LifespanActivity Time: 23 min
Tina’s seven-year-old cousin is having trouble in school. His teachers complain of behavior problems and he has difficulty concentrating. List your differential diagnosis. What assessments would you perform?
Model Note: The differential diagnosis includes hearing impairment, ADHD, autism, and other pervasive developmental disorders. Further assessments should include a history of behavioral, social, verbal, motor, and learning problems to guide a psychological diagnosis, a hearing test to rule out hearing impairment, and Denver II test to rule out developmental delay. The DSM-IV should be consulted for diagnosis of a psychological disorder.
Tina’s 80-year-old great aunt complains that she can’t sleep unless she drinks alcohol before bed. She mentions that her husband died last month. Her children visited for the funeral, but recently returned to their homes out-of-state, leaving Tina’s great aunt alone in her home. What risks might you be concerned about? What would you include in your treatment plan?
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Model Note: Her insomnia and alcohol use suggest that she is struggling with depression, most likely related to the death of her husband. Her use of alcohol as a sleep-aid puts her at risk of alcohol-dependence, which is especially unsafe given that she lives alone. Tina’s great aunt’s age, social isolation, alcohol use, and widowed status puts her at a high risk for suicide. She is also at increased risk for falls and injuries. Treatment plans should include a counseling referral, antidepressant medication, a sleep-aid, and a discussion about alcohol use and sleep hygiene.
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