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Behavioral Treatment For The Mother And Child Discussion

Behavioral Treatment For The Mother And Child Discussion

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Complete and submit an outstanding comprehensive psych note from an actual patient you cared for in your practicum experience.

PLEASE SEE THE ATTACHEMNTS. MUST ENTER INFORMATION IN THE TEMPLATE
THE INFORMAION MUST BE LIKE Comprehensive Psych Note – Unit 1
.
ALSO, PLEASE DO PAPER ON A 10 YEAR BOY WITH ADHD Behavioral Treatment For The Mother And Child Behavioral Treatment For The Mother And Child Discussion

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Comprehensive Psychiatric Evaluation

 

 

Source of Information

 

 
Identifying data

 

Patient: J.G. Age: 10 Gender: Male Race: White
Summary Concerned about J.G.’s conduct both at home and at school, his parents and teachers have requested a mental assessment. Teachers have documented instances of disruptive behavior, impulsivity, and attention problems in the classroom. Concerns about following rules, acting impulsively, and struggling with homework are common issues that parents discuss in their own homes. Consequently, upon mental status examination and diagnostic tests, J.G.’s was diagnosed with ADHD. Behavioral Treatment For The Mother And Child Discussion
Background J.G. lives with his siblings and parents, but has problems in paying close attention, impulsivity and hyperactivity, which has negatively affected his performance in school. I was intrigued by his poor performance; hence, decide to look into the case study.
Case Presentation

 

J.G.’s parents and teachers are worried about his behavior at home and school, so they have sought a psychiatric evaluation. Attention issues, impulsivity, and disruptive behavior in the classroom have been documented by teachers. Parents talk about comparable difficulties they have at home, such as trouble adhering to rules, acting on impulse, and having trouble doing their assignments.
Demographics Patient: J.G. Age: 10 Gender: Male Race: White
Chief Complaint of Patient: The ten-year-old boy’s mother claims that her son has been acting strangely, always moving and finding it difficult to focus on any one thing for extended periods of time. Additionally, the school has reported to her that her son is extremely disruptive and unable to complete assignments assigned by teachers.
History of Present Illness Behavioral Treatment For The Mother And Child Discussion The patient is a 10-year-old male White boy who has been experiencing increasing levels of hyperactivity, inattention, and impulsivity for the past month. It has nothing to do with the youngster not understanding the instructions. According to the mother, the child doesn’t exactly exhibit defiance either. Any time of day can bring on the symptoms, which are only momentarily eased by rebuke. On a scale of 1 to 10, the mother gives the symptoms an 8 out of 10.
Current Medications Not on medications
Past Psychiatric History No psychiatric history
Past Psychiatric Medications Not using any psychiatric medications.
Substance Use/Abuse No history of substance use or abuse.
Medical History At age three, he got pneumonia, which was effectively treated while he was an inpatient. Given the measles, BCG, tetanus, diphtheria, and pertussis vaccinations (2017–2018), the influenza vaccination (2017), and the pneumonia vaccination (2019). His mother states that he has never had meningitis or malaria. Behavioral Treatment For The Mother And Child Discussion
Allergies He has a penicillin allergy. His mother states that he is not allergic to any other drugs, foods, or surroundings.
Family History Neither the mother’s nor the father’s sides of the family have a history of mental illness.
Psychiatric and Addiction History No history
Developmental and Social History Within a family of four, J.G. is the second child born. The eldest sibling is a twelve-year-old girl who is free of mental or physical health issues. The mother is a nurse, and the father works as a computer engineer. The father drinks infrequently but smokes. The mother does not smoke or drink. Behavioral Treatment For The Mother And Child Discussion
MSE: Appearance and behavior
   

Motor activity

 

  Speech

 

  Mood

 

  Affect

 

  Thought content (sensorium)

 

  Thought process

 

  Perceptual disturbances

 

  Cognition

 

  Abstract Reasoning

 

  Concentration

 

  Impulsivity

 

  Insight

 

  Judgment

 

  Threat to self or others

 

  Motivation

 

Strength and Weakness

–          Appears neat; though aggressive

 

–          Restless

 

–          Normal

 

–          Angry and irritable

 

–          Full

 

–          Normal

 

–          Distractable

 

–          Normal

 

–          Impaired

 

–          Normal

 

–          Difficult concentrating

 

–          Talks a lot Behavioral Treatment For The Mother And Child Discussion

 

–          Fair

 

–          Fair

 

–          Negative

 

–          Interest

 

–          Strengths: Hyperfocus, creativity, compassion, conversational skills, spontaneity, and high energy.

 

–          Weaknesses: Poor in paying attention, concentrating, listening, and putting effort in schoolwork. Restless and learning disabilities.Behavioral Treatment For The Mother And Child Discussion

Diagnostic Tests –          DSM-5 criteria for ADHD.

–          Blood testing to rule out Lead poisoning (Rubia et al., 2019).

–          Swanson, Nolan, and Pelham version IV scale teacher form or SNAP-IV to confirm ADHD (Rubia et al., 2019).

–          Full blood count to rule out any systemic infections (Groeneveld et al., 2019).

Case Formulation

 

 
Differential Diagnosis (with rationale)

 

1.      ADHD with combined presentation – Given that the boy’s presentation the DSM-5 diagnostic criteria for ADHD, this is the initial and most likely diagnosis. Behavioral Treatment For The Mother And Child Discussion

2.      Autism spectrum disorder – The learning problems exhibited by the boy indicated development of this disorder. However, it was ruled out based on communication skills of the boy, since children with ASD may struggle with confined or repetitive behaviors or interests, as well as social communication and engagement (Salunkhe et al., 2021).

3.      Oppositional defiant disorder – ODD children behave aggressively, defiantly, and uncooperatively towards peers, teachers, parents, and other adults in authority (Atherton et al., 2020). This was ruled out because the significant issue with the child is on concentration and being still.

Diagnosis (Include ICD 10 codes)

 

ADHD with combined presentation (314.01[F90.2])

This subtype ought to be employed in cases where six (or more) inattention symptoms in children and five (or more) hyperactivity-impulsivity symptoms in adults continue to exist for at least six months.

This is patient’s diagnosis because fails to pay close attention to essential details and makes unnecessary mistakes in schoolwork. Also, has challenges in maintaining attention, organizing activities and tasks, and listening (Rohde et al., 2018). Behavioral Treatment For The Mother And Child Discussion

Treatment Plan:

 

Pharmacology

 

Psychotherapy

 

 

 

 

Referrals

 

 

 

Patient Education

 

 

–          Start methylphenidate (Focalin) 2.5 mg twice a day (Barkley, 2022).

 

–          Cognitive behavioral therapy, psychoeducation, social skills training, and behavioral treatment for the mother and child (Barkley, 2022).

 

–          Clinical psychologist or psychiatrist to carry out a thorough assessment in order to ascertain the diagnosis.

 

–          For the mother to feel less alone, I would encourage her to attend a support group for parents whose kids have ADHD. In order to report the negative effects of Focalin as soon as they arise, I will educate the patient and the mother on how to note them. Finally, she ought to inform the teachers at her son’s school about the condition he is dealing with and the fact that he is receiving treatment and medicine. Behavioral Treatment For The Mother And Child Discussion

Outcome and Follow-up The patient has been diagnosed with ADHD, and has been initiated in treatment plan. Also, follow-up will be done four weeks later to evaluate how the medication and therapy that were started are doing.

 

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References

Atherton, O. E., Lawson, K. M., Ferrer, E., & Robins, R. W. (2020). The role of effortful control in the development of ADHD, ODD, and CD symptoms. Journal of personality and social psychology118(6), 1226. https://psycnet.apa.org/doi/10.1037/pspp0000243

Barkley, R. A. (2022). Treating ADHD in children and adolescents. Guilford Publications. https://books.google.co.ke/books?hl=en&lr=&id=fLCFEAAAQBAJ&oi=fnd&pg=PP1&dq=treating+ADHD+in+children&ots=weLa5hzwnz&sig=iRp9C0mfbwcGYfAdK_vFSfeCluY&redir_esc=y#v=onepage&q=treating%20ADHD%20in%20children&f=false

Groeneveld, K. M., Mennenga, A. M., Heidelberg, R. C., Martin, R. E., Tittle, R. K., Meeuwsen, K. D., … & White, E. K. (2019). Z-score neurofeedback and heart rate variability training for adults and children with symptoms of Attention-Deficit/Hyperactivity Disorder: A retrospective study. Applied psychophysiology and biofeedback44, 291-308. https://link.springer.com/article/10.1007/s10484-019-09439-x

Rohde, L. A., Kieling, C., & Salum, G. A. (2018). Current diagnostic criteria. Oxford Textbook of Attention Deficit Hyperactivity Disorder, 139. https://books.google.co.ke/books? Behavioral Treatment For The Mother And Child Discussion hl=en&lr=&id=tIJZDwAAQBAJ&oi=fnd&pg=PA139&dq=ADHD+with+combined+presentation+(314.01%5BF90.2%5D)+in+children+&ots=n6-RBOuGou&sig=5i1vB5zoUtT0Mfa3N8cHsaILBgc&redir_esc=y#v=onepage&q&f=false

Rubia, K., Criaud, M., Wulff, M., Alegria, A., Brinson, H., Barker, G., … & Giampietro, V. (2019). Functional connectivity changes associated with fMRI neurofeedback of right inferior frontal cortex in adolescents with ADHD. NeuroImage188, 43-58. https://doi.org/10.1016/j.neuroimage.2018.11.055

Salunkhe, G., Weissbrodt, K., Feige, B., Saville, C. W. N., Berger, A., Dundon, N. M., … & Klein, C. (2021). Examining the overlap between ADHD and autism spectrum disorder (ASD) using candidate endophenotypes of ADHD. Journal of Attention Disorders25(2), 217-232. https://doi.org/10.1177/1087054718778114 Behavioral Treatment For The Mother And Child Discussion

 

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