Case Conceptualization
Client is 17 years old male. Client’s mother and teacher reported complaints of Poor
focus in every task, Assistance in every task, Lacks daily living skills, Less social
engagement, Less verbal communication, and laziness. Most of the client’s problems are
persistent from childhood. His father is with mild intellectual disability. Client’s delivery was
done through C-section and client’s motor and developmental milestones are delayed. Factors
like below average IQ, speech issues, poor cognitive and adaptive skills and lack of social
engagement are maintaining the client’s problems. Client’s psychological assessment
included informal assessment (behavioral observation and clinical interview) and formal
assessment (BGT, SPM, VABS and HFD) methods. He is diagnosed with 318.0 (F71)
“Intellectual Disability (Intellectual Developmental Disorder), Moderate”.
According to Bilder et., al (2013), there are multiple prenatal and perinatal factors that
can be associated with intellectual disability. It is reported that primary cesarean sections are
one of the most important predisposing factors that can lead towards intellectual disability as
in this case, client’s mother reported that client’s delivery was done through c-section and her
age at that time was 27 years.
According to Biopsychosocial model, biological, psychological and social factors
collectively lead towards intellectual disability. It is not ideal to say that one factor leads
towards intellectual disability rather it results by the mixture of different biological, social
and psychological factors. In this case, there are multiple factors that are contributing towards
client’s intellectual disability. Like in biological factors, there is a genetic factor as client’s
father is with mild intellectual disability. Moreover, there are birth complications as well as
client’s mother reported that client’s delivery was done through C-section. In social factors,
there is lack of social engagement and less verbal communication as his mother and teacher
reported that he doesn’t engage with his fellows and doesn’t talk much in class. His social
engagement is poor. Beside this there is another factor which is discrimination in playground,
where the client’s peers don’t invite him to play due to his poor fine and gross motor skills
which also maintains his problems and because of this he doesn’t learn new things. In
psychological factors, there are factors like poor cognitive abilities (planning, judgement etc.)
and poor adaptive skills that are maintaining his issues and contributing in client’s overall
problem.
1
According to the behavioral perspective, problematic behaviors can be modified
through conditioning (classical or operant), and observational learning. Children and
adolescents with mental disabilities can learn new behaviors through conditioning and
observational learning. Client will learn new skills and behaviors in order to become more
independent in his personal and social life.
2
Case Formulation
Predisposing Factors
Precipitating Factors
o Genetic Factor Client
o Birth Complications o Delayed Milestones
Presenting Complaints
Perpetuating Factors
o Poor focus in every
o Below average IQ Protective Factors
task
o Speech issues o Assistance in every o Family as a
o Poor cognitive skills task protective factor
o Lacks daily living o Special attention
o Poor adaptive skills skills from teacher.
o Poor social o Less social o Mother’s support
engagement and attention.
engagement
o Less verbal
o Discrimination
communication
Prognosis
Psychological Tests Diagnosis o Prognosis is good.
BGT o Emotional support
318.0 (F71) “Intellectual
from family.
SPM Disability (Intellectual
o Interested in
Developmental Disorder),
VABS learning self-help
Moderate” skills and kitchen
HFD
chores.
