ABSTRACT
At 17 years of age and 6 feet tall Donald was a real handful. He presented all the classic symptoms of AD/HD (combined type) to an extreme degree. He seemed only able to concentrate when he was enjoying the task, for example when engaged in a computer game, often art, or an intensive sporting activity, such as basketball or skateboarding. With difficult or boring tasks he showed almost no perseverance, having enormous difficulty getting started and then quickly going off task. Once off task Donald would do whatever seemed to excite his interest, be it using a handy object as an improvised javelin, or setting light to someone’s hair (see below). Getting him to change from one task to another, or to tear himself away from an activity he found interesting or fun were extremely difficult and could lead to heated confrontations. When Donald was not engaged in a stimulating activity he appeared restless and fidgety, apparently unable to keep still or settle. At these times he could easily fall to irritating and provoking anyone he came across. He consistently behaved in ways that showed no consideration for the consequences of his actions either for himself or others. He had enormous difficulty in waiting his turn in queues, conversations or games, and would say and do things he later regretted, which, in turn, led to social difficulties.
