What disorders do you suspect?

-Learning disorder, mood disorder, Autism, ADHD, reaction to stressors, Oppositional defiant disorder, sensory processing disorder

What are the appropriate steps to screen and evaluate this patient?

To screen and evaluate this patient the provider must complete a full assessment of previous medical history including birth history, family medical history, assessment of current family setting, physical assessment, and patient questionnaire/observation. Often, a behavioral assessment requires an extended amount of time, and the provider should ensure enough time is allotted. Entering into the assessment providers promote trust with caregivers and patients by having empathy, listening with curiosity, and providing support (Martinsone et al., 2022).

Questions that are an important part of the family history include medical and socioeconomic. In-depth familial mental and developmental health histories include questions related to “school failure, delinquency, substance abuse, learning disorders, reading problems, mood disorders, personality disorders, schizophrenia, attention-deficit/hyperactivity disorder (ADHD), autism, genetic syndromes, and birth defects (Garzon et al, 2025).” Socioeconomic factors that may affect the child’s behavior include incarceration, abuse, divorce, unstable living arrangements, school changes, teacher changes, and numerous more (Martinsone et al., 2022).

The physical assessment should note the child and caregiver’s appearance (are they disheveled, well groomed, appear nourished) as well as attitude/interaction (appropriate for age and setting, responsive to questions), activity level/behavior (fidgeting, lethargic, tense, etc), psychomotor activity (possible neurological involvement), speech (volume, tone, rate), thought processes (coherent, disorganized, flight of ideas, blocking, loosening associations, echolalia, perseveration), thought content (delusions, obsessions, perceptual disorders, phobias), level of impulse control (aggressive, oppositional), mood/affect (depressed, anxious, flat, guarded, fearful, irritable, elated, euphoric). The provider can also provide the child with dolls or paper/crayons and ask the child to act out scenarios with the dolls or draw photos to show their perception (Garzon et al, 2025).

What will be your management of this child?

The management of this child is completely dependent on the results of the assessment. Management can range from therapy, social services referral, cognitive behavioral therapy, and medications. If I were the provider, I would complete my assessment and if unable to pinpoint a diagnosis I would request a formal evaluation by developmental pediatrics to ensure an appropriate diagnosis (Garzon et al, 2025).

Please respond to two peers’ posts regarding their differential diagnosis list and/or plan. 

  • What did you find interesting about their response?
  • How did their differential diagnosis list or plan compare to yours?
  • Do you agree with their plan and recommendations?
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