Respond to the initial discussion post below of two other learners. What reactions do you have to the ideas the learner has presented? Include examples from your own experience to support your perspective, and raise questions to continue the dialogue.

The Vignette of Marcus: Marcus is a 10-year-old boy who has been struggling at school. During the past year he has frequently been distracted in class, and fidgety while in his seat. He often gets into trouble for not paying attention to the teacher, and has difficulty engaging in solitary activities such as reading or taking tests. He gets into trouble in school for talking too much, and for talking out of turn. While at recess, he continues to have difficulties standing still and taking turns. During class time, Marcus has difficulty following instructions and completing his work. He is easily distracted, does not pay attention to details, and frequently leaves his seat to interrupt the work of other students.

Marcus continues to have difficulty at home. He spends the weekdays with his mother and two younger brothers whose ages are 5 and 7. He tries to help with many of the household chores his mother cannot tend to while she is at work full-time, but has difficulty following through. He seems to want to be helpful. He has some difficulty getting along with his brothers, and often will take their toys without asking. On the weekends, Marcus lives with his father, stepmother, his 11-year-old stepsister, and his 3-year-old half-sister. He describes his father and stepmother as being very strict, which causes some difficulty for Marcus. He has difficulties sitting still, which causes significant difficulty when he goes out to dinner or to other events with his father and stepmother.

Marcus' teacher has met with his parents on several occasions to discuss his poor academic progress. She has expressed concern with the level of his academic skills in writing and math, as well as with his ability to control his energy and to 'fit in' with the others in his class. Both the teacher and school principal have recommended counseling for Marcus, and the parents' insurance plan will pay for 10 visits. Marcus' pediatrician has also suggested the possibility of medication.

Peer 1 response

Which mental disorder would you consider to describe what is problematic for Marcus?

According to the vignette, Marcus shows many traits and behaviors consistent with Attention-Deficit/Hyperactivity Disorder (ADHD). Marcus is demonstrating the inability to sit and focus for extended periods of time. He has also shown a lapse in academic progress compared to others in his age group. Marcus has been receiving behavioral consequences for his actions which include the inability to wait for his turn to speak or distracting others when they're engaged in independent practice. At home, he tries to help his mother with chores but is unable to successfully complete what he starts frequently. Taking these behaviors into account leads me to believe he is functioning with ADHD.

List the specific criteria from theDSMthat you believe Marcus meets, given the information you currently know about him. Be sure to review and include all required diagnostic criteria to make a diagnosis. Use the Differential Diagnosis Tool, which you can find in theWeek 7: Diagnosing ChildrenLinks to an external site.reading list, to determine the appropriate diagnosis.

When following the differential diagnosis by the trees, the behaviors specified in the vignette provided the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) (3.1.4) (ACA,2022) The product of all of the behaviors Marcus has demonstrated leads to this conclusion. Marcus has the inability to maintain his patience and will frequently speak out of turn, get out of his seat, and has trouble socializing appropriately with others. He frequently fails to follow directions in class and completing his work and assignments. Marcus also shows difficulty getting along with his siblings. Marcus appears to want to make a change but fails in doing so. Professionals around his school have urged him to attend counseling and his pediatrician has even talked about the possibility of implementing medicine.

1. What score would you document for Marcus, if Marcus' family completed the parent- or guardian-rated Level 1 crosscutting symptom measure? Include the specific information you included when coming up with this score.

When referencing the Level 1 Cross-cutting symptom measure, I noticed the use of 12 domains. With the information that was provided, Only domain 3 which is "inattention" can be measured. A score of 4 for that particular question seems to be appropriate. To get a more definitive score and result, the assessment would need to be completed by Marcus or an adult who can guide Marcus through the questions due to the complexity of each one. Further observations relating to Marcus's inability to sleep, anxiousness, somatic symptoms, depression, psychosis, substance use, etc. can help determine other behaviors or diagnosis for Marcus.

References:

American Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders(5th ed., text rev.).

Peer 2

Compare early behaviors typical of those diagnosed with ASD, evident in the description of Temple and Richard.

Autism Spectrum Disorder (ASD) includes deficits in social communication/interactions and insistent repetitive patterns of behavior. Richard displayed his social impairment by not greeting his parents, ignoring his brother, screaming when left alone with a stranger (babysitter), and not using facial expressions to communicate. Temple did not want to be held, did not make eye contact with others, and lacked interest in people. The insistent, repetitive behavior of Temple included rocking back and forth and spinning, watching sand go through her fingers, and sitting for hours in a trance-like state. Richard's behavior included an intense resistance to change, collecting items to arrange in patterns that could not be moved, and attachment to a toy car that would trigger tantrums if taken from him. He would stare at bright lights and spinning objects and begin laughing, dancing on his tiptoes, and flapping his hands. These two clients are examples of ASD with two very different displays of behavior. They both started these behaviors in early childhood.

How have the developments in the field since the time Temple was young changed how we understand Richard's symptoms and their causes?

At the time that Temple was born, ASD was unknown. She was dismissed from school because she didn't fit in, even though she scored high on IQ. Temple was fortunate to have a mother who pushed for Temple to get an education despite ASD not being identified at the time. Since then, we have identified ASD and its characteristics. Biological and neurological factors are believed to play a role in the disorder. Neuroimaging scans suggest a variety of structural abnormalities in the brains of persons with ASD that contribute to impairments in social interactions and, therefore, could be a result of genetic factors (Nolen-Hoeksema, 2019). The treatment of ASD has advanced since Temple was a child, with medications for symptom reduction, psychosocial behavior therapies, and mainstreaming children with ASD to be included in regular classrooms. These are available to Richard, which doctors did not have the knowledge when Temple was growing up.

Reference:

Nolen-Hoeksema, S. (2019).Abnormal Psychology(8th ed.). McGraw-Hill Higher Education (US).https://capella.vitalsource.com/books/9781260426151Links to an external site.