A Case Study: Cartercarter Was Initially Referred For Possib

A Case Study Cartercarter Was Initially Referred For Possible Special

A Case Study Cartercarter was initially referred for possible special education services in a first-grade compensatory classroom at Browning Elementary School. The compensatory class, a district Tier II intervention, served students who had not reached the criterion score for first-grade placement on the district readiness test. This classroom had only 15 students and was served by a teacher and a full-time aide. Carter was referred by his mother, who had many concerns about her son. She noted that his progress seemed slow, that he not only had problems with academics but had a lot of trouble paying attention, was impulsive, and had poor motor control.

Carter's teacher concurred with the mother's concerns. Carter was having very little success in the classroom and was constantly in motion. This had become a problem even in this developmentally appropriate, alternative first-grade program. He was easily distracted and had trouble delaying gratification. He was impatient and gave up easily. He was easily discouraged, and he complained that he did not have any friends. His teacher reported that Carter voiced fears that were "unusual" for this age group. Carter was the younger of two children. He had been a large baby (10 pounds at birth), and the pregnancy had been complicated by high blood pressure and toxemia. However, no adverse effects were noted after the birth.

His mother described Carter as a clumsy child, with repeated falls and bumps. Normal developmental milestones were somewhat delayed. He did not crawl until he was 8 months old or walk until he was 2. Speech development was interrupted by a loss of hearing at 18 months due to ear infections. The speech and language evaluation, done at the time of referral, confirmed difficulty with some sound frequencies, and it confirmed deficits in speech and communication skills.

Carter was taking Ritalin twice a day, prescribed by his pediatrician for attention and hyperactivity problems (ADHD). Even so, Carter's mother described him as a creative, sensitive, and generally happy child. At age 6½, Carter was evaluated by the school psychologist, who noted that Carter was able to concentrate more easily on tasks that involved manipulation of objects but was very distracted in auditory tasks. He needed encouragement and reinforcement to sustain effort during the testing.

The results indicated the following: WISC-IV (measure of intellectual functioning): Full Scale IQ: 105; Composite scores: Verbal Comprehension 102; Perceptual Reasoning 109; Working Memory 95; Processing Speed 110. Carter also achieved a standard score of 105 (63rd percentile) on the Peabody Picture Vocabulary Test, a measure of receptive language ability, which indicated age-appropriate receptive language skills consistent with the WISC-IV results.

Carter was given two measures of academic achievement: Diagnostic Achievement Battery-3 (reading: 109, math: 94), and the Wide Range Achievement Test (WRAT-4): Reading composite score 112, Word reading 113, Sentence comprehension 110, Spelling 108, Math computation 103. The multidisciplinary team concluded that Carter was a student of average intelligence with no significant strengths or weaknesses. Based on state guidelines, he did not qualify for special education at that time.

Carter continued to second grade, on Ritalin, with classroom teachers sensitive to his needs. He continued to show socialization problems and difficulties getting along with peers. In third grade, he moved schools but returned to Browning Elementary in fourth grade, where he was often in trouble. His medication was at the highest dose, but his behaviors persisted, including unwarranted fears and obsessions with violence. Math skills declined further, and he exhibited increased emotional and behavioral issues both at school and at home.

In January of that year, he was placed in a resource room under the new eligibility of "other health impaired" because of ADHD. He also received counseling at a community mental health clinic. His attention issues were particularly problematic during transitions, especially before medication effects took hold. During this period, Carter was weaned off Ritalin for a planned brain scan; as his medication was discontinued, his attention declined sharply, and academic engagement was impossible.

Subsequent evaluations by the school psychologist indicated that Carter’s issues extended beyond ADHD to significant emotional problems. His inability to distinguish reality from imagination, fears of crowds, and stories about violence suggested underlying emotional or behavioral disorder issues. Despite medication, behaviors continued unchanged, correlating with persistent emotional problems rather than purely attentional deficits.

In April, the multidisciplinary team reconvened with Carter’s mother to determine the best placement and intervention strategies. It was evident that Carter’s ongoing struggles were primarily emotional/behavioral rather than purely cognitive or attention-based. The team debated whether to place him in a special class for emotional or behavioral disorders or to continue in the general education setting. The consensus was that his emotional issues were central, and a more intensive, supportive, self-contained environment might facilitate progress.

The team’s decision was driven by the desire to address core emotional and behavioral difficulties with specialized interventions, with the hope that this environment would foster both emotional stability and academic development. Despite previous medication and interventions, Carter's complex profile underscored the importance of tailored, multisystem approaches to special education and behavioral health.

Paper For Above instruction

The case of Carter Carter exemplifies the complex interplay of cognitive, behavioral, and emotional factors that influence educational functioning. His early developmental history, characterized by delayed milestones, hearing impairments, and difficulties with motor skills, suggests a profile with multiple overlapping issues. These early challenges are often indicative of neurodevelopmental vulnerabilities that can predispose children to later behavioral and emotional difficulties, especially when compounded by environmental and medical factors.

Carter’s initial evaluation revealed average intelligence, with a Full Scale IQ of 105, and age-appropriate receptive language skills. Despite intellectual strengths, his academic performance was inconsistent, particularly in areas requiring sustained attention and emotional regulation. This discrepancy underscores a common phenomenon in students with neurodevelopmental and emotional difficulties: cognitive capacity may be intact or above average, but emotional and behavioral regulation challenges often hinder academic progress.

The role of ADHD in Carter’s case was significant but not exclusive. His medication, Ritalin, provided some behavioral and attentional benefits but failed to address underlying emotional issues. The persistent behavioral problems, fears, and stories about violence point towards a probable emotional or behavioral disorder. This distinction is critical for educational planning because interventions for attention deficits differ from those targeting emotional and behavioral regulation (Barkley, 2015).

Research suggests that children with comorbid ADHD and emotional disorders—such as anxiety or conduct problems—require integrated interventions targeting both areas (Mikami et al., 2017). Carter’s behavior episodes, including difficulty transitioning, unwarranted fears, and storytelling about violence, highlight the emotional component that medication alone could not remediate. Moreover, his inability to distinguish reality from imagination raises concerns about potential underlying trauma or more profound emotional disturbances.

His placement history further illuminates the need for a supportive educational environment attuned to emotional and behavioral needs. Initially placed in a compensatory classroom, Carter’s persistent difficulties and changing diagnoses prompted a move to a resource setting designated as "other health impaired" due to ADHD. However, the core emotional issues remained unaddressed, emphasizing that placement alone is insufficient without targeted, comprehensive intervention.

The decision to consider a specialized classroom for emotional and behavioral disorders (EBD) reflects a broader understanding of best practices in special education. Such environments offer structured behavioral supports, social skills training, and counseling interventions to manage emotional dysregulation and reduce disruptive behaviors (Connor et al., 2019). Evidence indicates that these settings, coupled with mental health services, can significantly improve social-emotional functioning and academic outcomes for children like Carter (Sullivan et al., 2018).

Carter’s case underscores the importance of a multidisciplinary approach. Medical, psychological, and educational assessments, alongside family involvement, are essential to formulating individualized education programs (IEPs) that address the unique constellation of needs. Furthermore, ongoing monitoring and flexible interventions are vital, especially given the dynamic nature of emotional and behavioral conditions (Bruder et al., 2020).

Considering Carter’s trajectory, it becomes evident that early identification and intervention are crucial. Children demonstrating delayed developmental milestones, listening difficulties, and behavioral challenges should be monitored closely for emerging emotional or psychiatric disorders. Interventions should be holistic, encompassing behavioral therapy, social skills training, and, when necessary, psychiatric treatment (Reid et al., 2021). Such proactive approaches can alter developmental trajectories, reduce frustration and emotional distress, and support meaningful academic and social success.

In conclusion, Carter’s case highlights that effective support for students with complex profiles must go beyond academic accommodations. It requires an integrated, multidisciplinary approach that prioritizes emotional well-being alongside cognitive and behavioral interventions. Educational environments capable of addressing emotional disorders and promoting social emotional learning (SEL) are essential to fostering resilience, improving behavior, and enabling academic achievement. Tailoring interventions to meet these needs is critical for ensuring that children like Carter can thrive both academically and emotionally.

References

• Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Publications.
• Bruder, M. B., et al. (2020). Multidisciplinary approaches to emotional and behavioral disorders in children. Journal of Special Education, 54(3), 143-156.
• Connor, D. J., et al. (2019). Educational interventions for students with emotional and behavioral disorders. Remedial and Special Education, 40(3), 153-165.
• Mikami, A. Y., et al. (2017). Co-occurring emotional disorders among children with ADHD. Journal of Clinical Child & Adolescent Psychology, 46(4), 562-574.
• Reid, R., et al. (2021). Early intervention strategies for emotional and behavioral disorders. School Psychology Review, 50(2), 188-203.
• Sullivan, A. L., et al. (2018). Impact of behavioral supports on academic and social outcomes. Exceptional Children, 85(2), 193-209.
• Raymond, E. B. (2020). Characteristics of learners with mild disabilities: A behavioral approach. Pearson Education.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• National Institute of Mental Health. (2022). Attention-Deficit/Hyperactivity Disorder (ADHD). NIH Publication.
• Walker, H. M., et al. (2015). The social development intervention: An effective response to emotional and behavioral challenges. Journal of School Psychology, 63, 125-137.