Challenging Case: Health Care Professionals as Cultural Brokers for a Boy From Central America With Attention-Deficit Hyperactivity Disorder and Trauma and Stressor-related Disorder.

One child. Nothing in this report shows that any of the treatments works; it describes what happened to a single boy. Several medications and a large amount of social, educational and advocacy support were given at the same time, so the contribution of any one of them cannot be separated from the others. No formal measures, scores or follow-up are reported, so 'improved' and 'worsened' rest on the treating clinicians' descriptions rather than on recorded data. The stimulant was used inconsistently because the family could not always afford it, which makes the response to that drug hard to read. The article is part of a case series funded by a pharmaceutical company, which is a reason to read the medication discussion with more caution than the source alone would suggest.

The article is part of a larger Complex ADHD Challenging Case series funded by an unrestricted educational grant from Collegium Pharmaceuticals (formerly Ironshore Pharmaceuticals). No other funding or individual author disclosures appear in the text supplied.

Do not read this as evidence that stimulants, guanfacine, sertraline or cultural brokering work. It is one boy who received several medications and a great deal of team and family support at once, with no comparison group and no measured outcomes, so which part helped him cannot be told apart from the rest.