Zach is a four-year old Caucasian male who was referred to the clinic by his mother. Zach’s symptoms began at age 2 years old with behaviors such as fidgeting, impatience, talking excessively, interrupting others, and climbing on furniture. Zach’s behaviors include noncompliance especially in his morning routine and when asked to obey, throwing a temper tantrum when things are not his way, hitting others, destroying property, hyperactivity, and lying or blaming others to get out of trouble. Zach will lie to get avoid punishment and blames others about 7 times a week and the behavior started 6 months ago.
Zach does not get along with his siblings or peers. He will fight, not share, and avoid them. Both is brother and sister, will not play with …show more content…
Zach does not have proper self-regulation so when things do not go his way, then he will act out irrationally. For example, if his food is not cut in a certain way, if his clothes are not lined up properly, and if his favorite foods are not being served then he will throw a tantrum which include behaviors such as whining and stomping. Zach’s mother says that she tries to meet his needs, but the tantrums do not end. When Zach’s mother or teacher commands him to complete a task, they will have to ask at least 3-4 times all while he actively defies them. He will lay on the floor screaming, jump on furniture, whine, hit, and throw things. Zach began preschool last year and was held back in the 3-year old class for another by his mother. He is in school two times a week for two hours and spends time at his grandmother’s (mother’s side) in-home …show more content…
Zach’s mother stated that her parents were divorced and her biological after was somewhat “odd” since he never finished a task or got rid of anything and he was specific in his order on how she should address him. Zach’s great-grandfather on his father’s side committed suicide and Zach’s grandfather was aggressive and had “behavior problems”. In the family’s home, Zach’s mother and father are married and both work full time jobs. Around the house, Zach’s mother does most of the housework because when her husband comes home from work he is normally in a negative mood – this makes her tired and feel resentful. Mrs. M has stated that she sometimes stops forcing Zach and enforcing consequences to prevent tantrums. When Zach’s father is present he has a quick temper that affects his actions towards Zach’s behaviors which include yelling at him and leaving the room. The parents disagree on the condition of Zach’s behaviors which is causing a strain in their marriage. Zach’s medical treatment history starts from when he was born preterm at 35 weeks in a difficult birth and after being home for a few days he was readmitted for high bilirubin levels which were stabilized after two weeks. Zach’s mother said that Zach was a difficult to soothe and easily irritated as a baby to too much noise or stabilization. Zach has had multiple ear