Read the case provided by your instructor for this week’s Discussion and identify relevant symptoms and factors. You may want to make a simple list of the symptoms and facts of the case to help you focus on patterns.
Read the Morrison (2014) selection. Focus on Figure 1.1, “The Roadmap for Diagnosis,” to guide your decision making.
Provide a full DSM-5 diagnosis of the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months
With the information provided, Emmanual is diagnosed with intellectual disability, ICD-11, an intellectual developmental disorder. This information about Emmanual is as recent as of September 2019. The specifiers in Emmanual’s case include problem-solving abilities, academic level, learning, communication, and attentive abilities. With the multiple levels of severity, they are defined based on adaptive functioning and not through IQ scores because adaptive functioning determines the level of support that is required (American Psychiatric Association., 2013j). The severity of Emmanual’s case is moderate (318.0 (F71)). The Z Code in relation to Emmanual’s case is a parent-child relational problem (Z62.820). Parent-child relational problems are used to test the quality of the parent-child relationship and when it is affecting the course, prognosis, or treatment of the mental or medical disorder (American Psychiatric Association., 2013l). Emmanual’s parents used their own treatment for his conditions by using natural and cultural treatments. This prolonged his condition and was not getting the appropriate treatment. It is important to note that this was done based on religion.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis
Emmanual displays challenges with his schoolwork, such as direct guidance needed, not retaining information, and challenges with his grades. Additionally, he experiences social cues from his peers, struggles with friendships, behavioral challenges, and lacks of communication skills. Emmanual’s diagnosis matches that on a moderate level. Moderate intellectual disability symptoms include an individual’s conceptual skills lagging behind those of peers, differences in social and communicative behaviors, social cue differences, an extended period of teaching and time is needed for the individual, and friendships affected by communication or social limitations (American Psychiatric Association., 2013).
Identify which four diagnoses you initially considered in the case of the client, using the DSM-5 diagnostic criteria to explain why you selected these four items. In one or two sentences each, explain why three of these diagnoses were excluded.
When diagnosing Emmanual, the four diagnoses I considered for his condition included specific learning disorder, autism spectrum disorder, communication disorder, and intellectual disability. I considered a specific learning disorder for Emmanual because of his inability to process information efficiently. Specific learning disorder was excluded because it implies select deficits in an individual’s inability to process information. Autism spectrum d
CASE of ALIM
Intake Date: August 2020
IDENTIFYING/DEMOGRAPHIC DATA: Alim is a 12-year-old male in 7th
grade who lives with his mother, father and brought in for services by
his adoptive mother. The adoptive parents are upper middle class and have three
biological children (ages 9, 7, and 5).
CHIEF COMPLAINT/PRESENTING PROBLEM: The mother reported that
Alim often hides food in his room and gorges himself when he eats. She said 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. Alim sometimes reacts when his lunch is packed
differently within his lunch box for school. He also seems to pay less attention to
teachers and often interrupts class with his own comments.
HISTORY OF PRESENT ILLNESS: Alim acts younger than his 12
years, carrying around toy cars in his pockets, which he proudly displays and talks
about in detail. Aim’s mom reports that Alim 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 times to stop him from hurting himself and others.
The parents have never sought help before, as Alim managed to largely keep up
with his schoolwork. His mother said that he has always taken things literally, but
up until 6th grade, he had attended school without major problems. They had not
been concerned about his grades or lack of friends. His mother said that he has
always been “very shy” and never had a “best friend.” He has always
shown interest in cars, trains, and trucks. Recently, behaviors at school changed
and worsened. His school has complained of his inability to focus and the increase
in his disruptive behaviors.
Collateral contact with his teachers confirmed that he struggles with school, has
no friends, and often has “meltdowns” when he does not get his way. One teacher
noted that in small group classroom activities, Alim has trouble with restlessness
and will stumble over his words, pause excessively, and restart talking fairly
rapidly and loudly. In 6th grade his teachers were concerned about occasional
facial “tics” that occurred at times. His teachers commented that Alim talks more
about World War II topics than any other topic.
PAST PSYCHIATRIC HISTORY: Alim had never had any testing for special
education, nor had he ever received any counseling services.
SUBSTANCE USE HISTORY: No substance use is reported.
PAST MEDICAL HISTORY: Alim is very small in stature, appearing to be only
8 years old. His parents report that Alim was given all the vaccines required to
attend school.
FAMILY HISTORY INCLUDING MEDICAL AND PSYCHIATRIC: Alim
was adopted at age 3½ from an orphanage in Haiti. The orphanage knows little
about his
Social work clinicians keep a wide focus on several potential syndromes, analyzing patterns of symptoms, risks, and environmental factors. Narrowing down from that wider focus happens naturally as they match the individual symptoms, behaviors, and risk factors against criteria A–E and other baseline information in the DSM-5.
Over time, as you continue your social work education, this process will become more automatic and integrated. In this Discussion, you practice differential diagnosis by examining a case that falls on the neurodevelopmental spectrum and/or within Disruptive, Impulse-Control, and Conduct Disorders.
To prepare:
· Read the case provided by your instructor for this week’s Discussion and identify relevant symptoms and factors. You may want to make a simple list of the symptoms and facts of the case to help you focus on patterns.
· Read the Morrison (2014) selection. Focus on Figure 1.1, “The Roadmap for Diagnosis,” to guide your decision making.
· Identify four clinical diagnoses relevant to the client that you will consider as part of narrowing down your choices. Be prepared to explain in a concise statement why you ruled three of them out.
· Confirm whether any codes have changed by checking this website: American Psychiatric Association. (2017, October 1). Changes to ICD-10-CM codes for DSM-5 diagnoses. Washington, DC: Author. Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5/coding-updates
By Day 3
Post a 300- to 500-word response in which you address the following:
· Provide a full DSM-5 diagnosis of the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
· Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
· Identify which four diagnoses you initially considered in the case of the client, using the DSM-5 diagnostic criteria to explain why you selected these four items. In one or two sentences each, explain why three of these diagnoses were excluded.
· Explain any obvious eliminations that could be made from within the neurodevelopmental spectrum.
· Describe in detail how the client’s symptoms match up with the specific diagnostic criteria for the primary disorder that you finally selected for him. Note two other relevant DSM-5 criteria for that illness from the sections on “diagnostic features” and “development and course” that fit this case.
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