Child and Adolescent Psychiatric Consultation in Micronesia

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Little is known about child mental health in Micronesia. The objective of this brief report is to describe some features of childhood attention-deficit hyperactivity disorder (ADHD) in 1 Micronesian state, Yap. A retrospective review of records from 2 site visits made in 2010 was conducted. During the visits, the author assessed the majority of the children on the island who had been identified as having “special needs” by their primary care provider. The author’s assessment included clinical interviews with the child, caregivers, and special education teachers, as well as review of medical records and school reports, when available. A total of 16 child cases were reviewed, 9 of whom carried a diagnosis of ADHD; 6 of these children were on clonidine, the only medication available for ADHD in Yap. Most children had multiple other diagnoses, usually a seizure disorder or some form of developmental delay. Behavior management strategies used by parents and teachers varied from child to child. Psychoeducation on ADHD and behavior management strategies (while respecting Micronesian culture and family structure) are potential areas to focus on during future site visits.

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