Introduction
The focus of the assignment is on making three decisions regarding the diagnosis and treatment of a client, 8-year-old Caucasian female with school difficulties. The first decision will involve making a differential diagnosis for the client and providing a rationale for selecting the decision. The second decision will involve making a decision about the treatment pan psychotherapy and providing a rationale for the decision. The last decision will be about treatment plan psychopharmacology and justifying the decision. In addition, the co-morbid physical and mental factors that may affect the diagnosis and treatment of the client will be considered. Finally, the paper will discuss the ethical considerations that may influence the treatment plan and communication with the client and her family. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.
Decision #1: Differential Diagnosis
The selected decision for the differential diagnosis of the client is 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation. This decision was selected because the client meets the criterion for A1 (inattention) for ADHD. According to American Psychiatric Association (2013) the DSM-5 criteria confirming diagnosis of ADHD inattention include: the person fails to be attentive to details or makes mistakes in work, classwork, and other activities; difficulties in maintaining attention in tasks or play activities; often seems like one is not listening when spoken to directly; fails to follow through on instructions, does not finish classwork, chore or workplace duties; experiences difficulties in tasks and activities organization; normally avoids, does not like or is unwilling to take part in activities or tasks that need sustained mental efforts such as classwork or homework; regularly misplaces things essential for activities or tasks such as pens, books, toys; gets easily diverted and distracted by unnecessary stimuli and is often forgetful in daily activities (Volkmar et al, 2014). The client meets most of the above symptoms as indicated by the scoring of the Conner’s Teacher Rating Scale, subjective data and mental status exam. The Conner’s Teacher Rating Scale indicated that the client is inattentive, gets distracted easily, makes careless mistakes in her classwork, forgetful about the already learned content, poor in arithmetic, spelling and reading, short attention span and has difficulties in peer interactions. Subjective data indicated that the client could not sit still during the interview, was interruptive and reported that her mind wanders during class Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree. The mental status exam revealed that the client’s attention and concentration were somehow limited. Other standardized assessment instruments that might be essential in identifying symptoms of ADHD include ACTeRS and the Vanderbilt Assessment Scale. In addition, the Child Behavior Checklist can be used to further assess the behavior of the client (Sadock et al, 2014).
By selecting this decision, the expectation was that the correct diagnosis for the client would facilitate appropriate prescribing of the treatment regimen for the client.
Decision #2: Treatment Plan for Psychotherapy
The selected decision is to begin Adderall XR 10 mg orally daily. Adderall is a branded combination of (75%) dextroamphetamine along with (25%) levoamphetamine salts. This decision was selected because Adderall is FDA approved for the treatment of ADHD. In addition, evidence shows that Adderall is a stimulant that is effective in improving and balancing neurotransmitters level within the brain. Adderall also has minimal side effects and has fewer rebound symptoms because the medication wears off gradually and it is typically a long-lasting medication (Lakhan & Kirchgessner, 2013). According to Lakhan & Kirchgessner (2013), Adderall is an extended-release formulation that has a duration action of about 10-12 hours. This is a notably longer duration of action when compared to the majority of other methylphenidate formulations whose duration of action is a maximum of 6 hours. In addition, studies show that Adderall is a neuro-enhancement medication that is effective in memory improvement, improving focus and attention span (Lakhan & Kirchgessner, 2013). Accordingly, Adderall would be effective in treating the symptoms and signs of ADHD for the client. Autism Spectrum Disorder, ADHD, ODD, and ICD Decision Tree.
By choosing this decision, it was expected that symptoms and signs of ADHD for the client would improve since Adderall has been shown to be effective in improving symptoms such as attention span. Specifically, it was hoped that the client’s disruptive behavior would reduce as well as
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