Child Study Center Helped a Patient Navigate ADHD, Now He's Heading to TCU on a Full-Ride Scholarship
Moses gives credit to the medication and care he received at Cook Children’s to overcome the distractions and behavior problems when he was younger.
By Jean Yaeger
Attention-deficit/hyperactivity disorder (ADHD) made school a struggle for 17-year-old Moses Hernandez as far back as kindergarten.
“Basically I was all over the place. I would talk a lot, always. I couldn’t stay focused on one thing,” he remembered. “It was hard for me to listen to the teachers.” At home, he caused trouble.
Moses came to the Cook Children’s Child Study Center in 2009 for an evaluation that diagnosed him with ADHD and disruptive behavior disorder. Through medication and therapies -- targeting his anger and impulsiveness – Moses’ symptoms diminished while his self-discipline and academic success took off.
He’ll graduate in June from Fort Worth’s Benbrook Middle-High School, where he took rigorous courses such as Advanced Placement calculus, economics and engineering. He played football and wrestled, worked part-time, and won full-ride scholarships to study mechanical engineering at Texas Christian University.
Moses gives credit to the medication and care he received at Cook Children’s to overcome the distractions and behavior problems when he was younger. ADHD is a chronic condition that can’t be cured but managed. This article explains the complex challenges and the treatments that can help patients like Moses and their families.
Focus and Self-Control
In elementary school, Moses and his brother lived with their grandfather. Their grandfather tried to read with Moses and go over the homework. But Moses wasn’t interested in school, and his grades showed it.
“I was like, ‘I am not doing this work. Why do I have to study?’ I would fail every word test,” he said.
Staff at the Child Study Center began working with Moses to rein in his ADHD and disruptive behavior. The first medications prescribed made him prone to crying and staring at the wall, he said. At a reduced dosage, he felt better.
Meanwhile, the death of his grandfather created more difficulties. A cousin, Jenean McDowell, became the boys’ guardian in 2014. Jenean recalls Moses arguing about chores, rebelling, picking on his brother, and even climbing on the roof. “He was a rough piece of work,” she said.
Moses was additionally diagnosed with adjustment disorder, defined as an unhealthy or excessive reaction to a stressful event or life change. He also suffered from mixed anxiety and depressed mood. Therapists at the Child Study Center coached Moses on coping skills and techniques to calm himself down. Jenean noticed greater motivation, organization and cooperation after about one year.
“He didn’t talk back anymore. He didn’t sneak around and tear things up. He decided he liked straight As,” she said. “He’s like a totally different kid.”
Moses explained that the medications he takes allow him to focus on tasks. He describes himself as more in control of his emotions, less likely to “do something that’s really dumb” on a whim. During the COVID-19 lockdown in 2020, he temporarily quit taking his medication as an experiment. But without the meds, he said, he couldn’t sit still or stop himself from aggravating his brother.
Therapy sessions over the years at the Child Study Center taught him to think through his options before acting impulsively. He learned breathing techniques to manage his anger. Although he didn’t initially want the treatment, and the medication caused some side effects early on, now he encourages others with ADHD to consider the meds as a tool.
Moses remains energetic and – as he puts it -- goofy and excitable. He’s also confident in the classroom, a leader on the wrestling mat, and a hard worker who aspires to start his own business by the time he’s 30. He’s grateful for Jenean’s love and the Child Study Center’s expertise.
Becky Neander, MSN, APRN, CPNP-PC, joined Moses’ care team in 2017, providing resources and medication oversight. She sees him as an example of tenacity and hope for those who deal with ADHD and behavior disorders.
“I could not be more proud of Moses,” Neander said. “He has achieved so much already, and I look forward to hearing about all of his successes as a TCU Horned Frog!”
Moses takes Concerta (a stimulant) and Intuiv (a nonstimulant that requires careful monitoring for a potential drop in blood pressure) once a day. Checkups at the Child Study Center every three months have helped keep Moses’ medications at the right level, and his behavior in check, Jenean said. “It really 100% worked. That is what saved us.” She offered this advice to caregivers and parents: “Don’t give up.”
The Diagnostic and Statistical Manual of Mental Disorders -5th edition lists several criteria for diagnosing ADHD in children and adolescents, including these signs:
- Inattention: Seeming to not listen; careless mistakes; frequently losing things; getting sidetracked; forgetfulness
- Hyperactivity and impulsivity: Fidgeting; difficulty staying seated; running and climbing at inappropriate times; interrupting and blurting out; difficulty waiting their turn
- Multiple symptoms have been present for at least six months; symptoms are inappropriate for the child’s development level; symptoms interfere with school, friendships or work activities.
Treatment plans for teens and children ages 6 and up often take a combined approach of medications, behavior management and behavioral classroom interventions. For preschool-aged children, behavior therapy is recommended as the first line of ADHD treatment.
Up to 80% of children with ADHD report improvement when taking stimulants, the most widely used ADHD medications, according to the U.S. Centers for Disease Control. Because stimulants can affect appetite, sleep and weight, patients must be closely monitored so that adjustments can be made if needed.
Neander said scientific studies have shown differences in the neurotransmitters, which are the chemicals that transmit signals between nerve cells, as well as in brain structure and operation in children with ADHD. The executive function works like the brain’s manager, she said. Impairment to executive function can cause the inattention and/or hyperactivity typically associated with ADHD, as well as other issues.
“Executive functions help people organize, regulate attention, make decisions, problem-solve, keep information in immediate memory, manage time, control emotions and motivation and control impulses,” Neander pointed out. Possible concurrent symptoms along with ADHD can include aggressive behaviors, anxiety, low self-esteem and learning disabilities.
An estimated 5% of children worldwide are diagnosed with ADHD. Parents with concerns should talk to their child’s pediatrician. Diagnosis can be made by a primary care provider or mental health professional.
Services at the Child Study Center
The Child Study Center at Cook Children’s is a comprehensive hub for diagnosing and managing a wide range of developmental disorders including ADHD, Autism Spectrum Disorder and intellectual disabilities
“We start by educating the caregivers on the child’s particular symptoms or difficulties, so they have a better understanding of the cause of each child’s behavior,” Neander said. “We then manage the medications that help with impulsivity or other behaviors. We can provide therapy/counseling through our psychology department or with outside referrals. We also can work with the school on behavior plans/interventions.”
Neander saluted Moses’ grandparents and cousin for supporting him along the way. Parents, grandparents and guardians are the strongest advocates for their children, she said.
“It is vital that caregivers educate themselves on their child’s diagnosis, what to expect, and how they can help at home or through the school. We provide resources, but families must take an active role in their child’s management,” she said. “We must work as a team for the child to be successful in school, with friendships, and eventually as independent adults with the tools they are given.”
The Child Study Center at Cook Children's
For more than 50 years, the Child Study Center at Cook Children's has provided diagnosis, treatment and education to help children with complex developmental and behavioral disabilities. Services include the Jane Justin School, the Behavior Disorders Clinic, autism services, developmental pediatrics, and psychology testing and therapy. Our clinicians and specialists take a multidisciplinary approach and use evidence-based practices for your child’s unique needs.