Expert answer:Dsm-5 Case study

Expert answer:This is a discussion question not a paper: The Case of Chase, analyze Chase’s story, and note his original DSM-IV diagnosis. Using the DSM-5 diagnostic criteria, determine Chase’s primary clinical diagnosis. Next, note the changes in the Autism Spectrum disorders, and include the Other Conditions That May Be a Focus of Clinical Attention (ICD-10-CM, Z codes) in your diagnosis. Then identify the potential risk and prognostic factors from both the biological and environmental perspective. Also respond to the following: What should Chase’s diagnosis be according to the DSM-5 criteria? What predisposing and risk factors led to the outcome of this case? What potential protective factors could have been introduced to address this situation? Do you think these protective factors may have changed the outcome and diagnosis?Reference:American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.“Neurodevelopmental Disorders” (pp. 31–86)“Other Conditions That May Be a Focus of Clinical Attention” (pp. 715–727)
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Working With Children and Adolescents: The Case of Chase
Chase is a 12-year-old male who was brought in for services by his adoptive mother.
He is very small in stature, appearing to be only 8 years old. He also acts younger than
his 12 years, carrying around toy cars in his pockets, which he proudly displays and talks
about in detail.
Chase was adopted at age 3, from an orphanage in Russia. The adoptive parents are
upper middle class and have three biological children (ages 9, 7, and 5). Chase is reported
to often get upset with his siblings and hit or kick them. His mother stated that Chase has
always had issues with jealousy, and when her other children were younger, she had to
closely monitor him when he was around them. She reported several occasions when she
found Chase attempting to suffocate each of his younger siblings when they were babies.
The mother stated that Chase came to the United States without knowing any English.
She knows very little about his family of origin other than that he lived with his
biological parents until age 2 and then lived in the orphanage until he was adopted. She
reported that the plane ride from Russia was horrible and that Chase cried the entire flight
and refused to sleep for the first 2 days they had him.
The mother reported that Chase often hides food in his room and gorges himself when
he eats. She does not understand this behavior because he always has enough food, and
she never restricts his eating. In fact, because of his small size and weight, she often
encourages him to eat more. She also reported that Chase hates any type of transition and
will get upset and have temper tantrums if she does not prepare him for any changes in
plans. He is reported to kick and hit both parents, and they have had to restrain him at
Working With Children and Adolescents: The Case of Chase / Page 1 of 3
© 2016 Laureate Education, Inc.
times to stop him from hurting himself and others. The parents have never sought help
before, but recently the school has been complaining of his inability to focus and
increasing disruptive behaviors. His teachers report that he struggles with school, has no
friends, and often has “meltdowns” when he does not get his way. Prior to our meeting,
Chase had never had any testing for special education nor had he ever received any
counseling services.
During intake, I met briefly with Chase alone. He appeared anxious, had pressured
speech and facial tics, and was unable to keep his legs still. He chose to play a board
game during our time in the session and talked in detail about World War II and each of
the boats in the game. When asked how he knew all about warships, he stated that he
often watched television documentaries on the subject. Chase’s medical history shows an
outdated prior diagnosis in DSM-IV of the following: Pervasive developmental disorder
NOS and a Transient tic disorder
Plan:
Initially Chase’s parents were unsure what to do about their son’s behaviors. His
mother was the primary caretaker and his father thought she should handle any therapy or
problems related to school. His mother reported that she was “at the end of her rope” and
was ready to give her son up to foster care. She shared her frustration with her husband
who “just did not understand how hard it was.” It was concerning that Chase had never
received any services prior to our meeting and that the school had not properly referred
him for testing to address his behaviors and his academic struggles.
Both parents were asked to come in for sessions together to work as a united front in
Working With Children and Adolescents: The Case of Chase / Page 2 of 3
© 2016 Laureate Education, Inc.
addressing Chase’s behaviors and to be supportive of each other. The school complied
with the parents’ request for testing, and Chase was found to meet criteria for special
education, and an individual education plan (IEP) was established. In addition, a referral
was made to psychiatry, and medication was prescribed to help Chase with his outbursts,
his tics, and with focus while at school. Lastly, Chase was offered a socialization group
with other children on the autism spectrum, and he developed better skills in making
friends and eye contact and self-soothing and calming himself to avoid tantrums.
Chase obviously had major developmental issues and issues related to socialization.
Both parents were unaware of their rights and how to advocate for their son. In addition,
the father was very traditional and thought that his wife was responsible for taking care of
the children and that he did not need to be involved in parenting. In addition, neither
parent had demanded help for their son within the school system and they needed to be
educated about their son’s educational rights and how to get his needs met.
Adapted from:
Working with children and adolescents: The case of Chase. (2014). In Plummer, S.-B.,
Makris, S., & Brocksen S. M. (Eds.). Social work case studies: Concentration year (pp.
10–12, 97–99). Baltimore, MD: Laureate Publishing. [Vital Source e-reader]
Working With Children and Adolescents: The Case of Chase / Page 3 of 3
© 2016 Laureate Education, Inc.
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