20 Jun CASE PRESENTATION – Emmanual
CASE PRESENTATION – Emmanual
INTAKE DATE: September, 2019
IDENTIFYING/DEMOGRAPHIC DATA: Emmanual is an 8-year-old, Haitian-American male in third grade. He lives with his parents and a younger brother who is 6-years-old in Miami, Florida. His parents immigrated to the United States 11 years ago.
CHIEF COMPLAINT/PRESENTING PROBLEM: Emmanual’s parents are concerned about Emmanual’s behavior in school and his relationships with his peers. He has some challenges with his grades which seem to be suffering. There have been several parent/teacher meetings this year. His parents believe his intellect level is above average but his grades do not indicate that. This has been consistent since Emmanual started attending school and the parents chose to previously deal with the school issues at home. They are more concerned now since there are issues in the classroom
HISTORY OF PRESENT ILLNESS: Emmanual has struggled in school relating to his peers since he began preschool. Emmanual often has difficulty taking direction in the classroom not understanding any inferences for the work and must be directly guided. He misses normal social cues for his developmental age. Emmanual appears to comprehend the material but doesn’t retain what is not specifically told to him. Emmanual’s mom worries that Emmanual does not know how to socialize with others and believes it may be because of her paying attention to her younger son.
Emmanual has some behavioral challenges in school. His behavior has been addressed in reference to proper behavior (his communication style) inside the classroom as opposed to the playground. He is reported to be nice to others and does have several friends in his class but rarely has conversations with his peers or knows when to listen rather than speak. His friends have changed over these past several years, even though they started preschool together, because of his difficulty to relate to his peers. Emmanual does bring home report cards that seemingly fail to reflect his cognitive ability.
PAST PSYCHIATRIC HISTORY:
Emmanual’s parents tried all kinds of culturally traditional ways to help their child relate to others. When nothing changed and the parent/teacher conferences increased, they chose to seek outside help.
SUBSTANCE USE HISTORY:
Emmanual denies any use of drugs or alcohol.
PAST MEDICAL HISTORY:
Emmanual has been fairly healthy throughout his young life. Any illness was remedied by his parents’ through natural means and by following their religious prescriptions.
FAMILY MEDICAL AND PSYCHIATRIC HISTORY:
This is a Haitian family which adheres to the behaviors and parenting of their culture. There is no reported psychiatric history in the family. Any medical conditions were treated with herbal remedies or medicinal foods.
CURRENT FAMILY ISSUES AND DYNAMICS:
Emmanual’s parents are from Haiti. In the Haitian culture, Emmanual’s behaviors might be interpreted as indicating a poorly raised child whose behavior could be modified by parental discipline. His family suggested that these “unnatural” behaviors are attributed to bad spirits. According to Haitian American tradition, the family often tried therapeutic foods, natural sedatives and purgatives from herbal medicine, and religious treatments to help alleviate these issues.
The parents report running a strict Haitian household. Both children are required to do household chores daily. Emmanual’s parents become worried when Emmanual is assigned chores and does not understand exactly what to do. He is worried about trying to please his parents. The parents are not comfortable bringing Emmanual in for an evaluation, but they were referred by the school system.
MENTAL STATUS EXAM:
Emmanual presents as a casually dressed child his stated age of 8. He is a bit anxious during the interview. His affect is appropriate but worries about disappointing his parents. Motor activity is appropriate. Speech is clear. At times during the interview, he does not share information and seems to have difficulty communicating. There is no evidence of delusions or hallucinations. Emmanual’s intelligence appears average. He is oriented to time, place, and person but has challenges answering those questions.
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