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2nd Case Report

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Identifying Information:

Name F.A

Age 13

Gender Male

Birth order 4th

NO Siblings 3

Duration of Assessment 4 months

and Intervention

Source and Reason of Referral

The child was brought to Rising Sun Institute with complaints of Aggressive behavior,

inattention, hyperactivity, He was referred to the present trainee clinical psychologist for

assessment and management of his symptoms.

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Presenting Complaints.

Table 1

Duration Complaints

6 Years ‫سیکھنے میں اپنے عمر کے بچوں سے پیچھے ہے‬

5 years ‫پڑھائی میں خاص توجہ نہیں ھے‬

6 years ‫فضول چیزوں میں مصروف رھتا ھے‬.

5 years ‫بےمعنی باتیں کر تا ہے‬

4 years ‫چیزوں کو توجہ نہیں دے سکت‬

Family history

Child’s father was 50 years old. He had done Matriculation. He had a dominating

personality and was somewhat extrovert and friendly. The mother reported that although the

father used to love the kids and has strong attachment with him.. His general health was normal.

He didn’t have any physical and psychological illness.

Child’s mother was 48 years old. She was uneducated and she was housewife. She was

kind and cooperative by nature. She had loving attitude towards the child as well as other

children. She didn’t have any psychological illness.

Child’s parents were first degree cousins and had congenial and friendly relationship

between them.
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Child was 4th born and had three siblings. The first born was sister 19 years old. She was

physical and psychologically healthy child. She has friendly and cooperative relationship with

him. She is student of BA class. The 2nd born was a brother 17 years old. His general health was

normal and healthy. And he was a student of FA class. he also had loving relation with a target

child. The 3rd born was also a brother 13 years old. And student of 8 th class he also had a good

friendship with target child.

General Home Environment.

The child’s family belonged to a middle socioeconomic class. The child lived with his

parents and three siblings. his home environment was also healthy, cooperative and satisfactory.

his father was the authorized person at home.

Birth history

Child’s mother has four pregnancies of which the special child was 4 th born. Child had a

mature birth after complete gestation period of 9 months. His mother experienced no any serious

issue during her pregnancy. His immunization during pregnancy was also completed. Length of

labor was about four hours and she was born through c-section delivery. he had immediate first

cry. he had fair complexion and had a normal weight at birth. Breast feeding was initiated soon

after birth. Child didn’t have any breathing problem, after birth immediately Breast feeding was

continued till 2 years. his vaccination was also completed on time.

The child achieved most of developmental milestones on time, but few were delayed. he

started holding his head at the age of 5.6 months, sitting at 8 months, crawling at 10 months,

walking at 1.4 year, controlling bladder and bowel movements at the age 5-6 years.
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Table: 2

Ages of achievement of developmental milestones.

Developmental Milestone Normal Age of Development Child’s Age of Achievement

Social smile 1-4 months 2-3 months
Neck holding 1-1/2 months 4 months
Sits without support 7 months 8 months
Crawling 9-10 months 10 months
Walking 15- months 14 months
Speech single word 9-12 months 1 years
Speaking in sentences 38 months Not reported
Bladder control 2 years 5-6 years

Hetherington & Parke (1993)

Psychological Assessments

Table 3

Psychological Assessments

Informal Assessments Formal Assessments

Clinical Interview Colored Progressive matrices.

Behavior Observation Portage Guide test

List of Reinforcement
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Informal Assessment

Clinical Intervie

Behavioral Observation

Identification of Reinforcers

Clinical Interview

The psychologists conduct an initial meeting, known as the clinical interview, with a

child to assess what types of problems the child is dealing with. clinical interview was

conducted with the child to collect detailed information about the child’s history of

present illness, presenting complaints, educational, family and personal history.

Moreover, r.

Behavioral Observation

The child apparently seemed to be 12 years old boy. his height and weight were normal. his

personal hygiene was properly maintained. he was wearing weather appropriate clothes. She

maintained appropriate eye contact. he didn’t seem to be attentive and was not responding

properly the present trainee clinical psychologist despite of this he was busy with looking

around him. he was trying to grasp other materials in assessment room despite of being

forbidden by the present trainee clinical psychologist and presence of many books in front of

him. his cognition and comprehension were not judged in initial session because of his

inattention and hyperactivity. In later session, it was depicted that he had intact cognition and

comprehension because he could easily grasp concepts that were taught by present trainee
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clinical psychologist. he had good idea of money value. he had good orientation about time,

person, and place.

Identification of Reinforcers

Reinforcer refers to anything/stimulus which strengthens or increases the probability of

a specific response. Therapist identified reinforcers because they are helpful in therapies. In a

therapy when the therapist wants to teach some behaviors or skills to the child, he uses

reinforcers (Miltenberger, 1997).

In the first session the therapist noticed that the child has too much interest with colors

and coloring the drowning pictures He was excited to have drowning to color it.

The therapist used the identified reinforcers to design the sessions. The child was given

reinforcer (such as empty pictures for coloring and give him different colors and allowed to draw

pictures and coloring activities) if he exhibited the desired behavior. Whenever the child

performed well in session the The reinforcers were also used to carry out homework tasks.

Formal Assessment

Portage guide to Early Education.

Coloured Progressive Matrices.

Portage Guide to Early Education.

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The Portage Guide to Early Education (PGEE) was developed to serve as an aid to

teachers, parents or others who needs to assess the child’s behavior and plan realistic curriculum

goals that lead to additional skills.

There are four goals of PGEE; to enhance a developmental approach to teaching, to

concern itself with several areas of development including cognitive, language, motor,

socialization and self-help skills, to provide a method of recording the existing skills and

recording skills learned in the intervention period, to provide suggestions on how new skills

could be taught (Bluma, Shearer, Froham & Hilliard, 1976).

Results.

Quantitative Analysis.

Table 4
Scoring of 1st missed item and last passed item with their respective age range

Categories First missed Age range Last missed Age range

Item years item Years

Communication/language/ literacy: 2 5-6 8 4-5

Social emotional development: 11 5-6 17 5-6

Exploration/Approaches to language: 20 5-6 28 5-6

Purposeful Motor Activity: 30 5-6 34 5-6

Sensory Organization: 36 5-6 37 5-6

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Appendix

Missing items Of PGEE

Table:5
Showing the items missed on Portage guide early education.
Categories. Missed Items

Communication/Language/Literacy 1.4.5.6.8. on words

Social emotional development: 10.12.13.14.15.19 on words

Exploration/Approaches to Learning: 21.22.23.24. on words

Purposeful motor activity: 27.28.33.34 on words

Sensory Organization: 37.36.37 on words

Qualitative Analysis.
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. The results of PGEE show that child has age inappropriate self-help, motor, language and

socialization skills whereas he is lagging behind his age in all domains. The chronological age of

the child was 13 years and 4 months in contrast his scores on socialization fall between the range

of 5-6 years, this depicts the child the is far behind his age level. In communication domain the

child’s first failure is on item no1. The child gave last correct response on item no. 37 which lies

between 5-6 years range. It means that he was 7 years lagging behind his chronological age.

Colored Progressive matrices.

Table 6

Total Score Percentile Grade Intellectual Level

15 5% V Intellectual

Deductive
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Reference.

Hetherington & Parke (1993)

(Miltenberger, 1997).

(Bluma, Shearer, Froham & Hilliard, 1976).