Vignette AssumptionStory:Tatiana Tatiana is five years old and was adopted at age three. Tatiana's adoptive parents have three biological sons, aged eight, ten, and seventeen, who the parents say "adore" Tatiana. The family spends a great deal of time with both sets of grandparents, who have welcomed Tatiana as their only granddaughter.Tatiana's adoptive parents report that Tatiana is unable to adapt to changes in the environment, has no persistence, and has no observable curiosity. She will passively play with her brothers, but the second they take their attention off of her, she will go back to solitary play.Tatiana has no problems with her family. They are very accepting of her; however, they do worry as they believe she is not functioning to her full potential in their home and they are no sure why. Tatiana's parents had her in daycare in hopes of improving her social skills, but her bouts of crying - especially when loud noises or changes in the routine occurred - and her intense fear of using the bathroom resulted in the decision to keep her at home. A new employee has been hired to help Tatiana's father with their business so that Tatiana's mother can stay home with Tatiana during the day, and for the past two weeks she has been at home during the day.Tatiana's adoptive parents describe themselves as having a strong marriage, a strong support network, and solid financial resources from owning a successful business. Approximately a year ago Tatiana's parents began to seek services for her due to concerns about how she is acting. They are also concerned because Tatiana is unable to accept their care and physical affection in the way their sons had, appears fearful much of the time, and is withdrawn around other children. They are concerned as they feel they do not have the appropriate knowledge to help Tatiana effectively. Tatiana lived with her biological family until she was two years old. Her father left the family when Tatiana was one, and her mother had to take on two jobs to make ends meet. Tatiana and her brothers - aged six and seven at the time - were left at home alone while their mother was at work. During one of her mother's absences Tatiana experienced a broken femur, however her motor development has not been impaired.The cause of the injury is unknown. Children's Aid investigated this incident, and Tatiana's mother voluntarily relinquished custody of all three children. Tatiana's brothers were adopted by a family friend and appear to be developing normally. Tatiana resists assistance in feeding and dressing herself. Tatiana is comfortable using the toilet in the home but resists using any other toilet so adamantly that her parents cannot bring her to any public washrooms because they are afraid others will think they are hurting Tatiana when she begins to cry. At the time of her adoption Tatiana was petrified of the bathtub, but has since allowed her parents to bathe her without too much difficulty. Tatiana experiences much anxiety when it comes to using the washroom outside of the home. It is affecting her ability to go to school. Tatiana is often quiet and when corrected, will immediately ask to go to bed. She is having a difficult time adjusting and rarely smiles or laughs.Tatiana's parents report that it is difficult to communicate with Tatiana as she has problems following 1-step commands.

Caregiver Strengths & Needs

• 0. No evidence of need. No action needed
• 1. Significant history or possible need that is not interfering with functioning. Watchful waiting/prevention/additional assessment
• 2. Need interferes with functioning. Action/intervention required
• 3. Need is dangerous or disabling. Immediate action/intensive action required
• 0
• 1
• 2
• 3
• 1. Supervision
• 2. Involvement
• 3. Knowledge
• 4. Empathy for Child
• 5. Organization
• 6. Social Resources
• 7. Residential Stability
• 8. Physical
• 9. Mental Health
• 10. Substance Use
• 11. Developmental
• 12. Access to Child Care
• 13. Military Transitions
• 14. Family Stress
• 15. Safety
• 16. Marital/Partner Violence