The mother of an 8 year old male currently diagnosed with AD…
The mother of an 8 year old male currently diagnosed with ADHD accompanies the child to appointment with PMHNP. He has been taking methylphenidate ER 18 mg every day. The mother recently started a new job and has concerns that the patient has become increasingly angry, impulsive and irritable over the last 4 weeks, pushing his younger brother and threatening to hit mother if she takes his tablet away. He is not falling asleep until very late and consistently wakes up irritable. Mother is concerned that the child needs medication for bipolar disorder because he is happy one minute and then mad as soon as he doesn’t get his way. Mother says, “He’s just like his estranged biological father”. After contacting the school staff and reviewing behavior checklists returned by teachers, it is clear there are no major behavioral concerns at school, only mild impulsivity and distractibility during the initial portion of each day. Which of the following recommendations by the PMHNP reflects contingency management?