Client Name: Sam Williams Date:
I. Description of the Client
Sam Williams is a 4-year-old boy. He is an African-American who lives in the suburbs of New York City. Sam comes from a family of a lawyer and a homemaker.
II. Presenting Concerns and Symptomology
Sam’s parents have experienced a hard time raising up their child who has been unresponsive to simple orders. He was slower in development than her older sister. Some milestones such as crawling and sitting up alone were a problem. The response of his motor area would achieve uneven proportions with normal crawls for few days then no crawl at all for some time. Sam was late in developing speech and seemed not to understand anything his parents were telling him. He did not respond to simple requests. When forced to talk or understand, he would go into tantrums and what ensued was yelling and screaming while throwing himself to the floor.
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As time went, he started rapid hand movements which were repetitive and then would go on for several minutes. In some instances, he would roll his eyes continuously around the socket. Despite having no speech, Sam would make smacking sounds which would lead to loud outbursts of laughter for no apparent reason. Social development also elicited the attention of his parents as he would not look at them while touching him. Sam did not play with his sister and preferred lone games. He would not play the normal plays with toys as driving cars into a gas station. Instead, he would just rotate the wheels continuously. The ceiling fan was the only interest to Sam as he would sit there watching it spinning.
Using the DSM-V criteria, the client’s symptoms fit into the spectrum of Neurodevelopmental Disorders. In this section, the client faces a range of developmental challenges in the social and intellectual skills. Sam has a weird way of dealing with his family. He prefers to be alone which makes him want a sameness in watching the fan. He also has attention deficit. Given these disorders are frequent with pre-grade children, the client fits into the classification.
III. Cultural considerations
Brofenbrenner’s ecological model breaks down the development of a person into various factors that play important roles. The macro environment is one of the aspects in which the ecological systems affect the development of the child. Under this section, we have the cultural values, economic issues, and political views. The one that has the most effect among the three, in this case, is the cultural values. One of the cultural values that affect the family is the aspect of the source of income. The culture in which Sam lives in makes him not get the affection from the extended family as the nuclear one seem to get him bored. This scenario worsens the symptoms.
The client is likely to be living in a secluded or gated community with only his parents and the sister. The fact that his mother is a homemaker makes it easier to assess any unusual symptoms as she stays with him mostly. The father may be away most of the time though due to work. Also, the family is well-off financially and lives in better conditions of the suburbs. The father being a lawyer means that he can afford the treatment plan for his son thus would see an improvement in the way he receives the treatment.
IV. Treatment Goals and Plan
The first intervention is applied behavior analysis (ABA) ( Roane et al., 2016) . The purpose of this intervention is to provide an evidence-based approach to understand the behavior of the client and getting to know how it is influenced by the environment. During the treatment, the practitioner interviews the parents provides direct assessment and observes the child to identify the target behaviors that denies the child the chance to learn from the natural environment ( Hagerman, 2009) . The assessment will check on functional communication, noncompliance, toileting, social skills, and play and leisure time.
The second goal is speech therapy. In this intervention, the child will be assessed and treated on individualized speech and language (Insel, 2014). The parent will also be educated on the best practices. The assessment will continue up to twenty-two years of age. The expression and language therapy will address joint attention, expressive language skills, motor planning techniques, receptive language skills among others. This goal is aimed at offering speech therapy, alongside collaboration, and interdisciplinary treatment.
References
Insel, T. R. (2014). Mental disorders in childhood: shifting the focus from behavioral symptoms to neurodevelopmental trajectories. Jama, 311(17), 1727-1728.
Hagerman, R. J. (2009). Neurodevelopmental disorders: Diagnosis and treatment . Oxford University Press.
Roane, H. S., Fisher, W. W., & Carr, J. E. (2016). Applied Behavior Analysis as Treatment for Autism Spectrum Disorder. The Journal of pediatrics , 175 , 27-32.
