Vital Signs: HR 88, RR 18, BP 100/72, Temp 94.8 ax, O2 sat-96%
Henry lawless is a 12 year old African American male who is in 7th grade and lives with his parents and seven year old sister. He was referred to outpatient child and adolescent and family center.
According to the mother,” My son’s aggressive behavior is out of control.”
History of Chief Complaint:
The parents report that Henry has been a good student but in the last six months his mood has been irritable and angry at home, and he has been having physical shoving matches with his sister that end in her crying and the patient being disciplined. He has been easily annoyed by anything his parents say to him, causing arguments with his parents and blaming them for annoying him. His teachers report that he seems more argumentative and disruptive in class. He had one episode at school where he became verbally aggressive with a student in class.
Past Psychiatric History:
Henry’s mother reports that her son’s behavior was somewhat a problem during early kindergarten. He did not like going to school, would protest, and then become aggressive with the other children, taking their toys, shoving and hitting them if they did not respond to his request.
His mother also indicated that during this time he would be ” mean” to the small dog that they adopted and kicked the dog when he walked past him. He would sit in timeout for at least 15 minutes, which would work sometimes but other times he would go back and try to kick the dog. The pattern of behavior became so bad that the parents had to go for counseling to deal with their anger towards Henry. A child psychiatrist diagnosed Henry with attention deficit/hyperactivity disorder (ADHD) and recommended that he be started on a psychostimulant at age 7. His parents were worried that he would become addicted and since his report cards were good they did not start the medicine.
This is an unfolding case study which we will be utilizing for this discussion
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