Case Study

Case Study

Case Study

A wide variety of psychological problems may occur in childhood. These include problems that compromise children's capacities to learn and communicate, such as intellectual disability; language delay; specific learning disabilities; and pervasive developmental disorders including autism. Problems developing bowel and bladder control, sleeping and waking routines, and feeding and eating disorders such as anorexia nervosa may also occur in childhood and adolescence (Barlow, Lawton-Esler and Vitali, 1998). Children and adolescents may develop neuropsychological problems and adjustment difficulties secondary to conditions such as epilepsy or head injury. All of these difficulties are of concern to psychologists who study abnormal behavior. However, in addition to these difficulties, two broad classes of conditions have been a focus for psychologists who study abnormal behaviour in childhood. These are disruptive behaviour disorders (such as attention deficit hyper-activity disorder, oppositional defiant disorder, conduct disorder) and emotional disorders (such as anxiety and depression).

Attention deficit hyperactivity disorder, attention deficit disorder, hyperkinetic disorder, hyperkinesis and minimal brain dysfunction are some of the terms used for a syndrome characterized by persistent overactivity, impulsivity and difficulties in sustaining attention (Barkley, 1998). In this chapter preference will be given to the term attention deficit hyperactivity disorder (ADHD) since this is currently the most widely used.

Case example

Shonda, aged 12, was referred for assessment because her teachers found him unmanageable. She was unable to sit still in school and concentrate on her schoolwork. She left her chair frequently and ran around the classroom shouting. This was distracting for both her teachers and classmates. Even with individual tuition she could not apply herself to her schoolwork. She also had difficulties getting along with other children. They disliked him because she disrupted their games. She rarely waited for her turn and did not obey the rules. At home she was consistently disobedient and according to her father ran 'like a motorboat' from the time she got up until bedtime. She often climbed on furniture and routinely shouted rather than talked.

Family history

Shonda came from a well-functioning family. The parents had a very stable and satisfying marriage and together

Table 1.1 Clinical features of childhood behaviour disorders

Domain

ADHD

Oppositional defiant disorder

Conduct disorder

Cognition

• Short attention span

• Distractibility

• Unable to foresee consequences of behaviour

• Immature self-speech (internal language)

• Low self-esteem

• Lack of conscience

• Learning difficulties and poor school performance

• Limited internalization of social rules or norms

• Hostile attributional bias ...