Reference no: EM133668500

Assignment:

Read the case study below:

Case Study

Into Everything

Eddie, age 9, was referred to a psychiatry at the request of his school because of the difficulties he creates in class. He has been suspended for a day twice this school year. His each complains that he is so restless that his classmates are unable to concentrate. He is hardly ever in his seat, but roams around the class, talking to other children while they are working. When the teacher is able to get him to stay in his seat, he fidgets with his hands and feet and drops things on the floor. He never seems to know what he is going to know next, and may suddenly do something quite outrageous. His most recent suspension was for swigging from the light fixture which hangs over the blackboard. Because he was unable to climb down again, the class was in an uproar.

His mother says that Eddie's behavior has been difficulty since he was a toddler, and that as a 3 year old he was unbearably restless and demanding. He has always required little sleep and been awake before anyone else. When he was small, "he got into everything," particularly in the early morning, when he would awaken at 4:30 am or 5:00 am and go downstairs by himself. His parents would awaken to find the living room or kitchen "demolished." When he was age 4, he managed to unlock the door of the apartment and wander off into a busy main street, but fortunately, was rescued from oncoming traffic by a passerby. He was rejected by a preschool program because of his difficult behavior; eventually after a very difficult year in kindergarten, he was placed in a special behavioral program for first- and second graders. He is snow in a regular class for most subjects, but spends a lot of time in a resource room with a special teacher. When with is own class, he is unable to participate in games because he can not wait for his turn.

Psychological testing has shown Eddie to be of average ability, and his achievements are only slightly below expected level. His attention span is described by the psychologist as "virtually non-existent." He has no interest in TV, and dislikes games or toys that require any concentration or patience. He is not popular with other children, and at home prefers to be outdoors, playing with his dog or riding his bike.

If he does not play with toys, his games are messy and destructive, and his mother cannot get him to keep his things in order. and discuss the below diagnosis and treatment approach and give detailed critics:

"Differential Diagnosis:

• Attention-deficit/hyperactivity disorder (ADHD), combined type
• Oppositional defiant disorder (ODD)
• Conduct disorder (CD)
• Generalized anxiety disorder (GAD)
• Bipolar disorder (BP)
• Intellectual disability

Treatment Plan:

• Stimulant medication - start with methylphenidate (Ritalin) trial
• Start 10 mg ER PO qam, may increase by 10 mg/day q7 days; Max 60 mg/day
• May increase to BID not to exceed total daily max
• Parent management/training
• Educational intervention
• Psychotherapy - cognitive behavioral therapy (CBT)
• Optional: family counseling, support groups, mindfulness-based attention training, neurofeedback, child individual counseling, and traditional social skills training".