This case study presents a 7-year-old boy who was referred for concerns related to inattention, daytime urinary incontinence, frequent urination, and strong fear of using the toilet alone. His mother also reported forgetfulness, easy distraction, and a clear decline in school performance over the past six months. These problems started gradually but became more noticeable with time. The child also showed signs of emotional discomfort and appeared guarded during early clinical sessions. He avoided certain situations, especially those related to bathroom use, and often needed reassurance from adults. A comprehensive psychological assessment was conducted using clinical interviews with the child and parent, behavioral observation, and standardized assessment tools. The results showed symptoms consistent with Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation, along with elevated anxiety symptoms. The child showed difficulty with attention, working memory, and emotional regulation. During the therapeutic process, the child slowly began to share experiences that made him feel unsafe and fearful, which appeared to increase his anxiety and avoidance behaviors. A structured and multidisciplinary intervention plan was provided. This included cognitive behavioral therapy; play based therapeutic techniques, emotional regulation support, and occupational therapy. The main goal was to help the child feel safe, reduce anxiety, improve emotional expression, and strengthen attention and daily functioning. The child was also supported in developing coping skills and confidence in managing difficult situations. Over a period of six months, the child showed noticeable improvement. His anxiety reduced, emotional expression improved, and his ability to focus and participate in daily activities increased. He became more comfortable in therapy and showed better adjustment in daily routines and school related tasks. This case highlights the importance of careful psychological assessment and timely intervention when children present with attention and anxiety related concerns. Providing emotional safety, consistent support, and multidisciplinary care can help improve both emotional wellbeing and functional outcomes in children.
Alam et al. (Sun,) studied this question.