Abstract
Children with learning disorders (LD) experience low self-esteem and loss of self-confidence at school and in everyday situations, in addition to difficulties with learning, which potentially lead to school refusal and/ or social maladaptation. We present a case of a child diagnosed with attention deficit/ hyperactivity disorder (ADHD) and suspected LD at initial examination during his first year of elementary school. Subsequently, the child experienced school maladaptation during early adolescence following a traffic accident resulting in interruption of therapy. Maternal anxiety contributing to detrimental mother-child attachment factored in persistence of the child's school refusal to nearly three years. Such circumstances led up to the child's inpatient treatment at Asunaro Hospital.
While the suspected diagnosis of LD was confirmed during the hospital treatment, training, and schooling over a period of 18-months, he underwent gradual improvement in social skills accompanied by elevation of self-esteem. Improvement of his long-term school refusal allowed the child to advance on to high school, where he is now leading a smooth life. Constructing a solid relationship with him and his parents, understanding their anxieties and emotional conflicts, was of great importance in determining valid treatment policy.
While outpatient treatment is limited to hospital assistance and day care, enrollment in the comprehensive inpatient treatment program enabled provision of more effective treatment tailored to the needs of the child, through a combination of family support and therapy, education, social skills training, grounded upon a relationship of mutual trust, supported by close cooperation among the various specialists involved.
