Unit 3 Discussion

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Identify and discuss three similarities and differences between attention deficit hyperactivity disorder and oppositional defiant disorder: Although Attention-Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) share some similarities, there is also some differences between the two disorders. One similarity between the two disorders is that symptoms must be present for at least 6 months to meet criteria for a diagnosis (APA, 2022). Another similarity for both ADHD and ODD is that it is more prevalent in males than females (APA, 2022). Both disorders also begin to show symptoms during childhood (APA, 2022). However, ADHD is most often identified when a child is in their elementary school years, due to inattention becoming more evident during this time. ODD symptoms, on the other hand, begin to show during preschool years (APA, 2022). An individual must exhibit 6 or more symptoms of inattention and/or hyperactivity and impulsivity to meet the criteria for ADHD, while individuals only have to meet 4 symptoms of angry/irritable mood, argumentative/defiant behavior, and/or vindictiveness to meet criteria for ODD (APA, 2022). Another difference between the disorders is that ADHD symptoms must be present in more than one setting, while ODD symptoms can be present in only one setting to meet criteria for diagnosis (APA, 2022). Formulate a diagnostic impression for Tommy with coding and specifiers from the DSM-5. Explain your answer in terms of how he meets the diagnostic criteria for the disorder or disorders that you gave: My diagnostic impressions for Tommy would be F90.2 Attention-Deficit/Hyperactivity Disorder, combined presentation, with moderate severity. Tommy meets 6 or more symptoms of inattention as well as hyperactivity and impulsivity. The symptoms he meets for inattention are as follows:  Tommy often makes simple mistakes on assignments that can be easily avoided if he would take his time and not rush.  Tommy has difficulty staying on task, is disorganized in his work, and easily loses track of what he’s working on.  Tommy’s mother stated that he often does not seem to listen when given directions at home.  In his after-school program, Tommy prefers to engage in unstructured, outdoor activities rather than any activity that requires mental effort.  Tommy’s psychologist also noted some of these symptoms during his evaluation, such as losing focus and forgetting the sequence of steps for a task he was asked to complete. Tommy also exhibits several symptoms for hyperactivity and impulsivity, such as:  Squirming in his seat during his psychological evaluation.  Constantly getting up out of his seat during class.  Constantly running around his home and he climbed up the stairs using the banister.  Blurting out answers during class and not being to engage in leisure activities with his peers, such as singing a completely different song as everyone else in his after-school program.  Being eager to “go home” during his psychological evaluation.  Having trouble taking turns with his peers in class.

Although the psychological evaluation did not specify a timeframe of at least 6 months in order to formulate a diagnosis, the incident where he sprained his wrist by climbing up the stairs using the banister instead of the stairs was stated to be one year ago. Therefore, we can infer that these symptoms have been present for at least 6 months. I would also diagnose Tommy with F91.3 Oppositional Defiant Disorder, severe. According to the psychological evaluation, Tommy meets at least 4 or more symptoms for this diagnosis. Tommy ‘s mother described him as being angry and does not listen to directions at school or at home. Tommy can also be said to deliberately annoy others by his statement that he cannot wait to go home to fight with his sister. In his after-school program, Tommy blamed another student for biting him first when it was clear that he was the aggressor. Tommy would fall under sever ODD due to exhibiting these symptoms in three or more settings: home, school, and after-school program. What are one or two differential diagnoses that you considered for Tommy and what helped you to rule them out? A diagnosis I initially considered for Tommy was intellectual developmental disorder. However, I was able to rule this out due to the fact that Tommy’s symptoms are also present in nonacademic settings (APA, 2022). What diagnosis or diagnoses would you diagnose Tommy with? Discuss your diagnosis or diagnoses by specifically detailing how his behavioral and cognitive symptoms for each diagnosis meet the diagnostic criteria: I would diagnose Tommy with Attention-Deficit/Hyperactivity Disorder, combined presentation, with moderate severity. Tommy meets 6 or more symptoms to meet criteria for this diagnosis, as detailed above. Behaviorally, Tommy exhibits being unable to sit still, running around, interrupting others, unable to take turns, blurting out answers, and displaying aggressive behaviors towards others. Cognitively, Tommy is unable to focus in school, has trouble finishing tasks, is described as disorganized, and would rather engage in activities that do not require his mental effort. Why is it important to refer clients to a psychiatrist or nurse practitioner for a medication evaluation instead of making one yourself? It is imperative to make a referral to a psychiatrist or nurse practitioner for a medication evaluation for the simple fact that I, as a master’s level counselor, do not hold the credentials or training to do so. Although I can formulate diagnoses and develop a treatment plan for my clients, at times a disorder can be better treated via medication management. Using 1-2 scholarly sources, how would Tommy’s behavior be responded to in a school setting depending on his racial identity? A study conducted in 2014 shows that 70% of Black children in the United States were less likely to be diagnosed with ADHD in comparison to White children (Morgan et al., 2014). This study also revealed that Hispanic children were likely to be underdiagnosed for ADHD (Morgan et al.,

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