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Case Study #1 - Rapid Response

Rapid Response - 7.5 Months

Matt:  age 19, Grade 14,  NDD Presence Score:  8+ (Possible NDD = 5-8)

Pregnancy - Uneventful 

Labor & Delivery - Birth 2 weeks past due date.  Little spontaneous labor; induced with pitocin; 12 hours of intense labor  Birth weight 7 # 3oz.

Family History - negative, no relevant genetic, inherited risk factors.

Presenting Symptoms, History of Disorder - When starting school, from third grade on, would take about 2 months to gear down from vacation and settle into school.  Fifth grade - behavior disruptive, grades down.  Parochial school through 5th grade.  Since fifth grade potential greater than achievement.  Started public school in sixth grade, didn’t take transition well, began to associate with students with poor grades, and talked back.  Disrespectful at home, class clown in school, grades variable.  Would think, “Why can’t I settle down and get the grades I could”.

AB average through high school.  Studied less than friends with similar grades, but would study mostly at the last minute.  Starting college - studied more, but less effectively.  Major - construction engineering. First semester grades were Ds and Fs.  Increased fatigue, more naps, low energy level. Second semester studied more effectively, ended with Cs and Ds.  Started this fall semester with good attitude, studying well, plateaued at 6 weeks.  Described material as “boring”, grades down, eyes tired after an hour of reading.

Oculomotor – No difficulty learning to read.  Never had an interest in reading outside of that required in classes.  Seventh grade would get tired reading, better after eighth grade.  In high school, eyes would feel “tired”.  Reading 1.5-2 hours, eyes tired, concentration and attention difficult.  Mother says reading would typically last 30 minutes, then he would find an excuse to get away from it.  When concentration was lost, would lose place, page become fuzzy and blurry, skipping and rereading lines, skipping words.

Vestibular -  Motion sickness - none riding.  Vertigo reading in car on winding road, difficulty keeping eyes on line of print.

Fine Motor Coordination - No writing problems, uses cursive.  Thumb pain with prolonged writing.  Written expression normal.

Other - Unusual fatigue in high school, naps after school.  Past 2 months when fatigued will experience for a minute or two being unable to understand conversation.  Injured back at age 15 pole-vaulting, poor technique, then less participation in sports.

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