Case Study Reflection, Middle Childhood 

CASE STUDY

Mark is a 9-year-old boy who lives with his mother and presents today for “school issues.” He is in the third grade and is an A student. During the last two weeks, he has refused to go to school and has missed six school days. He stays awake most of the night worrying about going to school. In the mornings when it’s time for his mom to take him to school, he begins crying and yelling that he can’t go. In the last two weeks, he’s experienced headaches, abdominal pain, and vomiting on school days. His grades are slipping, and he has stopped reading for fun. Mom states, “he seems depressed and he’s not himself anymore.”

Mark’s review of systems is negative except for headaches, abdominal pain, and vomiting. Mom states that the symptoms improve when he is not attending school. There is a family history of generalized anxiety disorder. Vital signs are within normal range for age, and height and weight are at the 50th percentile. He is up to date on immunizations and the physical exam is negative for any abnormal findings.

Assignment Information: Journal Article or Evidence-based Guidelines

Research and find one journal article with the similar case study or evidence-based guidelines from a peer-reviewed resource that is relevant to this week’s case study. The resource must have been published within the last five years (2019 or newer)

Instructions

On the title page of the assignment submission, include your name, as well as the author(s) names, date of publication (within 5 years), the title of the article, journal name, volume, and issue number, and page numbers.

The body of your submission should be no more than one page in length, in APA format, and should include a summary of the article’s purpose and findings, the reason for selection, and applicability to the assessment, plan, and management strategies you posted on the discussion board for this week’s case study.

Below is the plan/management and differential diagnosis for your review.

Case Study

Assessment:

Mark is a 9-year old boy presents to the clinic with his mother for complaint of headache, abdominal pain, and vomiting on school days for last two weeks. Mother is the primary source of information. Mark has missed 6 days of school and shows symptoms of anxiety and depression. Mother stated that he is a A grade student but recently his grades are falling, and he starts crying and yelling and doesn’t want to go to school. Family history is significant for generalized anxiety disorder. Vital signs are within normal limits. Physical exam is unremarkable, and ROS is negative for headaches, abdominal pain, and vomiting.

Plan and Management:

Screen for Child Anxiety-Related Disorders (SCARED) tool should be used to conduct the evaluation, along with Revised Children’s Anxiety and Depression Scale (RCADS) to narrow down the cause of anxiety and depression. Sub-items of RCADS such as separation anxiety disorder, generalized anxiety, social phobia, performance anxiety should also be used to validate the differential diagnosis (Runyon et al., 2018; Radez et al., 2022; Walter et al., 2020). Mood and Feeling Questionnaire (MFQ) should also be used since The MFQ consists of a series of descriptive phrases regarding how the subject has been feeling or acting recently. Results for MFQ reflect whether the phrase was descriptive of the subject most of the time, sometimes, or not at all in the past two weeks (Creswell et al., 2020).

Parent should then refer to a child psychologist for cognitive behavioral therapy and multidimensional family therapy. Encourage parent to monitor child’s sleeping pattern, eating habits, internet and media use and make a note for any unusual patterns. Parent should also meet with school management and teachers to discuss this behavioral change and discuss topics such as bullying, phobias or performance anxiety at school (Creswell et al., 2020; Kim et al., 2020)

Parent should be educated on when to seek emergency care in case of acute conditions or self-harm

Differential Diagnosis:

  1. Generalized Anxiety Disorder
  2. Social Phobia
  3. Separation Anxiety Disorder (Creswell et al., 2020; Elmore & Crouch, 2020).