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Nancy is a 13-year-old Grade 8 student currently living at home in Toronto with her two parents and older sister. She was referred to Springboard Clinic for an evaluation to further understand her focusing concerns and her existing learning profile of strengths and concerns. It is reported that she enjoys arts and crafts, and participating in social media websites. At times, she experiences mood fluctuations and irritability; noting that her anger and frustration tend to be connected with her sadness. In any case, such activities as drawing, listening to music, and swimming help her to relax.

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Historically, Nancy has experienced difficulties with school work completion, inattentiveness, distractibility, disorganization, impulsivity and mood fluctuations since her first entrance to school. Nancy’s teachers describe her as a hard-working, cooperative student, yet they indicate that homework responsibilities have been an issue. Not only that, they also note that she is a very reluctant reader, and has consistently scored lower than average on reading comprehension and vocabulary tests (the psychoeducational testing indicated average cognitive abilities).

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Nancy states that she is struggling to meet expectations at home and at school, complete academic work, and communicate effectively with others who do not share her interests. She also indicates that she often becomes anxious when she is asked to speak in public, or to spend time with people she does not know. Her parents note that Nancy has difficulties making new friends and taking risks, which she “longs to get invited, but won’t make the first move”. Additionally, she experiences ongoing sleep difficulties, primarily with settling into routines at night.

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Long story short, her parents report increased anxiety around school participation this year. The 13-year-old child reports feeling nervous when going to school because of her presentations and homework. As a result, she describes hating school and experiencing difficulties completing her work on time because “she can never focus”. Her parents note concerns with negative body image and self-talk. Nancy’s older sister has been identified as “gifted” and appears to be highly motivated academically and almost “driven” to excel in all her life domains (even though she later was diagnosed with a serious eating disorder). Both her parents are university graduates. Her father is a hard-working financier who stays fit, running marathons while her mother is currently a full-time homemaker. Bottom line, there is an extended family history of alcoholism, marital relationship instability, and possibility of inheriting ADHD characteristics.