation Findings

High sensory-seeking behaviour with insufficient vestibular input; weak proximal upper-limb stability affecting pencil control; weaker executive functioning (task-switching). Not "disobedience".

Intervention Approach

Weekly 50-minute home-visit sessions + parent home strategies (sensory micro-activities, writing posture adjustments, transition-time visual schedules).

Outcome

After 3 months: writing speed improved ~40%, homework time halved, teachers reported markedly better classroom attention. Parents learned how to support their child in daily life.

Background

10-year-old P4 boy. Diagnosed ASD Level 1 (formerly Asperger's) at age 3; added ADHD-Combined Type diagnosis at age 6. FSIQ 130+; exceptionally strong academics but social, emotional, and executive functioning difficulties intensified with age. Already switched schools twice (the previous two had asked him to leave after emotional outbursts). Mother told me at intake: "I've tried other therapists, each one plateaued at 3 months. They said my son is 'too smart, too challenging'."

Evaluation Findings

- Cognitive strengths: language, abstract reasoning, visual-spatial. - Difficulty domains: Executive functioning — markedly weak task initiation, time sense, transitions, self-monitoring. - Emotional regulation — "0 to 100" explosive episodes triggered by sensory overload combined with cognitive rigid thinking. - Social — difficulty taking others' perspectives, yet deeply yearning to be understood. - Sensory — auditory and tactile hypersensitivity, vestibular seeking. - Key finding: previous therapists mostly used "behaviour correction" approaches, which the child resisted; he needed an intervention model that treated him as a collaborative partner. - Pre-existing self-image damage: "I keep wondering whether something's wrong with me."

Intervention Approach

First step — talk directly with the child. At 10, he needed to be treated as a collaborative partner, not a treatment object. We defined goals together; he chose: "I want to learn how to pause before I melt down" and "I want to learn how to chat with friends without annoying them." Polyvagal Theory psycho-education: taught him to identify his own nervous-system states (using a traffic-light metaphor), reframing "I lost control again" into "My nervous system is on red — how do I down-regulate?". Executive functioning coaching: using his favourite Minecraft as analogy, framing daily tasks as "building blocks". Sensory strategies: appropriate use of noise-cancelling headphones, classroom seating recommendations. Close collaboration with school SENCo and EP. Parent coaching with mother: shifting from "daily disaster management" to "daily collaboration".

Outcome

After 8 months: emotional outburst frequency dropped from 3–4 times weekly to 1–2 times monthly. School reported he began proactively requesting "I need a sensory break" instead of melting down. Family relationship visibly improved — mother described "I finally feel like my son and I are on the same team." Academics continued excellent, but more importantly he started taking ownership of his brain: "My brain is unique; I'm learning how to work with it."