CCMH/504 v6 Case Study: Ian CCMH/504 v6 Case Study: Ian Ian is a 7-year-old male, just finishing first grade. He reportedly does not pay attention in class, often disturbs the class when he is talking out loud, and doesn’t follow directions. When he is asked to quiet down or pay attention, he does it momentarily and then goes back to his same behavior. When he has to “turn a card†(a green/yellow/red system for behavior at school), he will be upset, sometimes tearful, will throw things off his desk, and has even tipped his chair over. He will then lay on the floor and be noisy or loud. Regarding school subjects, Ian does poorly in reading and spelling. He is good at math and likes numbers. He likes to draw. At home, Ian is the oldest of three children. He has a 4-year-old sister and a 2-year-old brother. He is living with his single mother and a friend that she met while in the women’s shelter. Ian’s mother called the shelter after a particularly violent beating by her husband. He had brought Ian and his siblings to the living room and had them watch as he beat on Ian’s mom, choked her, and threatened to kill her. Ian was 5 1/2 when this event happened. His mother had Ian call 911 after the dad had left and then they went to a shelter. They were in the shelter for about 6 months. His dad was arrested for domestic violence and he hasn’t seen his dad since that time. Ian was close to his dad and they often wrestled, played football, and played catch together. Ian’s dad favored Ian, taught him to be a “man’s man,†and ignored Ian’s siblings. Ian’s mom reported that she had been with her husband since she was 16, and he was physically, verbally, and emotionally abusive the entire time. She also stated that he had a drug and alcohol use disorder, had trouble maintaining a job, and lost many of his relationships with friends because he was “hot-tempered.†Ian picks on his little sister and often calls her names. He pushes her around and hits her. He disrespects his mother and calls her names as well. He is good to his little brother and doesn’t show any violence towards him. He is also good to the female roommate who lives with them and takes care of Ian and his siblings while his mother is working. Ian’s mother is gone most days for at least 10 hours working as an assistant manager in a retail store. When Ian is with the roommate, he is more respectful, and he talks to her at great length and tells her how he feels. He doesn’t do that with his mother, and it appears that he tries to make his mother angry. Recently Ian’s moodiness has become worse. At school he is throwing more tantrums, getting into physical fights with his classmates, and is violent towards them on the playground. He is sent to the principal’s office almost daily and sent home 2–3 times a week. Culturally, Ian is Caucasian. He has grandparents on his mother’s side who are practicing Jehovah’s Witnesses, but his mother has rejected the religion and says she is an atheist. His mother’s brother is supportive but wants the family to practice the religion. The family is in a low SES (socioeconomic status) household and rural area. Ian’s father didn’t allow them to participate in community activities. Ian now lives in a small town, less rural, and is in a different school. He was in kindergarten when the incident with his father happened. He was in the shelter’s school for 6 months and then he was placed in first grade in this school just before the second semester began. The school’s major concern is his violence and aggression, which has been getting much worse over the past few weeks. His mother’s main concern is also the aggression and that he gets sent home so often, but she is worried about his poor reading and spelling as well. Ian is of average height and weight for his age of 7 years, 1 month. He is talkative and very active, good at gross motor activities, not great at fine motor skills, cannot read and spells poorly, appears to be inattentive and unfocused, has trouble sitting still, and is very negative.

Paper For Above instruction

Ian's behavioral and emotional challenges are indicative of underlying developmental, environmental, and possibly clinical issues that require comprehensive assessment and intervention. As a 7-year-old, Ian exhibits signs of poor attention, hyperactivity, and behavioral dysregulation, which align with characteristics of Attention Deficit Hyperactivity Disorder (ADHD). His difficulty following directions, impulsivity, frequent tantrums, and aggression suggest significant challenges with self-regulation and impulse control that may be rooted in neurodevelopmental factors as well as his traumatic background.

Environmental factors also profoundly impact Ian's development. His exposure to domestic violence, parental neglect, and inconsistent caregiving routines contribute to emotional insecurity and behavioral problems. Living in a household characterized by violence, substance abuse, and emotional neglect can hinder a child's ability to develop a secure attachment and emotional regulation skills. His mother's absence for many hours, coupled with inconsistent responses to his behavior, likely exacerbate his behavioral issues, as children often seek attention through disruptive behaviors when feeling neglected or insecure.

From a clinical perspective, Ian's difficulties extend beyond behavioral issues to academic challenges, notably poor reading and spelling skills. These academic struggles may be linked to inattentiveness and possible learning disabilities, which often co-occur with ADHD. Additionally, his strengths in math and drawing suggest that his cognitive profile includes specific areas of competence that could be leveraged in intervention strategies. His poor fine motor skills and attention difficulties could also reflect neurodevelopmental factors affecting both his academic and behavioral performance.

Psychosocial development is also impacted. Ian's social interactions are strained by his aggressive tendencies and negative behaviors. His tendency to pick on his younger sister and disrespect his mother further indicates difficulties with social and moral development, potentially stemming from modeling aggressive behavior seen at home and insufficient positive reinforcement of prosocial behaviors. His positive interactions with his younger brother and female roommate show some capacity for appropriate social relationships, which can be fostered through targeted guidance.

Developing a supportive intervention plan for Ian involves addressing both his behavioral issues and underlying trauma. Trauma-informed care is essential to help him process and recover from the violence he witnessed. Additionally, behavioral interventions such as implementing consistent routines, positive behavioral supports, and social skills training can help improve his self-regulation. Academic support tailored to his specific needs in literacy can facilitate his reading and spelling development. Parental involvement, including mother education on effective behavior management and ensuring consistent routines, is critical to creating a stable environment. Collaboration with mental health professionals for trauma therapy and possibly neuropsychological assessment will provide a comprehensive approach to supporting Ian’s development.

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