Worksheet about Dannys Case.
Areas does she have difficulty? 3. In Table A.11, the OT treatment given is stated in general terms. Describe in detail the methods and approaches you believe will be most helpful to the client. 4. What additional community supports or aftercare strategies would be helpful for this client? Case 9: A 12-Year-Old Boy With Attention-Deficit Hyperactivity Disorder and Oppositional Defiant Disorder15 Danny B. Case #38-499 Danny is a 12-year-old boy who is in the fifth grade. He is being homeschooled by his father, who is a freelance illustrator; his parents feel that he is too distracted by peers to function in a school setting because of his behavioral problems (Table A. 12). His school history shows below-average academic achievement (he repeated fourth grade) despite average verbal and mathematical intelligence in m ff. testing with the Wechsler Intelligence Scale for 1g 15Composite based on several clinical cases.
618 Appendix A Case Examples TABLE A. 12 peers as bullying and unaware, insensitive to con- DSM-5 Diagnosis at Admission text, intense and needy, and in the words of one (Case 9) teacher "clueless about he out how to be a member of 314.01 Attention-deficit hyperactivity disorder a group." Relationships with siblings are stormy, but Danny relies on his 9-year-old sister to be a 313.8 Oppositional defiant disorder friend and companion. He is jealous of his sister’s V codes friends; when friends visit his sister, Danny often V61.8 Sibling relational problem disrupts their play, sometimes destroying toys and V62.4 Social exclusion or rejection drawings. Danny has few chores but does them if reminded several times. He enjoys taking in the Children, 4th ed. (WISC-IV). Since entering mail and sorting it. He takes out the trash some- school, he has had difficulty getting along with times. His mother complains that he dawdles and other children and has been picked on and ostra- takes forever to finish some chores, such as set- cized. In kindergarten, he threw a chair across the ting the table and taking out the trash. He feeds classroom. Teachers in second and third grades the two cats and the rabbits and likes to pet the restrained him several times when he struck out animals. The cats have scratched him for being at classmates. He has been tested for learning too rough. Danny’s mother says she doesn’t make disabilities, but none were found. Danny is being him do too many chores because he is impatient medicated with divalproex (Depakote), methyl- and has broken too many things. phenidate (Ritalin), and bupropion (Wellbutrin). Danny has been homeschooled for the past Danny is the oldest of four children, with a year. On a typical day, he and his father work on younger sister aged 9 and twin brothers aged the lessons for 2 hours, and then Danny has 4 to 18 months. He was a full-term baby, delivered 6 hours of independent work. Danny’s father says by cesarean section after unsuccessful attempts that Danny focuses well on his schoolwork and to move him from a breech presentation. Mother seems in particular to enjoy math and reading. recalls that as an infant, Danny was fussy and However, Danny’s father has to work longer hours cried a lot in comparison with her other chil- to generate more income and would like to have dren. Developmental milestones were within Danny back in school. normal limits (WNL). At age 2, Danny began to Danny has had 3 years of psychotherapy with a have intense temper tantrums. He seemed easily psychologist; his parents say they see little change. frustrated according to his parents. His parents They feel the medications have helped somewhat assumed he would outgrow it, but the behavior in curbing Danny’s impulsivity and oppositional continued. He would, for example, refuse to join in behaviors. The psychologist suggested occupa- family activities, causing the entire family to miss tional therapy for evaluation of social skills and planned events because he would kick anyone who for interventions to enable him to develop rela- attempted to drag him along. Parents and teach- tionships with other children and to function in a ers have described Danny as absentminded and public school classroom. inattentive, demanding, argumentative, disruptive, loud, stubborn, withdrawn, suspicious, and moody. Danny has no current peer friendships and Questions for Case 9 no sustained peer relationships in the past. 1. What challenges do you anticipate in forming Teachers and parents describe his behavior with a relationship with Danny?
React: Write three words about the Record your three words here: client that came to mind as you read the case study for the first time. Respond: What challenges do you anticipate in forming a relationship with the client? The OT would like you to involve the client in an activity to observe and assess task skills and general approach to tasks. What activities would you consider? How would you try to engage the client? Brainstorm your personal biases, Record your brainstorming here: assumptions, beliefs, feelings about the psychiatric diagnosis and the developmental stage of your assigned case.
Focus: From the brainstormed list Record uncomfortable biases here: above, highlight or circle thoughts or feelings that make you feel particularly uncomfortable. Research: Using reputable sources, Topic: conduct an internet search about Facts: one uncomfortable bias from the list above. Record the facts and information obtained. Reference APA Citation required: Reflect One thing that I learned personally about myself that I can carry forward into my professional development is: One thought or idea that particularly challenged my views is: When I compare the personal biases and the factual information that I gathered, I understand
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