An 11-year-old boy, Jake, was referred to an inpatient unit of the Children's Hospital for

further diagnostic evaluation and treatment by the pediatric liaison team on call. He was

socially isolated at school and in the rural community where he lived. He had behavioral

difficulties at home and difficulties in adhering to the boundaries set by the parents. His

mother labeled him as a "troublemaker" and he was oppositional at school with

inappropriate behavior. He was frequently interfering with teaching in the classroom.

Although he wanted to socialize with other children, he was clumsy and aggressive in

his attempts to initiate contact. Teachers and other children's parent's complaints

objectified the presence of behavioral problems. His behavior was described as

aggressive and violent. His play and his reactions were often inappropriate and fearprovoking

to othersi.e., he performed animal amputations, made and collected

poisons, destroyed objects, and set fires.

Jake was born at full term and was described as a quiet baby. In the first three months

of his life, his mother became worried as he was unresponsive to cuddles and hugs. He

also never cried. He has no friends and, on occasions, he has been victimized by

bullying at school and in the community. His father is 44 years old and describes having

had a difficult childhood; he is characterized by the family as indifferent to the children's

problems and verbally violent towards his wife and son, but less so to his daughters.

The mother is 41 years old, and describes herself as having a close relationship with

her children and mentioned that she usually covers up for Jake's difficulties and makes

excuses for his violent outbursts.

Questions

1. Which of Erickson's Stages of Development does Jake fall into? Describe some

characteristics of the stage that apply to Jake that may be important to know/ask

about as a counselor?

2. When working with children of this age range, what ideas do you have about

strategies might you use to highlight that child's strengths in order to help him or

her build a positive sense of self?

3. Which of Piaget's Stages of Cognitive Development does Jake fall into? What is

something that you read in his case study that signifies to you that he falls in that

stage?

4. As a future counselor understanding Human Growth and Development, what are

some things that you are curious to further understand about Jake based on this

case study, and why?