WHAT IS THE PRIMARY DIAGNOSIS FOR THIS CASE STUDY? (HELPS TO USE THE DSM) Jessie is an 8-year-old boy in a local public elementary school. He is in the first grade and is one of the older students in his class. He is an only child. His mother works for the county and his father is a foreman in a local factory. During the interview session, Jessie was quite active; fidgeting with his hands, rubbing his head, waving his arms, and constantly into everything. He displayed an appropriate affect and would frown frequently with narrowed eyes when he made eye contact. He was dressed in jeans and a t-shirt with no laces in his shoes and his jeans were bunched up around his heals. His mother presented with an appropriate affect, was pleasant, appropriately dressed, but did not smile much. A review of Jessie’s school records reveals that he has periods of time when he behaves well, usually in the morning, but by the afternoon he reportedly often “acts out” and has emotional outbursts in the classroom, which tend to be violent. Due to the violent nature of his outbursts, the school has provided him with a full time aide. Since then, his behavior has improved, but is still problematic. Jessie was initially referred by his school principal who reports that Jessie’s problems get worse when he does not have his aide. The principal would like to know Jessie’s diagnosis to see if it justifies the continued cost of an aid. Jessie reportedly had developmental delays and emotional problems shortly after the age of one. He was hospitalized for a period of time and attended an early childhood intervention program. His father abandoned him and his mother when she was pregnant. After his birth, his mother was increasingly unable to care for him. Eventually, child protective services took him away from his mother and placed him in foster care until the age of 5, when he was adopted. Jessie’s adoptive parents are well able to support him and are described as warm and caring. They report that he generally behaves better in the home environment. However, his mother reports that he is fascinated with fire and flames and that he likes to break glass. He has broken three windows in the neighborhood in recent months, which he describes as accidents. Jessie has a number of medical problems. He wears glasses and initially had problems in school until his vision problems were corrected. He has had recurring ear infections and had tubes inserted into her ears when he was 5 years of age. He had an emergency appendectomy at the age of six. Jessie’s father reportedly beat his mother during her pregnancy. His mother also reportedly used alcohol during her pregnancy. There is a family history of learning disabilities. Jessie’s teachers also report that he frequently gets in fights at school. Jessie justifies this by saying that he only hits and bites after others pick on him. However, his teachers report that he hits other children, even when they are not picking on him. His self-control worsens in the afternoon, especially after recess. Psychological assessment revealed speech abilities at a 5-year-old developmental level, and writing skills at the first grade level. His aide needed to present during two of the testing sessions to keep Jessie calm and on tasks. At one point during the assessment, he threw the testing materials at the examiner.
WHAT IS THE PRIMARY DIAGNOSIS FOR THIS CASE STUDY? (HELPS TO USE THE DSM)
Jessie is an 8-year-old boy in a local public elementary school. He is in the first grade and is one of the older students in his class. He is an only child. His mother works for the county and his father is a foreman in a local factory. During the interview session, Jessie was quite active; fidgeting with his hands, rubbing his head, waving his arms, and constantly into everything. He displayed an appropriate affect and would frown frequently with narrowed eyes when he made eye contact. He was dressed in jeans and a t-shirt with no laces in his shoes and his jeans were bunched up around his heals. His mother presented with an appropriate affect, was pleasant, appropriately dressed, but did not smile much.
A review of Jessie’s school records reveals that he has periods of time when he behaves well, usually in the morning, but by the afternoon he reportedly often “acts out” and has emotional outbursts in the classroom, which tend to be violent. Due to the violent nature of his outbursts, the school has provided him with a full time aide. Since then, his behavior has improved, but is still problematic. Jessie was initially referred by his school principal who reports that Jessie’s problems get worse when he does not have his aide. The principal would like to know Jessie’s diagnosis to see if it justifies the continued cost of an aid.
Jessie reportedly had developmental delays and emotional problems shortly after the age of one. He was hospitalized for a period of time and attended an early childhood intervention program. His father abandoned him and his mother when she was pregnant. After his birth, his mother was increasingly unable to care for him. Eventually, child protective services took him away from his mother and placed him in foster care until the age of 5, when he was adopted. Jessie’s adoptive parents are well able to support him and are described as warm and caring. They report that he generally behaves better in the home environment. However, his mother reports that he is fascinated with fire and flames and that he likes to break glass. He has broken three windows in the neighborhood in recent months, which he describes as accidents.
Jessie has a number of medical problems. He wears glasses and initially had problems in school until his vision problems were corrected. He has had recurring ear infections and had tubes inserted into her ears when he was 5 years of age. He had an emergency appendectomy at the age of six. Jessie’s father reportedly beat his mother during her pregnancy. His mother also reportedly used alcohol during her pregnancy. There is a family history of learning disabilities.
Jessie’s teachers also report that he frequently gets in fights at school. Jessie justifies this by saying that he only hits and bites after others pick on him. However, his teachers report that he hits other children, even when they are not picking on him. His self-control worsens in the afternoon, especially after recess.
Psychological assessment revealed speech abilities at a 5-year-old developmental level, and writing skills at the first grade level. His aide needed to present during two of the testing sessions to keep Jessie calm and on tasks. At one point during the assessment, he threw the testing materials at the examiner.
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