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Steven is an 11-year-old Asian American boy . He is an only child. Steven was referred to you by his school counselor. Despite the modifications and accommodations provided by his school, Steven continually struggles academically and socially. Steven's parents report that his inattention and academic frustration lead to classroom failure, poor self-image and behavioral difficulties which mom tells you began in the 3rd grade. Steven has had a hard time in reading and understanding social situations that resulted in him being bullied and feeling tremendous anxiety in social settings. He struggles with feelings of social isolation and being looked at as "odd." Dad tells you that Steven has daily visits to the nurse with complaints of stomach aches and headaches. Academically, Steven is a fluent reader who struggles with comprehension and inferencing and performs as developmentally immature for his age. Steven and his family struggle with his academic ability and his poor classroom performance leading to a decline of emotions and behaviors that interfered with everyday functioning in school, at home and with his peer groups. Dad tells you that he is disappointed that his son cannot manage his emotions and succeed academically. Mom, on the verge of tears, asks you to please help her son.
1. What are some initial diagnostic thoughts for Steven? Discuss how you would formulate a differential diagnosis assessment of Steven. Given the information you have in the vignette, what further information might you need and why? Consider age, gender, culture, socioeconomic status, genetics and familial influences.
2. Given the vignette information and your diagnostic thoughts in question 1, create an intervention plan for Steven. What treatment considerations would you incorporate in your treatment plan? Other questions to consider in your response are: Would you work with Steven individually? How would you include the parents? What are the pros and cons of family therapy in this case? With whom and how would you collaborate with the school for continuity of care? What suggestions could you offer with regard to behavior management at home and at school?
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