Peer Responses – Case of Hao, A Patient with Autism and ADHD

Peer Responses – Case of Hao, A Patient with Autism and ADHD

Hello Felicia,

Thank you for your post. This is a good analysis of Hao’s case. Considering the biopsychological and social risks and protective influences before the onset of the disorder and during the course of the disorder is essential in diagnosing complex disorders such as attention deficit hyperactivity disorder (ADHD). An interesting biological influence on the onset of ADHD that you have identified is Hao having older parents. Although the risk of having ADHD is higher when any of the parents have the disorder or other mental health issues, it is reportedly clear that Hao’s parents have no known chronic diseases. However, besides being male and young being a risk factor for developing ADHD, the mother’s age is identified as a biological influence. Parental age plays a significant role in the development of neurodevelopmental disorders, including ASD and ADHD. Evidence shows that advanced parental age increases the risk of developing these disorders (Janecka et al., 2019). The old age of Hao’s parents and other social and psychological risk influences can explain the onset and course of Hao’s ADHD.

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References

Janecka, M., Hansen, S. N., Modabbernia, A., Browne, H. A., Buxbaum, J. D., Schendel, D. E., Reichenberg, A., Parner, E. T., & Grice, D. E. (2019). Parental Age and Differential Estimates of Risk for Neuropsychiatric Disorders: Findings From the Danish Birth Cohort. Journal of the American Academy of Child and Adolescent Psychiatry, 58(6). https://doi.org/10.1016/j.jaac.2018.09.447

Peer Response 2

Hello Priscilla,

This is a great post. Your assessment of Hao’s case, with a focus on the risk and protective factors before and throughout the onset of ASD and ADHD symptoms, is a solid foundation for developing a more specific diagnosis. It is also a good approach during the time of developing the diagnosis to assess Hao’s family and medical history. The family and medical history is one way of understanding the biological, social, and psychological risk factors that may have influenced the development of neurodevelopmental disorders and the progression of the disorder. It is a great thing that you have developed care goals that align well with the needs of the client. Additionally, considering his strengths and focusing on nurturing them during his care is a recommended approach in strengths-based diagnosis and therapy (Yuen et al., 2020). Additionally, considering his religious beliefs and those of his family is also among the best practices in the diagnosis and providing care to children or patients from a different cultural background.

References

Yuen, E., Sadhu, J., Pfeffer, C., Sarvet, B., Daily, R. S., Dowben, J., Jackson, K., Schowalter, J., Shapiro, T., & Stubbe, D. (2020). Accentuate the Positive: Strengths-Based Therapy for Adolescents. Adolescent Psychiatry, 10(3), 166–171. https://doi.org/10.2174/2210676610666200225105529

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Case 1: Hao

Diagnosis: Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder

Rationale: Hao has been struggling to stay alert in class. He has problems relating to other children in class and can’t follow basic instructions such as handwashing. Hao has temper tantrums when his favorite activities get interrupted. Also, ignores his parents when they try to discipline him.

Additional Information Needed: Teacher’s perspective and notes. Family and medical history. Autism and ADHD assessment is needed.

Table A.1 Biopsychological Risk and Resilience Assessment for the Onset of the Disorder.

	Risk Influences	Protective Influences
Biological	Male, ADHD, and older parents.	The mother was able to access quality prenatal care and had a healthy pregnancy and delivery. Both parents are healthy and report no chronic physical or mental illness.
Psychological	Throws tantrums/ can’t sit still.	He gets strong verbal communication and direct eye contact from his parents.
Social	Hao always wanted to play alone but has problems connecting personally with other children.	Has 11 first cousins, sees them mostly every weekend, and interacts with them well.

 Table A.2 Biopsychosocial Risk and Resilience Assessment for the Course of the Disorder

	Risk Influences	Protective Influences
Biological	Severe food allergies/ eczema.	Their parents are closely involved with his pediatrician, and his mother monitors his food intake well.

Psychological	Hao speaks very loudly and close proximity to people’s faces.	IQ of 130, and incredibly gifted in books, musical instruments, and computer games.
Social	The strain on parent’s marriage.	Parents rely heavily on the guidance of their faith.

 Goals:

1. Explore therapy, and appropriate treatment plans for Hao that will help him develop social, communication, and behavioral skills.
2. Make sure Hao has additional support at school.
3. Educating parents on Autism, and ADHD. Also, additional support should be provided to help them better understand these diagnoses.

 Critical Perspective of the Diagnosis: Hao displays a lot of weaknesses, but also has a lot of strengths as well. As we diagnose and develop treatment plans, it’s important we look at his family culture and perspectives in this situation before going further.

 Discussion 2

Priscilla

 Diagnosis: Autism and ADHD

Rationale: Hao is not able to relate to other children, throws temper tantrums when easily frustrated, has trouble focusing, is not able to follow instructions, washes their hands constantly, stares into space, and has little to no emotional expression.

Additional Information Needed:  Family history of both parents, medical evaluation, results from assessment of Autism and ADHD, speech and language assessment.

Table A.1  Biopsychosocial Risk and Resilience Assessment for the Onset of the Disorder

	Risk Influences	Protective Influences
Biological	Male, parents are older, severe food allergies	Mother had quality prenatal care, normal delivery, and birth weight, and achieved developmental milestones on time.
Psychological	IQ 130, poor social interaction, inadequate communication	Musically gifted and computer savvy, parents report to be healthy.
Social	Prefers to be alone, cannot follow a routine, and is easily frustrated	Interacts with cousins frequently and displayed fairly normal behavior in preschool.

Table A.2  Biopsychosocial  Risk and Resilience Assessment for the Course of the Disorder

	Risk Influences	Protective Influences
Biological	Delay in motor skills, food allergies	Sees pediatrician often, parents involved
Psychological	Tantrums, cannot sit still	Responsive to time-outs and direct eye contact
Social	Strained family (marriage), not engaged in activities of others his age	Parents are still together, gifted in music and computers

Goals:

1. Explore therapies that will aid in communication, social skills, and how to express emotions.
2. Explore resources that are available to those with Autism and ADHD.
3. Educated parents on Autism and ADHD and ways to engage and cope with issues.

 Critical Perspective of the Diagnosis: Hao has displayed many strengths, good to nurture those.  Need to take his culture and religion into consideration when developing a plan and treatments.