PUFW Raphael Michaelson Attention Hyperactivity Deficit Disorder Case Study

User Generated

oburar89

Health Medical

Purdue University Fort Wayne

Description

Case Study #2 (Child/Adolescent) Week 4

Please pick a patient that is 12 or younger. Please be sure to examine all developmental facets of the child. Please identify what Erickson stage of development they should be attempting to achieve. Also consider Piaget, Kohlberg, and Bolwby. There are at least 2 questions on boards that will ask you to identify their current stage!


Mini-Case Presentations

Points

Elements

20

Patient Scenario

• Patient Demographics

• Presenting Problem

• Reason for Visit

20

History

• Complete Psychosocial including genetics, multigeneraltional family assessment, environment, trauma, culture, ethnicity, spiritual beliefs and practices, coping skills, cognition/mental status, current and past history of violence, suicidal or self- harm behavior, substance use, socioeconomics, developmental stage and level of functioning

• Supporting Physical

20

Multiaxial Differential Diagnosis and Rationale

20

Plan of Care

• Additional Assessment that is needed, i.e.

o Neurologic exam

o Personality testing

o Lab Tests

• Relevant therapist characteristics viewed as herapeutic for this particular patient

• Interventions/ Strategies to be used

• Emphasis of Treatment, i.e.

o Level of directiveness

o Level of supportiveness

o Cognitive, behavioral or affective emphasis

2.5

• Nature of Treatment

o Individual

o Couple

o Family

o Group

1

5

• Medications

o Current

o Needed

o Rationale for Choice in Meds

2.5

• Adjunct Services

o Consultation

o Community Resources

o Legal advice

o Education

10

Summary and Prognosis

2

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Explanation & Answer

Attached.

Running Head: CASE STUDY ADOLESCENT

Case Study Adolescent
Student’s Name
Professor’s Name
Institutional Affiliation

CASE STUDY ADOLESCENT

2
Case Study Adolescent

Raphael Michaelson, an eleven-year-old male comes to the hospital accompanied by
his mother and older sister. His mother reports that he is often very active, acts impulsively,
his school grades have been dropping and he does not obey her anymore. She adds that in the
previous parent-teacher meetings, the teacher pointed out that Raphael is easily distracted,
has problems with maintaining concentration in class, and is restless during class time. On
history taking and physical examination, the following were noted. The mother is an
alcoholic and uses cigarettes as well. She reports that even when she was pregnant with
Raphael, she still used drugs. In addition, Raphael’s uncle, a brother to his father had similar
symptoms to those of Raphael’s. Upon history taking, we noted that his parents separated
about a year ago and his mother works for a delivery company to provide for the children and
herself. On physical examination, Raphael has scars on his hands and thighs, which he
reports that he self-inflicts them when he is frustrated, like when he fails a test. He often asks
me to repeat a question I had asked during examination because he did not catch it the first
time. I also noticed that he fidgets a lot and often tries to leave his seat. He also reports that
kids in school do not like him because they think he a bad kid.
According to Erick Erickson’s theory, Raphael is at the industry versus inferiority
developmental stage, which ranges between six to twelve years and is the stage where a child
should develop skills in sports, language and know how to calculate figures (Erskine, 2019).
If children at this stage fail to learn how to get along with others, they develop inferiority.
According to Piaget, Kohlberg and Bolwby, Raphael should be at the concrete operational
stage, which ranges between seven years to eleven years, and emphasizes that children’s
reasoning becomes more logical and focused (Li, 2016).

CASE STUDY ADOLESCENT

3

Based on the above data gathered from physical examination and history, Raphael’s
diagnosis is Attention Deficit Hyperactivity Disorder (ADHD). The possible differential
diagnosis is Post Traumatic Stress Disorder (PTSD) because of the history of his parents
separating (Ling, Cai, Ren, Zhang, Gao, & Chen, 2016). This could have caused trauma to
Raphael causing a change in behavior.
On management, Raphael is prescribed cerebral stimulants such as amphetamines
which help decrease hyperactivity and distractibility. They also increase the ability to
concentrate and reduce behavioral symptoms. Amphetamines on the other hand, are prone to
abuse and therefore should be monitored closely. Mood stabilizers would be successful in
controlling moods and alleviating hyperactivity. Other forms of treatment include behavior
therapy which focuses on rewarding good behavior and pushing unacceptable behavior.
Family therapy would be helpful in assisting the family members to understand the nature of
the disorder, its symptoms and how they should associate with the patient (Ling, Cai, Ren, et
al., 2016). Individual therapy may help the patient to talk about their problems openly to a
therapist and discover different ways of dealing with different problems. Group therapy may
benefit the patient since he can learn from other people’s experiences. Raphael and his family
ough...


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