Order ID:89JHGSJE83839 | Style:APA/MLA/Harvard/Chicago | Pages:5-10 |
Instructions:
BACKGROUND
Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katies teacher suggested that she may have ADHD. Katies parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.
The parents give you a copy of a form titled Conners Teacher Rating Scale-Revised. This scale was filled out by Katies teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work.
Katies parents actively deny that Katie has ADHD. She would be running around like a wild person if she had ADHD reports her mother. She is never defiant or has temper outburst adds her father.
SUBJECTIVE
Katie reports that she doesnt know what the big deal is. She states that school is OK- her favourite subjects are art and recess. She states that she finds her other subjects boring, and sometimes hard because she feels lost. She admits that her mind does wander during class to things that she thinks of as more fun. Sometimes Katie reports I will just be thinking about nothing and the teacher will call my name and I dont know what they were talking about.
Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time.
MENTAL STATUS EXAM
The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katies attending to the clinical interview and her ability to count backwards from 100 by serial 2s and 5s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation.
Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation
RESOURCES
§ Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.
Decision Point One
Begin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING
RESULTS OF DECISION POINT ONE
· Client returns to clinic in four weeks
· Katies parents report that they spoke with Katies teacher who notices that her symptoms are much better in the morning, which has resulted in improvement in her overall academic performance. However, by the afternoon, Katie is staring off into space and daydreaming again
· Katies parents are very concerned, however, because Katie reported that her heart felt funny. You obtain a pulse rate and find that Katies heart is beating about 130 beats per minute
Decision Point Two
Select what you should do next:
Change to Ritalin LA 20 mg orally daily in the MORNING
RESULTS OF DECISION POINT TWO
· Client returns to clinic in four weeks
· Katies academic performance is still improved, and the switch to the LA preparation is lasting Katie throughout the school day
· Katies reports of her heart feeling funny have gone away. Pulse was 92 during todays office visit
Decision Point Three
Select what you should do next:
Maintain current dose of Ritalin LA and re-evaluate in 4 weeks
Guidance to Student
At this point, Katies symptoms are well controlled (her attention is sustained throughout the school day) and her side effects have gone away following change to a long-acting preparation. There is no indication at this point that the dose should be increased as it is always advisable to use the lowest effective dose of stimulant medication. Katies heart rate is appropriate for an 8 year old girl and an EKG would not be indicated based on her heart rate.
RUBRIC |
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Excellent Quality 95-100%
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Introduction
45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned. |
Literature Support 91-84 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned. |
Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met. |
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Average Score 50-85% |
40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided. |
83-76 points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration. |
52-49 points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met. |
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Poor Quality 0-45% |
37-1 points The background and/or significance are missing. No search history information is provided. |
75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration. |
48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met |
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