ABC/123 Version X 1 Eddie Case Study Worksheet CCMH/522 Vers
ABC/123 Version X 1 Eddie Case Study Worksheet CCMH/522 Version
Provide the medication name, the dosage you would recommend, and what time of day you would suggest the medication be taken.
What are some special considerations or ethical concerns that you may encounter when using pharmacological treatment with children and older adults?
Explain the rationale behind your decision.
Would you recommend hospitalizing the client in this case? Explain the rationale behind your decision.
What alternative treatments might you recommend for this client to address the reported problems? What alternative medications might you suggest?
Identify the primary side effects of concern you would address with this client.
What primary presenting problems do you see in this case study?
What would be your DSM-5 diagnosis of this case?
Paper For Above instruction
Eddie, a nine-year-old boy, presents with significant behavioral problems that interfere with his functioning in school, at home, and in social settings. His primary presenting problems include extreme hyperactivity, impulsivity, difficulty maintaining attention, restlessness, and disruptive behaviors such as wandering during class and swinging from light fixtures. These behaviors have persisted since early childhood, with evidence of poor impulse control, difficulty sleeping, and a tendency to engage in risky activities like wandering into traffic. His behavior challenges the classroom environment and necessitated special educational services and behavioral interventions.
The DSM-5 diagnosis most consistent with Eddie’s presentation is Attention-Deficit/Hyperactivity Disorder (ADHD), predominantly hyperactive-impulsive presentation. This diagnosis aligns with his history of pervasive hyperactivity, impulsivity, and inattentiveness, alongside observable behaviors such as fidgeting, difficulty sitting still, and impulsive acts like climbing and swinging from fixtures. The severity and early onset further support this diagnosis.
Regarding pharmacological treatment, a stimulant medication such as methylphenidate could be appropriate. A typical starting dose might be 10-20 mg administered in the morning to manage daytime symptoms. The medication should be taken early in the day to minimize sleep disturbances. An alternative could be amphetamine-based medications, adjusted based on response and side effects. Medication management should include regular follow-up to monitor efficacy and adverse effects.
Primary side effects of concern include appetite suppression, sleep disturbances, and potential mood irritability or tics. Monitoring for any exacerbation of behavioral problems, worsening sleep patterns, and physical side effects such as increased heart rate or blood pressure is essential. Given Eddie’s age and history, assessing for medication tolerance and effectiveness is critical.
Hospitalization is generally not indicated unless there is a risk of harm to Eddie or others, such as his wandering into traffic or potential for injury from impulsive behaviors. In this case, outpatient management with behavioral interventions and caregiver support is preferable, with hospital admission reserved for acute safety concerns that cannot be managed outpatient.
Alternative treatments include behavioral therapy, parent training programs, and classroom accommodations, such as preferential seating and structured routines. Pharmacological alternatives could involve non-stimulant medications like atomoxetine or guanfacine if stimulant medications are poorly tolerated or ineffective. These options may reduce side effects and target impulsivity and hyperactivity more specifically.
Concerns regarding medication use in children include ethical considerations such as informed consent, balancing benefits and risks, and monitoring for adverse effects. Ethical issues also involve ensuring that medication does not replace behavioral interventions but complements them, and respecting the child's developmental stage and capacity to assent.
In conclusion, Eddie’s case exemplifies the complex interplay of behavioral, developmental, and safety concerns associated with ADHD. A comprehensive treatment plan combining medication, behavioral therapies, and environmental modifications is essential to improve his functioning and safety. Ethical and developmental considerations guide careful medication management and supportive interventions to ensure his best interests are prioritized.
References
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
- Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Publications.
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- Gonzalez, P., et al. (2020). Behavioral and pharmacological interventions for ADHD in children. Psychiatric Clinics of North America, 43(3), 459-472.
- Kollins, S. H., et al. (2018). Safety and efficacy of stimulant medications in children with ADHD. Journal of Child and Adolescent Psychopharmacology, 28(8), 526-535.
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- Subcommittee on Attention-Deficit/Hyperactivity Disorder. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of ADHD. Pediatrics, 144(4), e20192528.