routine causes a lot of tremendous anxiety and she compares it to a fear of the unknown. He needs to know what’s going to happen and exactly how things are going to go. “It really causes a lot of anxiety for him when what he expects to happen doesn’t happen,” Amy said. At suppertime Sam always asks how many bites he has to take or exactly what time his friends are coming. Amy believes it’s his way to have some measure of control in, what is for him, an uncontrollable world filled with chaos. His little brain is moving six different directions all the time, thinking of anything and everything all at one time. Sam is never out of control and he is on medication albeit a pretty low dose with good success Amy said. Most children with these issues are on some type of medication. For Sam, it gives him a little relief and settles his brain, so he can focus better. Sam’s lack of attention is one of the first things Amy and dad Jeff recognized about him when he was little and one of the first markers for ADHD children. Amy laughs when she describes how fidgety he is, realizing he moves constantly to expend all the energy he seems to have. Sam will be starting fifth grade this fall, looking forward to seeing his friends. Amy said he does have an Individual Education Program plan through the school district and one of the directives is he goes to the Resource Room every day for additional classroom help. The school district is very helpful and involved in meeting Sam’s needs. One of Sam’s special nuances is he is very literal. He has no imagination and doesn’t understand jokes. He struggles to visualize for instance, a fictional book. He can’t picture what is happening on the pages, so the Resource teachers help him with reading and he also has difficulties with math. Another resource for Sam is a Speech Therapy individual who Photo courtesy of DeAnn McClure Photography works with him on how to use his socialization skills correctly. The resource person works with him on his skills depending on his maturity level and developing social skills was only introduced to him this last year in fourth grade. In his early years they focused on scholastic skills and helping him make adjustments in the classroom. As Sam looks to the future and Middle School next year, the resource staff wants to help him make the transition to the active class schedule he will be faced with as easily as possible. Socialization will be an important skill needed to maneuver the halls with more classmates and a greater variety of teaching styles. vSAM continued on page 19 Expert health care FOR ALL AGES Amanda Duxbury, MD, Heather Kleeman, DO, Mary Jo Olson, MD, and Anastasia Searcy, DO, Family Medicine Make a personal, lifelong connection with the physicians at Sanford Vermillion. Our team specializes in preventive care, diagnosis and management of chronic conditions. Call (605) 677-3700 to schedule an appointment. 018027-00342 Rev. 7/18 HERVOICEvSEPTEMBER/OCTOBER 2018v7