Thekli Case Study: Behavior Problems In School

Introduction first step to gather as much information as possible about the person and his or her problems and behavior. In this case, Clara a 4-year-old adopted girl is brought by her parents to see Dr. Mason because they have

I must begin by admitting that I was a little shocked by this case. Given the child’s participation in the Childhood Development Services system, and previous diagnosis I was floored that the parent was refusing to consent to evaluations which would ultimately aid in his/her growth and development. I was especially shocked when it was revealed that the child routinely put dangerous objects in their mouth, and could not go to the bathroom or eat lunch without assistance (Bangor School Department v. Parent, p. 4). As an administrator I would fully support the school’s decision to pursue legal action, however, there are a few details I would like to attend to.

A collateral interview was conducted with Rami Kaminski, the mother’s therapist. Dr. Kaminski reported that he sees the mother alone for individual treatment. He indicated that he has not seen her husband. Dr. Kaminski reported that he started seeing Ms. Englebardt for about 2.5 years, while she was still living with her husband. He reported that she wanted to be out of the marriage and felt unable to initiate the proceedings. The mother tried to communicate with her husband but he was uncooperative in communicating with her. There was no domestic violence however, she felt frightened of the husband. The mother reported that the father would shout at her, tell her she was lazy and not a good mother. He was extremely critical of her.

She reported that her mother changed, she started to “hit and yell”. Thekli stated when she was in the fourth grade, things got even worse. She indicated in the middle of fourth grade, her mother was hitting her and going “crazy”, Thekli stated that her mother was not “ok.” Thekli reported that she was supposed to do her own homework but her mother started doing her homework. The child reported that her mother would kick doors to get into our room to hit us more. Thekli reported that we locked the doors and mom took a knife to open the door. Every single day in fourth grade, mom began to hit her on the backside, but not hard (a pat). Thekli indicated that her mother did not hit her brother as much. She indicated that she did not hit her or her brother hard. Theli later stated at times her mother did hit both of children hard. Other than this with her mother was ok. Things were normal in the

Anna is a 30-year-old mother of Latino descent, who is a single mother of her daughter Elizabeth. Anna's husband and Elizabeth's father, John, was an officer in the U.S. Army, John died in the line of duty when Elizabeth was six. Anna and Elizabeth live in Rogers Arkansas, in a small two bedroom home. Anna is a single parent and works full-time as a Librarian. Anna depends on John's parents for help with Elizabeth, due to the face that Anna's family lives’ in Mexico. Anna has noticed some concerning behaviors about her daughter and has decided to take her to the local pediatrician, Dr. Johnson.

Ms. Jeffries is a sixteen-year-old Africa American male who is being referred for intensive in home services by his biological mother. Ms. Jeffries mother reported within the last thirty days he has exhibited the following psychiatric problems: often loses temper (3-5x weekly); easily annoyed (Daily); often argues with authority figures and adults (daily); and refuses to comply with simple rules and request (3-5x weekly). The above-mentioned symptoms are present in the home and school setting and have impacted Mr. Jeffries’s level of functioning at as evidenced by not being able to receive the necessary allotted hour in the classroom setting and impacted his ability to recognize personal danger which has resulted in pending legal charges. When

The case vignette that was assessed was about elementary school student named Charlie. Charlie’s biological factors include being 6 years old, African American, and male. It is unclear if Charlie was premature, and if his mother, Eloise, was taking prenatal care during the pregnancy, which are also a part of Charlie’s biological factors. In regards to the psychological facts, Charlie appears to be having challenges interacting with the other children. Additionally, he becomes easily irritated and distracted, cries when someone tries to correct his behavior, and constantly has tantrums. His usual bedtime and mealtime routine have changed since his mother is not always available to attend. The social factors consist of his mother, step-father, aunt, and newborn sister. Additionally, moving in with his Aunt Eleanor and his school are social factors. Due to his mother, Eloise, having depression, she was in psychiatric hospitalization for a while. After her release, Charlie moved with his aunt in order for Eloise to spend time trying to recover from her depression. Ever since he moved with Aunt Eleanor, Charlie’s developmental factors have changed. Prior to moving with his aunt, Charlie was an actively involved child who was extremely social and reached his developmental milestones at an expected rate, as well as possessing amazing language and social skills.

Case manager called pt’s mother at 7:50am, as we agreed in our previous conversation with Dr. Kleinman. The patient's mother reported that she was functioning well, and she and the patient were getting ready to go to school. Case manager reinforced the patient's mother, if she has any difficulties please contact her in order to support her. Case manager also tell her that Dr. Kleinman is waiting for her at the schools to offer her support as well. Patient and family continue to be open to receiving support from case manager. HBCI will continue to work with patient and mother on exposures around school and social anxiety.

The clinical team concluded the observation and disclosed the A-B-C narrative collected with his parents, as well as some of the behaviors observed. The duration of this observation was for approximately one hour and 50

The reporter received a text message from another student at the school; the child alleged that Darren had threatned to commit suicide. The victim has no known plan or history of acting on his threats. Ms. Cleveland was called to the school and came to pick the child up with plans to take him to St. Francis Hospital for evaluation. When contacted later, Ms. Cleveland stated she'd changed her mind and would not be taking the child in. When asked about his suicidial ideation, Darren would not disclose his reeasoning. The vicimt's basic needs appear to be met but Darren has prior history of violent behaviors. Darren has never acted out or had a violent temper while at school. Mr. Flowers is unsure if a decision will be made in regards to the

Due to the child’s age and developmental stage, the history was obtained from asking the mother a combination of open and closed questions, the open questions allows the parent time to speak, as this may reveal many issues without having to ask specific questions (Bedwani et al. 2011). Duderstadt (2014)

The mother reported that the issue of mental health for Rafi was discussed in court prior to enrolling the child. The mother stated that the father was aware that the child was being placed in treatment. She indicated the father disagreed and treatment was delayed until the Court intervened and directed that treatment to start. In contrast, the father reported that he was unaware of the child’s treatment. He indicated that he learned that Rafi was in therapy three months ago at court. Mr. Solstein reported that the therapist wrote a letter to court indicating that the child should not have contact with the father. Mr. Solstein reported that he wanted to be involved in family therapy but is concerned that the current therapist has taken a position that the child should not be with him based on information from the mother.

The worker contacted Mr. Byars and provided her a brief update on the conversation with Dr. Lovelace and Ondria recommendations. Mrs. Byars agreed and stated that she will put off the trip to Germany until the services are completed. According to Mrs. Byars, she is residing with a family friend who is very supportive. The worker advice Mrs. Byars to enroll in services along with taking time to do self-care, and while balancing work/family. Mrs. Byars told the worker, she went ahead and enrolling in parenting class. She said Mrs. Zimmerman will do in home parent with her and give her strategies how to cope a deal with stresses that comes with

REPORTER: The reporter/School Counselor (Elizabeth) called to report abuse for the victim, Jaylon. According to Elizabeth, on yesterday (10/14/2015), the child tried to steal an ipad and put in his backpack. The reporter told the child “you made a bad choice” and that his mother would be notified about the incident, and he said “whatever you do, don’t tell my mom”. The teacher contacted the mother and told her about the incident. On today (10/15/2015), the reporter noticed that the child had marks on his body; the reporter said his “mother beat him”. There were marks on the child’s face and nose; his lips were puffy and he had a black right eye. There were extension cord marks on the child’s forehead and on his back (2 marks/ broken skin).

Discussion: Ms. Calandria reported that Devon behavior at school and home is "stable." She said that his grade is improving, he is able to engage and respond to questions appropriately. She said that the improvement in his intellectual wellness has been " a big step in the right direction." Ms.Calandria expressed her displeasure with Devon's pediatrician, she said that the wait for an appointment is long, as a result, devon is out of medication. Ms.Calandria stated that she is the process of changing his pediatrician.