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Case Diagnostic Assessment

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1. Presenting Symptoms and Objective Observations of the Client
2. Client's Subjective Experience of the Problem
3. Assessment of Mood, Thinking, Interpersonal Relationships, and Functional Daily Activities
4. Steps that will be Used to Develop a Diagnostic Hypothesis
5. Where tests will be obtained: Publishing sources of tests that will be used
6. Assessment approach that will be used at the end of treatment that will allow for the measurement of improvement.

Beth is a 6-year-old girl. She lives with her parents and an older sibling. Beth was born full term, and met developmental milestones until around 20 months. At that time, her mother noticed that she wasn't developing in language and other areas the way Beth's older brother did. Beth spent much more time imitating sounds, and when she did begin speaking words, her vocabulary seemed to grow at an exponential rate. Her pediatrician called her "the little professor" because of the adult way she sounded. The year before starting school, she developed an intense interest in fish species. She had collections and models of fish and could describe many facts about each one. Her assessment team recognized that Beth had an Autistic Spectrum disorder, most likely Aspergers her pediatrician concluded, and she was recommended for comprehensive services including occupational therapy, physical therapy, speech therapy, and case management. Beth also had sensory processing difficulties around loud sounds and textures, and was very picky about the feel of clothing she wore. Beth's parents were given home program activities to help reduce sensory sensitivity. Beth's parents had been working progressively with her Asperger's Disorder when the following incident happened with a neighbor an her brother. This incident and its effects are the reason Beth was brought for an assessment. Beth, her brother, and a neighbor boy name Kenji were playing "cops and robbers" when Kenji convinced Beth's brother that they should tie Beth up because she was a robber and would get away. They found a rope and tied Beth to a tree. Beth loved and looked up to her older brother, and when he seemed to go along with Kenji, she thought she should go along with it too. Kenji started to yell at her to "shut up" when the scratchy ropes hurt her arms and she cried. Kenji then pretended to talk to Beth's brother about killing her because she was a bad robber. Kenji did not intend to hurt her, but Beth was not able to understand in those moments that her brother and Kenji were still playing. After about a minute, Beth became completely silent and stopped struggling. Her brother realized Beth was upset and stopped Kenji and untied her and walked her home. After this incident, Beth lost all speech and communication. She cried frequently, and did not want to engage in her usual play activities. She put her hands over her ears anytime anybody tried to talk to her. She became more aggressive when frustrated, and bit her brother on the arm when he tried to hand her a snack. Her sensory issues returned to the extreme, especially her clothing preference, and she arched her back and cried anytime her mother put on one of her soft shirts, or rubbed her back dry with a towel. Beth had changed from a curious and interactive 6 year old girl to one who was withdrawn, sullen, and reactive. Beth has no other significant health issues, and other professionals have confirmed her Asperger's diagnosis over the years.

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https://pediatrics.aappublications.org/content/120/5/1162
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504094/
https://psychology-tools.com/test/cast

1. Presenting Symptoms and Objective Observations of the Client

The symptoms presented by "your" post are indicative of a child suffering from an extreme form of Asperger syndrome. The child has lost all ability to engage in speech and communication after the incident with her brother and his friend. In addition, she has refrained from engaging in her previous play activities while also becoming more aggressive resistance when frustrated by lashing out and even physically accosting her older brother. The sensory issues have also returned with more sensitive responses to clothing wherein the child's response to normal clothing and touches of fabric is extremely unnatural and disruptive for her life.

2. Client's Subjective Experience of the Problem

The client had previously experienced forms of this type of behavior but through education and treatment, the child had become a curious and interactive 6 year old who loved to learn and express herself. The child's regression ...

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