Florida Gulf Coast University Andy Child Abuse & DSM 5 Case Discussion – Assignment Help

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Discussion One

Mom is concerned about Andy’s imaginary playtime, decreased social interactions, isolation, frequent falls, and self-talk. Until a complete battery of appropriate testing has been completed, any diagnosis is simply speculation and thus open to ridicule. It is worrisome that mom’s concerns occurred after the father abandoned the family. Are Andy’s signs and symptoms caused by his father rejecting the family? Or is there a medical reason? How is Molly, Andy’s sister, handling this transition? How is mom, Emily, managing the change? Is there anyone else in the home?

As a current medical professional, my initial concern would be child abuse. Several factors may contribute, such as a father who has recently abandoned his family, Andy’s destruction of toys, and Andy’s frequent falls. To rule out child abuse, I would want a magnetic resonance imaging (MRI) or computerized tomography scan (CT) under the guise that Andy may have a subdermal hematoma due to his many falls. Additionally, I would want ex-rays done to rule out fractures or broken bones as well as blood work such as an electrolyte panel, creatine kinase (CK), complete blood panel (CBP), and basic metabolic panel (BMP). The electrolyte panel may explain weakness that leads Andy to fall an altered mental status (AMS) due to electrolyte imbalances. CK may explain general muscle weakness that may lead Andy to fall frequently. CBP may disclose such afflictions as Leukemia. The BMP may reveal kidney malfunctions, causes for decreased brain function, and unusual muscle contractions that may cause frequent falls.

From a psychologist’s point of view, once Andy was cleared on the above medical assessments, several other assessment measures may be conducted. A neuropsychological battery may be performed. Neuropsychological tests may assess for one maladjusted behavior or cover several different areas such as memory, sensory, communication, visual, behavioral, etc. “The Neurosensory Center Comprehensive Examination of Aphasia (NCCEA) is a battery of tests that focuses on communication deficit. The Southern California Sensory Integration Tests make up a battery designed to assess sensory-integrative and motor functioning in children 4 to 9. A neuropsychological battery called the Severe Impairment Battery (SIB) is designed for use with severely impaired assessees who might otherwise perform at or near the floor of the existing test. The battery is divided into six subscales: Attention, Orientation, Language, Memory, Visuoperception, and Construction” (Cohen & Swerdlik, 2018, p. 518).

The Bruininks-Oseretsky Test of Motor Proficiency was designed for use with children aged 4½ to 14½ (Cohen & Swerdlik, 2018, p. 511). To assess Andy’s overall motor skills, the Bruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2) takes 15 to 20 minutes to complete the short form version (Bruininks & Bruininks, 2010). The BOT-2 complete assessment may take 45 to 60 minutes to complete, including subtests for “fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, upper-limb coordination, and strength” (Bruininks & Bruininks, 2005).

Neuropsychological battery assessment like the Dean Woodcock Neuropsychological Battery (DWNB) may benefit Andy; however, it is long with an approximate 1 hour and 45 minutes administer time (Dumont, Willis, Viezel, & Zibulsky, 2013). The DWNB was created for those aged four and above, assessing the test taker’s emotional, sensory, and motor functions (Dumont, Willis, Viezel, & Zibulsky, 2013). In conjunction with the DWNB, the Personality Inventory for Children – Second Edition (PIC-2), for ages 5 to 19, should be conducted to obtain a “complete picture of the child’s emotional, behavioral, social, and cognitive adjustment” (Lachar & Gruber, 2002). The short version of the PIC-2 takes about 15 minutes with 96 true or false items, whereas the full version provides 275 true or false items and takes the parent about 40 minutes to complete (Lachar & Gruber, 2002).

Other assessments that may be favored are Behavior Assessment System for Children – 3 (BASC-3), Vineland Adaptive Behavior Scales – 3 (VABS-3), and the Children’s Depression Inventory – 2 (CDI2).

A behavior assessment, Behavior Assessment System for Children – 3 (BASC-3), or an adaptive behavioral measurement, Vineland Adaptive Behavior Scales – 3 (VABS-3), may be conducted. The BASC-3 “utilizes teacher and parent ratings to identify adaptive difficulties on 16 scales ranging from daily living activities to study skills” (Cohen & Swerdlik, 2018, p. 335). The BASC-3 covers ages 2 to 21 and takes about 15 to 20 minutes for completion by the parent or school teacher (Reynolds & Kamphaus, 2015). Also, the BASC-3 uses a “comprehensive set of rating scales and forms to provide a complete picture of a child’s or adolescent’s behavior and emotions” (Reynolds & Kamphaus, 2015), assisting in a treatment plan for Andy. The VABS-3 may properly assess Andy since the age range is from birth to 90, clarifying intellectual disabilities and developmental disabilities helping the psychologist make an accurate treatment plan (Sparrow, Cicchetti, & Saulnier, 2016).

Because Andy’s father abandoned the family, Andy may be depressed or feel that it is his fault that his daddy left. Therefore it is not out of the realm of reasoning to attempt to gauge Andy’s inner feelings with the Children’s Depression Inventory – 2 (CDI2) even though Andy is six years old. Hypothetically, the CDI2 is for ages 7 to 17 with at a first to second-grade reading level. Although the psychologist may have to improvise by assisting Andy in reading the items, the short version takes about 5 minutes, yielding results in emotional and functional problem areas (Kovacs, 2010). The CDI2 has four subscales that are reported: “negative mood/physical symptoms, negative self-esteem, interpersonal problems, and ineffectiveness” (Kovacs, 2010).

Part 2 – Andy is referred to Dr. Woody Pride, a neuropsychologist. Dr. Pride decides to administer Andy the Brief Neuropsychological Cognitive Examination (BNCE) published by WPS since it can be issued in one sitting and reports that it minimizes reading skills to complete it. Determine if this is an appropriate test to obtain additional data on Andy regarding neuropsychological concerns. If proper, then state that and provide your rationale for supporting this as a test selection. If it is not suitable, then communicate that and justify rejecting this as a test selection.

The Brief Neuropsychological Cognitive Examination (BNCE) is not appropriate for young Andy. The BNCE was created for 18 years and older individuals, excluding Andy at six years old. The BNCE test can be completed in under 30 minutes, providing an evaluative means to assess clients’ cognitive abilities with psychiatric disorders and manifestations due to neurological diseases (Tonkonogy, 1997). “Results can help you differentiate problems caused by subcortical lesions from those caused by cortical lesions and those caused by primary psychiatric disorders” (Tonkonogy, 1997). Regardless if you find the BNCE appropriate or not for Andy and the referring concerns, identify a second neuropsychological test that would be highly recommended for its use with Andy.

Though not previously addressed, the Childhood Autism Rating Scale second edition (CARS-2) may be a second neuropsychological test that could yield tempting results. CARS-2 takes approximately 15 minutes to complete, beginning at two years of age. CARS-2 helps identify children with autism and the severity of the autism based on parental or caregiver observations (Schopler, Van Bourgondien, Wellman, & Love, 2010). The next best choice would ultimately be the NEPSY-II is offered in two age categories: ages 3 to 4 and 5 to 16. The NEPSY-II can take from 45 minutes to 3 hours to complete. The number of subtests is not set. Therefore, the administrator can pinpoint which assessments will best fit the client, in this case, Andy. The NEPSY-II gauges “executive functioning/attention, language, memory/learning, sensorimotor functioning, visuospatial processing, and social perception” (Korkman, Kirk, & Kemp, 2007). The NEPSY-II is a far superior choice as a neuropsychological test for Andy.

As a test user, identify any AERA standards regarding The Rights and Responsibilities of Test Users, which are implicated in this case study of Andy Davis.

Because Andy is a minor child, several AERA standards are fitting. Standard 8.4 in Standards for Educational and Psychological Testing (2014, p. 134) states, “Informed consent should be obtained from test-takers, or their legal representatives when appropriate, before testing begins, except (a) when testing without consent is mandated by law or governmental regulation, (b) when testing is conducted as a regular part of school activities, or (c) when consent is implied, such as in employment settings. Informed consent may be required by applicable law and professional standards.” Accordingly, Emily must consent to any medical, psychological, and neuropsychological exams that may be requested or offered. Standard 8.1, “Information about test content and purposes that is available to any test taker before testing should be available to all test takers. Shared information should be available free of charge and in accessible formats” (American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, 2014, p. 133). Emily, Andy’s mother, has the right to information about the purpose and content within any test given to Andy. As Standard 8.3 states, “When the test taker is offered a choice of test format, information about the characteristics of each format should be provided” (American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, 2014, p. 134). Due to Andy’s many difficulties and obstacles in his young life, he should be allowed to test with a format that is easy for him to comprehend and understand, with the same respect provided to Emily, Andy’s mom.


Discussion Two


Part 1

Based on this referral information, what would be the three tests you would include in a standard battery for screening purposes that include neurological concerns?

Andy is a six year old by living with his mother, Emily, and his sister, Molly, who just moved into a smaller home because Andy’s father is no longer around. Andy has been referred because Emily has expressed several concerns regarding Andy’s behavior. Andy has reportedly being keeping to himself more often, with decreased social interaction, except when speaking to himself. Emily also mentioned Andy taking toys apart and falling a lot.

According to the DSM-5, there are various sections of neurocognitive disorders, which are caused by multiple reasons. However, taking an unbiased perspective, Andy’s behavior could be responses to a traumatic event, like the “abandonment” of his father, or a type of conduct disorder (DSM, 2013). At his young age, he is still learning, and taking away someone he potentially loved, could cause his “acting out”. There is also no reporting of Andy having any type of mental distress in the past, so conducting assessments are critical. Another aspect of the DSM is neglect and abuse, where Andy could be keeping to himself to work internally on what is happening to him at home.

In order to assess Andy, the test battery I would conduct would include mostly questions I would ask him. As he is a young child, he may not understand the questions on many assessments. One option in the battery is a child’s version of the Beck Depression Inventory to determine how Andy is feeling internally. This will gauge if he is feeling lonely, sad, unloved, and other emotions related to depression (Cohen, 2018). Further, to address the abuse or neglect option, I would utilize anatomically detailed dolls. If Andy has had a traumatic experience on his spectrum, the doll would provide insight. Further, assess Andy’s executive function, I would include the tower of Hanoi.

Part 2

You complete your evaluation using the three (or more) tests in your standard battery and obtain signs signaling that a more thorough neuropsychological evaluation is recommended. Subsequently, Andy is referred to Dr. Woody Pride, a neuropsychologist. Dr. Pride decides to administer Andy the Brief Neuropsychological Cognitive Examination (BNCE) published by WPS since it can be administered in one sitting and reports that it minimizes reading skills to complete it. Based on this information from Dr. Pride, and after conducting your own research on this test selection, determine if this is an appropriate test to obtain additional data on Andy regarding neuropsychological concerns. If it is appropriate, then state that and provide your rationale for supporting this as a test selection. If it is not appropriate, then state that and provide your rationale for rejecting this as a test selection. Finally, regardless if you find the BNCE appropriate or not for Andy and the referring concerns, identify a second neuropsychological test that would be highly recommended for its use with Andy (you may select one from the list provided you in Unit 2, or another neuropsychological test battery).

Given the information provided by Dr. Pride, conducting the BNCE is inappropriate for assessing Andy. Even though this test is completed in thirty minutes or less, it is meant for adults, ages eighteen and older. Utilizing an assessment with this time frame is beneficial especially due to a child’s attention. This neuropsychological test does provide a general picture of cognitive function, and provides insight on diagnosis and follow-up (Tonkonogy, 1997). This assessment is also meant for those who are diagnosed with psychiatric disorders, which we have no evidence that Andy has. Making use of one that is similar to this but meant for children would important.

As a test user, identify any AERA standards regarding The Rights and Responsibilities of Test Users, which are implicated in this case study of Andy Davis.

In the case study of Andy, there are a few standards of test users that relate. One of the clusters is about validity of interpretations. This is important when reviewing Andy’s scores. For example, 9.1 is regarding the responsibility, as training, experience, and credentials are required. Another standard, 9.5, mentions the alertness of scoring errors. With this, standard 9.6 is correlated with the possibility of misinterpretations of test scores (APA, 2014). These are important because the test user should be able to understand the tests given to Andy, as well as understand what his scores mean.

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