Sarah 2.1 and Carlos 2.2 Case PDF

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Sarah 2.1 and Carlos 2.2 Case...

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Case 2.1 2.1-1 How would you describe the presenting problem? The presenting problem is a 7-year-old female Sarah presents with difficulty paying attention, does not like to listen when talked to directly, has difficulty following through with tasks assigned to her, often loses things necessary to complete her homework, has numerous outbursts, not able to stay seated, talking continuously, and is disruptive in school and organize activities. Her mother reports that Sarah’s behavior presented when Sarah started school. Sarah teacher reported that she has trouble with math and her letters sometimes reversing letters in words. Regina reported that Sarah’s father had similar difficulties while growing up and that they recently split up and are living separately. Sarah has outburst when she does not want to listen to an authority figure by stating “If my daddy were here, he’d let me”. 2.1-2 What resources might be available to help Sarah and her family? I would suggest resources such as support groups for Sarah and her mother with other family’s going through the same thing to have social support and learn coping skills. I would also suggest the school being involved with Sarah’s treatment with constant communication and plans to help Sarah in school with social and educational requirements. 2.1-3 Would you refer Sarah to any other professional while she is being seen by you? I would refer Sarah to a licensed psychologist for additional testing and possible medication. I would also refer her to an educational specialist to find out if there is dyslexia due to her reversing her letters in words and a medical doctor to make sure there is nothing medically going on. 2.1-4 What diagnosis would you give Sarah? Before I would diagnosis Sarah I would like to use measurement instruments to be certain such as The Conner’s Third Edition “offers a detailed assessment of ADHD and comorbid behavioral problems in children aged 6 to 18 years” (Pomeroy, 2015). Sarah presents with symptoms diagnostic criteria for ADHD by utilizing the DSM-5. She meets 6 or more of inattention symptoms that have persisted for at least 6 months including 1.often failing to give close attention to details or makes careless mistakes in schoolwork, 2.often has difficulty sustaining attention in tasks or play activities, 3.often does not seem to listen when spoken to directly, 4.often does not follow through on instructions and fails to finish schoolwork, 5.Often has difficulty organizing tasks and activities, 6. Often loses things necessary for tasks and activities, 7. Is often easily distracted by extraneous stimuli .Sarah presents with 6 or more of hyperactivity that have persisted for 6 or more months including 1. Often fidgets or squirms in seat, 2. Often leaves seat when remaining seated is expected, 3. Often runs about in situations where it is inappropriate, 4. Often unable to play or engage in leisure activities quietly, 5. Often talks excessively, 6. Often interrupts or intrudes on others. Sarah would be specified as 314.01 (F90.2) Combined presentation (American Psychiatric Association 2013).

2.1-5 List the psychosocial and cultural factors as V codes that would follow your diagnosis of Sarah. V62.3 (Z55.9) Academic or Educational Problems Sarah’s teacher reported that she is two grade levels below in math, difficulty finishing her work and irritates other children in the class.

V61.10 (Z62.898) Child Affected by Parental Relationship Distress Sarah’s parents are separated and her father is living with his girlfriend which has caused Sarah’s mother to be angry and depressed. Sarah’s mother works more to deal with her depression. Sarah does not see her mother or father often.

2.2 2.2-1 What are some of the psychosocial issues facing Mona and Ricardo? During Mona and Ricardo’s interview they never stated any support outside of each other this could potentially give feelings of alienation. During Carlos infancy, they reported concerns however stated that when they sought medical advice because they thought maybe it was his hearing the doctor told them there was nothing wrong with his hearing but didn’t refer the parents anywhere for further evaluation they lack medical support. 2.2-2 What are some of the strengths of the family? The fact that Mona and Ricardo support each other and stand together to help their son by continuing to seek out help for their son’s developmental disabilities. They love their son and can report strengths that he has even though he has not created that attachment to them that they had hoped for. Mona and Ricardo are responsible and committed parents that have patience and understanding. 2.2-3 What resources might be helpful to this family? Resources that would be helpful would be education on Carlo’s diagnosis, family support group and cultural support groups since the family does not seem to have any family support close to them. 2.2-4 How do you envision your role as a mental health practitioner on helping this family? I envision my role as a mental health practitioner to assist this family in properly having Carlos diagnosed then providing treatment for him and the family, making sure Carlos receives special education services, making sure that Carlos receives all services that he needs and referring him to outside services such as speech therapy and social support groups. 2-2-5 How would you diagnoses Carlos problem? 299.00(F84.0) Autism Spectrum disorder requiring substantial support for social communication and social interaction; Requiring substantial support restricted repetitive behaviors; with accompanying global development delay- 315.8 (F88). Carlos presents with 1. Deficits in social-emotional reciprocity (Not wanting to be held and hugged by parents, not wanting to play with other children) 2. Deficits in nonverbal communication behaviors used for social interaction (Never responds verbally) 3. Deficits in developing, maintaining and understanding relationships (recoiling when held, not attachment to parents, not interested in forming friendships). In Criterion B 1. Stereotyped or repetitive motor movements patterns or behaviors (flapping his arms, turning in circles, rocking back and forth) 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (changing his routine and beginning school, Carlos disturbance in the playroom) 3. Highly restricted, fixated interests that are abnormal in intensity or focus (Carlos interaction with the ball) 4.

Hyper or hyperactivity to sensory input or unusual interest in sensory aspects of the environment (Carlos shows hypersensitivity when over stimulated in his environment, in the playroom when the other child try’s more than once to play with him he sits in the corner and begins rocking, when at school he would sit and rock when the teacher was attempting to get him to engage). Criterion C Present since Carlos was born as reported from parents. Specifier D Symptoms do cause clinically significant impairment in social and school areas of functioning. 2.2-6 List the psychosocial and cultural factors that might impact your diagnosis of Carlos? I am thinking that possibly cultural background could have been an issue when Mona and Ricardo were first experiencing concern for Carlos. The language barrier could have influenced them not to push further with doctors or it could have been misunderstanding on either part. The family lacks social support systems. 2.2-7 Why would Social Communication disorder not be appropriate diagnosis for Carlos? I feel as social communication disorder would not be appropriate for Carlos even though they have similar symptoms there are differences in diagnosing. Social Communication does not have the restricted, repetitive patterns of behavior and for Carlos he currently has stereotyped or repetitive motor movements patterns or behaviors (flapping his arms, turning in circles, rocking back and forth) 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (changing his routine and beginning school, Carlos disturbance in the playroom) 3. Highly restricted, fixated interests that are abnormal in intensity or focus (Carlos interaction with the ball) 4. Hyper or hyperactivity to sensory input or unusual interest in sensory aspects of the environment (Carlos shows hypersensitivity when over stimulated in his environment, in the playroom when the other child try’s more than once to play with him he sits in the corner and begins rocking, when at school he would sit and rock when the teacher was attempting to get him to engage).

Respond to the postings of two classmates. If their answers to question #4 in case 2.1 and question #5 in case 2.2 differ from yours, please ask them to explain how they arrived at their diagnosis. If the two classmates you responded to have the same diagnosis for the cases as you do, ask them what psychosocial intervention would they use with these clients and why are they making these treatment recommendations. When diagnosing the case, please list the symptoms that are supportive of your diagnosis. In comparing cases 2.1 and 2.2, state why you did not give these two cases the same diagnosis.

1. The way I would describe the problem that is being presented is that Sarah’s behavioral problems are short ability to pay attention, difficult following directions and unable to play with other children due to her hyper activity and not being able to follow rules of the games. Sarah’s parents are going through a divorce, but she thinks her father will be back because of they have

not told her the truth. Whenever she is being punished or in an uncomfortable situation she makes references to her father. 2. Sarah’s parents could benefit from couples, family or individual therapy. Sarah’s mom maybe the one who would benefit the most from individual therapy because of the divorce and her child’s behavioral problems. The mom could also use some parenting classes to help cope with Sarah’s challenges. 3. Sarah could be referred to see a neurologist and psychologist. It would probably be best for Sarah’s mom to get second opinions on Sarah’s behavior instead of drawing a quick conclusion. In these cases it’s would be helpful so that Sarah isn’t put on medication so quickly and get other methods to help her with her behavioral problems. 4. According to the DSM-5 text Sarah’s behavioral problems seem to point to ADHD. She displays hyperactivity, boredom, aggression, difficulty focusing and short attention span. 5. The DSM V code for ADHD F90.2.

Case 2.2 1. The psychological issues Mona and Ricardo are facing is engaging Carlos in human interaction. Carlos does not express happiness according to Mona. She doesn’t believe he is a emotional happy child. Ricardo tries to play with Carlos and he realized that Carlos does not socialize or play with his father. Parents states that Carlos gets in a corner and rocks back and forth. He does not interact with other children. He was behind in a lot of development as a infant to toddler. He walked at 28 months. 2. Some of the strengths in the family are the ability to not give up. Even when the pediatrician said Carlos was just behind they kept trying to figure out what was wrong with Carlos. The parents did not stop interacting with Carlos and still enrolled him to school because it seems like they did not want to treat him differently. When the doctor referred him to the clinician you could tell the eagerness in wanting to finally find out what is wrong with Carlos and how to be able to help him. 3. It would be helpful for the parents to attend a closed group for parents that have child(ren) like Carlos. That would probably help the parents hear others and feel like they can relate to others having the same difficulty. Also the group would be beneficial for the parents to find better ideas on how they can help Carlos as well. 4. The way I envision my role is as a mental health practitioner is being able to provide the best services to the client and the family. It’s important to be a guide for them in getting the answers they need. I need to show empathy because discovering there son has a disorder must come with a lot of shock. Then providing empowerment to show they are able to do this and reminding them of their strengths. 5. After reviewing the DSM-5 text the behaviors that Carlos is displaying seems to be Autism. He fails to create/maintain a conversation, which seems because he is nonverbal. Carlos body language with other children displays no development and understanding of how to have a personal relationship. 6. The DSM V code for Autism is 299.00. 7. Social communication disorder would not be appropriate for Carlos because his behaviors don’t line up with these behaviors of Social Communication. Carlos does not interact with anyone and does not know hot to do simple things in his age group. When the kids came

over to talk to him he was rocking in a chair back and forth. Social communication does represent what Carlos has....