WK3Assgn_DiToto_A

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1 Case study: Diego Amy DiToto Department of Social Work, Walden University SOCW 6090: Psychopathology and Diagnosis for Social Work Dr. Michael Lloyd December 20, 2023

2 Attention Deficit/Hyperactivity Disorder, Predominantly Inattentive Type Diagnostic Criteria 314.04 (F90.0) A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2): 1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).  This is evidenced by Diego’s grades not matching his intellectual ability. He received poor grades, despite knowing the answers if he is called upon, as he does not retain information that he reads. This results in missing or overlooking important information and inaccurate written work. b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).  Diego has difficulty focusing on tasks in school, with his tutor, and on chores. Diego’s mother explained that he becomes distracted when completing chores and does not complete them. She also stated he loses focus with his tutor. Diego also shared that he is unable to retain what he had read, but can comprehend the material. Diego’s difficulty

3 focusing was also evidenced by his getting off-topic during the assessment and needing to be redirected. c. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).  Diego has difficulty completing assignments in school as well as chores. Diego’s mother noted that he becomes distracted and does not finish his assigned chores. He also stated he has difficulty completing his work, even when he knows and can verbalize the correct answers. d. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).  Diego stated that he has difficulty organizing his thoughts in order to get them on paper. He said, “I just stare at the page and nothing comes out,” and that he “just couldn’t get organized.” Additionally, Diego’s difficulties organizing his thoughts cause him to turn in incomplete assignments or to miss deadlines. e. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).  This is evidenced by Diego losing the papers on which he writes down his assignments.

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4 f. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).  Diego’s mother stated that he sometimes forgets to complete the chores he is assigned. Diego also forgets that he has assignments which causes them to be incomplete. 2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: a. Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.  Diego has had difficulty with inattentive symptoms since he was in 3 rd grade (8-9 years old). Diego has had difficulty completing assignments and keeping up with work every year since 3 rd grade. b. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings, (e.g., at home, school or work; with friends or relatives; in other activities).  Diego has difficulty focusing on tasks in school and at home. He has difficulty completing school work, homework, and chores, sometimes forgetting to complete them. c. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

5  Prior testing indicates that Diego is of above-average intelligence; however, his report card grades do not reflect his intellectual abilities. Diego is struggling academically, and his parents stated that his grades are not increasing despite attempts to help improve his grades and ability to focus. d. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).  There is no current evidence that Diego suffers from schizophrenia or another psychotic disorder. There is no family or client history of mental illness, he denies experiencing hallucinations or delusions, and stated there has been no substance use. Diego does not display any behavioral problems. Diego has enough symptoms in the inattention criteria; however, he only meets four of the six needed in the hyperactivity diagnostic criteria. As such, Diego is diagnosed with Attention-Deficit/Hyperactivity Disorder, Predominantly inattentive presentation as he has enough symptoms of inattention, but not hyperactivity- impulsivity, and symptoms have been present for the past 6 months. His symptoms are moderate as they impair his functioning in school and at home. Differential diagnosis and exclusions At the onset, I considered an intellectual disability or specific learning disorder. I ruled out intellectual disability as Diego has been tested to have above-average intelligence and does

6 not appear to have difficulty with abstract thinking. Diego is able to retain information when there is a lecture, and provide the right answer; however, he is unable to focus on material he reads which prevents him from retaining the information. A specific learning disability was also ruled out as Diego’s academic skills are not below what is expected; his inability to organize his thoughts and to focus prevent him from expressing the knowledge and skills he possesses. Culture Diego is the child of Cuban immigrants which impacts their views on Diego and his challenges. The parents noted that Diego’s behaviors reflect on them and give the impression that he is poorly behaved due to lack of parental discipline. His parents were also embarrassed to seek help, so there may have been a delay in seeking assistance due to their cultural belief that Diego just needed parental intervention. Likewise, Diego expresses sadness at disappointing his parents and are concerned about the stress this places on Diego. Despite their hesitation, they elected to seek help. Z codes and rationale Z55.9 Academic or Educational Problem. Z55.3 Underachievement in school. These Z codes are both evidenced by Diego’s academic performance not matching his intelligence level. He has tested with above-average intelligence, but his grades do not reflect this, and they are much lower than anticipated for someone of his intelligence.

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