Discussion #2 Case overview Echo Richard is a 3-year-old boy was referred by his parent for evaluation due to his uneven development and abnormal behavior.

Discussion #2 Case overview Echo Richard is a 3-year-old boy was referred by his parent for evaluation due to his uneven development and abnormal behavior.

Discussion #2

Case overview

Echo Richard is a 3-year-old boy was referred by his parent for evaluation due to his uneven development and abnormal behavior. Richard appeared to be self-sufficient and aloof from others. Echo seemed to suffer from separation anxiety. When left with a baby-sitter, he tended to scream much of the time. The major management problem was Richard’s intense resistance to any attempt to change or extend his interests. Removing his toy car, disturbing his puzzles or patterns, even retrieving, for example, an egg whisk or a spoon for its legitimate use in cooking, or trying to make him look at a picture book precipitated temper tantrums that could last an hour or more, with screaming, kicking, and the biting of himself or others. These tantrums could be cut short by restoring the status quo. Otherwise, playing his favorite music or a long car ride was sometimes effective. His parents had wondered if Richard might be deaf, but his love of music, his accurate echoing, and his sensitivity to some very soft sounds, such as those made by unwrapping a chocolate in the next room convinced them that this was not the cause of his abnormal behavior. Psychological testing gave him a mental age of 3 years in non-language-dependent skills (fitting and assembly tasks), but only 18 months in language comprehension.

mental status exam with target symptoms

Physical appearance, motor development and self-help skills all age appropriate. lack of response to social contact. Fascinated by bright lights and spinning objects, stare at them while laughing, flapping his hands, and dancing on tiptoe. He also displayed the same movements while listening to music, which he had liked from infancy.

Differential Diagnosis

ADHD

Autism Spectrum Disorder

Laboratory and Diagnostic Tools

ADHD diagnosis requires the symptoms of ADHD to be present both in school and at home. Furthermore, all patients must have a full psychiatric evaluation and physical examination. The diagnosis of attention deficit hyperactivity disorder (ADHD) is based on clinical evaluation (Gephart, 2019). No laboratory-based medical tests are available to confirm the diagnosis. Basic laboratory studies that may help confirm diagnosis and aid in treatment are as follows: Serum CBC count with differential Electrolyte levels Liver function tests (before beginning stimulant therapy) Thyroid function tests. The Conners Parent-Teacher Rating Scale is a questionnaire that can be given to both the parents and the child’s teachers (Gephart, 2019).

Autism Spectrum Disorder – Developmental Screening, CSBS DP Infant-Toddler Checklist, Modified Checklist for Autism in Toddlers (MCHAT)