Question

Case 2.1 2.1-1 How would you describe the presenting problem? Sarah is having issues in school and at home. The teacher has advised that Sarah is having “difficulty following questions and staying in her seat and talks incessantly”. (Pomeroy, 2015, p 26) She doesn’t seem to follow the game’s rules when playing with peers. She is struggling with learning her alphabet, writing, and numbers. Sarah’s parents have separate causing her and her mother, Regina, to move in with her grandmother. Sarah’s father, Don, is not often around as his job requires traveling and Sarah’s mom has been working a lot due to depression. Sarah’s grandmother takes care of Sarah while she is home, but Sarah gives her grandmother a hard time. Sarah also gets upset and become disruptive when she doesn’t get her way. Regina doesn’t know what to do with her daughter and isn’t getting help from her father when trying to discipline Sarah. 2.1-2 What resources might be available to help Sarah and her family? I believe Regina should consider seeing a therapist for her depression. I believe a parenting class and/or support group that helps parents with discipline techniques and patience would assist Regina. It is clear that she doesn’t like to use physical punishment with Sarah so parenting class should help. Sarah may need to see a therapist to cope with the new transition as she was used to living with both parents and now lives with one who works often. I would even consider family counseling for the parents to co-parent successful. 2.1-3 Would you refer Sarah to any other professional while she is being seen by you? Yes. I would recommend therapy as mentioned previously for the parent separation. 2.1-4 What diagnosis would you give Sarah? I would diagnosis Sarah with F90.2 ADHD -Combined Presentation, Moderate Symptoms: Inattention: 1.Easily distracted-Sarah had hard time focusing her attention on one thing while with Peggy 2.Makes careless mistakes-teacher says Sarah makes careless mistakes in class 3.Difficulty sustaining attention with task- Sarah struggled with paying attention in ballet 4.Does not follow instructions-teacher says Sarah doesn’t follow rules 5.Often avoids, dislike, or is reluctant to engage in tasks that require sustained mental effort- Sarah dislikes writing her letters over and over because it is boring 6.Does not follow through on instructions and fails to finish homework-teacher tells Peggy that Sarah struggles with finishing homework Hyperactivity and impulsivity: 1.Leaves seats when expected to stay seated- Sarah doesn’t stay in her seat 2.Talks excessively- Sarah “talks incessantly” (Pomeroy, 2015, p 26) 3.” On the go” acting as if “driven by a motor”- Sarah cannot stay still for extended amount of time 4.Interrupts people talking-Sarah interrupted a meeting with her own talk 5.Interrupts or intrudes on others- Sarah interrupts conversation or disrupts them 6.Runs around or climbs-Sarah would run around at brownie scouts F81.2 Specific Learning disorder for the impairment in math. Sarah is below average academically. She is two levels behind in math which is seen as a primary criterion for the disorder. 2.1-5 List the psychosocial and cultural factors as V codes that would follow your diagnosis of Sarah. The V-codes goes as followed: V61.20-Parent-Child Relational Problems V61.03-Disruption of Family by Separation or Divorce V62.3-Academic or Educational Problem Case 2.2 2.2-1What are some of the psychosocial issues facing Mona and Ricardo? Mona and Ricardo are facing anxiety, stress, and culture. 2.2-2 What are some of the strengths of this family? Strengths includes awareness of child’s actions, taking initiative when a child was delaying in development, going to the doctor to see if Carlos was deaf, and staying hopeful. 2.2-3 What resources might be helpful to this family? I would recommend a support group, aide for the child, finding different tools to help enrich and expand the child’s skills such as psychosocial interventions, and having the parent further their knowledge on autism. 2.2-4 How do you envision your role as a mental health practitioner in helping this family? I envision myself creating a relationship full with trust and honesty. I hope to provide comfort and information while getting their child through this journey. I intend to get the parents involved with support groups, psychosocial interventions, and educate. 2.2-5 How would you diagnose Carlo’s problems? F84.0 Autism Spectrum Disorder with language and intellectual impairment Symptoms: Repetitive behaviors-rock back and forth, flapping of arms Deficits in nonverbal communication- lack of eye contact and facial expressions Fixated interests- attachment to ball Failed to initiate or respond to social interactions- Carlos avoids his peers and doesn’t response to their play 2.2-6 List the psychosocial and cultural factors that might impact your diagnosis of Carlos. Cultural factors would include the Vasquez being Hispanic and knowing that there is a stigma around mental disorder. I would have to consider “homeopathic treatments and interventions” before suggesting medication, if I suggest it at all. (Pomeroy, 2015, p 24) I will to remember that the Vasquez’s culture is often “over-or underdiagnosed in minority children”. (Pomeroy, 2015, p 24) The diagnosis may cause depression or hopelessness as it will affect how the family is viewed within their culture. 2.2-7 Why would Social Communication Disorder not be an appropriate diagnosis for Carlos? The reason why is because social communication disorder doesn’t consist of repetitive behavior. Carlos has repetitive behavior which is a significant symptom for autism spectrum disorder. He rocks back and forth for long period of time. Carlos also flap his arms. I didn’t give case 2.1 and case 2.2 the same diagnosis because each child had unrelated symptoms. In case 2.1, the child faced issues with attention and hyperactivity impulsivity such as constantly talking, unable to sit still, easily distracted and interrupting others while 2.2 case has a child that lack verbal and non-verbal communication such as eye contact, had repetitive behavior that included rocking back and forth which is a defining characteristic for autism. compare and contrast? responds to this

Answer 1

In the case of Sarah, the family is of father Don Mother Regina and grandmother Sarah’s father and mother are living separately due to his working condition, her mother Regina is depressed due to the separation. Sarah and her mother have moved to the grandmother's house.

It is to be observed that from when the condition of Sarah has changed whether it was there from the beginning or it is recent development due to parents staying separately. Her behavior and interaction with her grandmother is due to change in the situation or was it rough from the beginning, If it is established that the condition is the effect of a recent change in her life then it is being treated with counseling and explaining to her that the situation is a temporary phase. If the condition is from the beginning like this but unnoticed and had increased due to change in the situation then she is suffering from Autism disease and ADHD ho is suffering from emotional turmoil, problem finishing her homework, she is showing trouble sitting at one place. Showing less interest in her studies and having difficulty in understanding the alphabets, she is hyperactive too.

Mona and Ricardos are suffering from anxiety due to their son's condition who is suffering from Autism and SCD (Social communication disorder). In the school, he doesn't play with his peer and classmate his answer to the question asked is very long as if he has not heard the question that shows the slow response in his behavior. He shows Autism Spectrum Disorder with language and intellectual impairment Symptoms:

Comparing the case of Sarah and Carlo the circumstances are different. Sarah's mental health problem may be due to change in the situation by getting separated from the father, Maybe she was too much attached to her father and by her father going away from her life would have created insecurity or lack of father figure, and the outcome is her mental health giving rise to Autism type of symptoms, it can be a temporary phase and she can be treated by counseling and parent-child meeting so the fear and anxiety that has given rise to this mental health problem can be solved. While Carlos is born with the deficiency and he is facing cultural disparity. Being Hispanic, He has to be treated for Autism, ADHD and SCD. Group discussion with parents and counseling is required

Indeed Homeopathic is a good idea as it gives relief to the mental problem, it is having the minimum side effect and a child can take those sweet pills.

Sarah can get treated with the change in the situation overcoming her problems. Carlos requires medical help support and motivation with proper caring.