Pediatric Allergy – Virtual OIT

Liam presents to follow-up for attention and focus concerns; medication management on 2026-02-09.

Liam was last seen by me for:
 1) Attention-deficit hyperactivity disorder, predominantly inattentive type (F90.0)
 2) Medication side effects: insomnia and decreased appetite (T43.205A)

Problems:  
1.  Attention-deficit hyperactivity disorder, predominantly inattentive type (F90.0).
 - Since the last visit, Liam has been on a 40mg dose of medication for attention and focus concerns.
 - Reports improvement in ability to focus, particularly in science class.
 - Continues to find it difficult to focus in math due to lack of interest.
 - Enjoys physical education and basketball, which he finds confidence-boosting.
 - Parents have observed increased fatigue and difficulty falling asleep despite a consistent bedtime of 9:30 PM.
 - Appetite is decreased, with minimal intake in the morning and incomplete lunches.
 - These symptoms are discussed as potential side effects of his current medication.

Physical examination:
Height is in the 85th percentile and weight is average for his age group.

Impression and recommendations:  
1.  Attention-deficit hyperactivity disorder, predominantly inattentive type (F90.0):
 - Continue current medication regimen at 40mg.
 - Monitor sleep patterns, appetite, and school performance.
 - Encourage use of a visual checklist for morning routines to promote independence.
 - Advise limiting sugary drinks and consider no-sugar sparkling water as an alternative.
 - Reassess in the summer for follow-up.

Thank you kindly for your referral.