Use full sentences. Also use application, analysis and synthesis. Include the case
study in your submission and answer the questions below that are in bold. The write-up needs to be typed with
appropriate grammar and supporting evidence to your statements, including an
(APA) tile page and reference page.
Part One
Some Milestones:
Age: 6 years old
Birth weight: 2720 g (5lb 15oz)
Length: 52 cm
Head circumference: 32cm
Duration of Labor: 7 ½ hours (born at 36 weeks –
no special care necessary)
Smiled: 5 ½ weeks
Turned over: 14 weeks
Sat up alone: 29 ½ weeks
First step: 42 weeks
Walking: 12 months
Slept through night: 2 yrs
Speech: Sentences – 2 ½ yrs
First word: Light
The client’s
parents had for some time noticed that he was different from other children. In
fact, they had spent many nights agonizing over the fact that he did not appear
to show or reciprocate love, that he lacked expression or expressiveness, that
he seemed to prefer his own company and that he appeared frustrated and puzzled
by a whole range of social conventions.
As a baby, the
client’s mother reports he often cried for hours at a time and appeared to be
hypersensitive to noises. He was not easily consolable. When not crying, at
other times he would appear thoughtful and solemn or he would giggle
occasionally when tickled. He did not
appear to enjoy being cuddled. He used a pacifier into his 3rd year.
He would either have the pacifier in his mouth or other objects. He did not
like to play with toys his parents bought him and did not appear to watch or
enjoy watching television shows. He did
like to play with pots and pans and could watch the pan lids spin endlessly for
hours.
The client has
a 2-year-old brother. At times, the client appeared to tolerate brother’s
presence and may have enjoyed his company at times, but had to be monitored
most of the time due to the client being aggressive towards the brother. The
client’s mother often had to separate client from brother and it required her
to physically turn the client’s head toward her to have a discussion. She
stated that the client rarely would make eye contact with family or peers.
Early Schooling Period
The client had
considerable difficulty in his first pre-school. According to the mother, his
teacher was quite strict and a stickler for rules. She got easily angered by him
when he got out of line, was aggressive, or did not act according to the social
norms for a child his age. He had
difficulty sharing with other children at the pre-school and would act
aggressive both towards the teacher and the other students at times. He was
labeled as a bully by the teacher.
Current School
Client has
been tested and appears to be in the average range academically. He did not
have any reading disabilities, but did have difficulty initially grasping new
concepts and required multiple avenues to learn. He is drawn to patterns and
visual representations.
Client
presents as a good looking child with regular features. He is above average
height and walks and runs with a slightly stiff gait. He continues to avoid eye
contact and often sits with a mask-like expression. By initial impression, he appeared
to be quite a normal six year old, but when continuing to prompt him in
conversation it became obvious that his social communication was idiosyncratic.
Conversations are very one-sided and he speaks quickly, almost frenetically, at
times.
1. Which milestones are indicative of normal or abnormal development
for this client?
2. What differentials and diagnosis would you give him based upon the
information you currently have? Provide
rationale.
Part Two
Four months
after your initial interview, you sense that the client’s parents are feeling
more relieved to have a diagnosis and appear to have gained a growing awareness
of the symptoms and issues related to his diagnosis. Client’s mother admits to
you that she is relieved that his behaviors were not a result of poor parenting
skills.
Client’s
mother has had some bitter experiences with other mothers, fathers and
schoolteachers who have been quick to blame her and her spouse for
over-indulgence or lack of parenting skills. One mother actually offered to
take client home with her for a week and said that he would come back a changed
boy.
3.
What would you say to the parents at this time? (Use your own words.)
4.
Discuss what treatments you would suggest/offer to the
client and his family (pharm and nonpharm).
5.
What are your
feelings about this case and this patient?
Share your “personal” feelings/thoughts about treating a patient with
these circumstances. This is more of a
reflection or introspective statement.
