NURS 6630 CC "I have trouble paying
attention at School" - Sarah Higgins a 9 year
old girl 2022/2023
CC: “I have trouble paying attention at school”
HPI: Sarah Higgins is a 9 year old AA girl who came in with her mother for mental evaluation. The patient has been inattentive most of the time at school. Sarah admits that she cannot remember all her assignments and the teachers have to write down the list of these assignments. However, the patient forgets where she has placed the list almost on daily basis. The mother has to write the list on her phone to keep reminding the child. She starts that the child has been forgetting her assignment since when she was in her kindergarten. The girl also has a problem of fidgeting and sitting still on her chair. She only sits a few minutes when she is reading an interesting book. However, she notes that she cannot recall what she has read on the book. Also, if a teacher reads the book for her, she cannot remember immediately what is being read. The patient has a tendency of loosing things. She starts leaving her geography book in a bus and a bracelet she was given by her mother in a bathroom in a restaurant.
The child reports being upset when her teacher asks her to do something because she cannot hear the instructions most of the time. She states that she daydreams playing with her dog, Conley while at school. She is frustrated because she makes a lot of mistakes while doing her assignments. During the interview, the girl presents with some level of inattentiveness and the mother keeps reminding her that the question was directed toward her. The patient admits she cannot recall what she was being asked during the interview because she was thinking about a picture on the wall. The mother reports that the patient has a behavior of running of a painting to another. The teacher’s reports highlighted that the patient has a problem waiting for her turn. The mother recounts a scenario where when the child was young, they could not take her to the Zoo because put her hands inside the cages of dangerous animals.
The child admits that she had a problem with her attention span and she needed help.
Past Psychiatric History
General Statement: The child entered treatment 2 months ago after separation of her parents
Caregivers: Parents (50% each of their time with the child)
Hospitalization: None
Medication: None
P a g e 1 | 8 Substance Use History: No history of substance use
Family Psychiatric History: Father, 36, alcoholic, mother, 32, no psychiatric conditions. No family history of suicides or mental illnesses
Social History: Sarah Higgins is the only child of Mr. and Mrs Higgins. Her parents are currently separated and they are working towards their divorce. They have sought counseling on who the divorce could affect their only child. The couple has tried to work things out, but it seems they are drifting away from the reconciliation. However, each parent spends 50 percent of their time with Sarah and their home to avoid disrupting the child. However, Sarah worries about the anticipated divorce of their parents. The couple acknowledges that they have challenges with their parenting styles. Although the mother
acknowledges the important of psychiatric evaluation of their child, the father is resistance of the services citing that what Sarah was undergoing was a normal developmental stage. However, the father agreed that the child should seek psychiatric services in fear of a potential divorce. The mother is a dentist while the father is a database manager working in a large IT firm
The child is a average student at school. She sometimes scores poorly because of her inattentiveness. She cites that her mother is her primary source of support. She has a dog that likes playing with. Her best friend is her next door child and they have known each other since kindergarten. She gets into trouble with her friends because she can be over excites and impatient waiting for her turn while playing. Sarah is good at 1:1 friends and likes interacting with other children. The parents reports that their divorce may negatively impact or worsen the condition of their child. Her inattentiveness at school
and home has caused both couple and individual stress for these parents. The father relates her condition as behavioral issue because Sarah has full attention while playing video games, but has reduced attention while doing her attention. On the other hand, the mother things that her inattentiveness is something more than just a behavior by a mental issues that should be addressed with urgency. The father also noted some fluctuation in social activities because the child scores very well in some while at home and misses almost every pass while at away field.
Medical History: All childhood vaccinations up to date including flu shot, tetanus booster, Tdap. No history of chronic conditions such as asthma. No history of hospitalizations or surgical history.
Current Medications: none
Allergies: Penicillin allergies-causes rash. No food allergies or cold allergies.
Reproductive Hx: Deferred
ROS:
GENERAL: No weight changes, appetite changes, fevers, chills, or changes in energy levels.
HEENT: No headaches or head injuries. No eye pain, double vision, vision changes, eye drainage or eye redness. No ear pain, ringing ear, or ear drainage. No nasal congestion, runny nose, or changes in smell. No sore throat, mouth sore, or ulcerations
P a g e 2 | 8
attention at School" - Sarah Higgins a 9 year
old girl 2022/2023
CC: “I have trouble paying attention at school”
HPI: Sarah Higgins is a 9 year old AA girl who came in with her mother for mental evaluation. The patient has been inattentive most of the time at school. Sarah admits that she cannot remember all her assignments and the teachers have to write down the list of these assignments. However, the patient forgets where she has placed the list almost on daily basis. The mother has to write the list on her phone to keep reminding the child. She starts that the child has been forgetting her assignment since when she was in her kindergarten. The girl also has a problem of fidgeting and sitting still on her chair. She only sits a few minutes when she is reading an interesting book. However, she notes that she cannot recall what she has read on the book. Also, if a teacher reads the book for her, she cannot remember immediately what is being read. The patient has a tendency of loosing things. She starts leaving her geography book in a bus and a bracelet she was given by her mother in a bathroom in a restaurant.
The child reports being upset when her teacher asks her to do something because she cannot hear the instructions most of the time. She states that she daydreams playing with her dog, Conley while at school. She is frustrated because she makes a lot of mistakes while doing her assignments. During the interview, the girl presents with some level of inattentiveness and the mother keeps reminding her that the question was directed toward her. The patient admits she cannot recall what she was being asked during the interview because she was thinking about a picture on the wall. The mother reports that the patient has a behavior of running of a painting to another. The teacher’s reports highlighted that the patient has a problem waiting for her turn. The mother recounts a scenario where when the child was young, they could not take her to the Zoo because put her hands inside the cages of dangerous animals.
The child admits that she had a problem with her attention span and she needed help.
Past Psychiatric History
General Statement: The child entered treatment 2 months ago after separation of her parents
Caregivers: Parents (50% each of their time with the child)
Hospitalization: None
Medication: None
P a g e 1 | 8 Substance Use History: No history of substance use
Family Psychiatric History: Father, 36, alcoholic, mother, 32, no psychiatric conditions. No family history of suicides or mental illnesses
Social History: Sarah Higgins is the only child of Mr. and Mrs Higgins. Her parents are currently separated and they are working towards their divorce. They have sought counseling on who the divorce could affect their only child. The couple has tried to work things out, but it seems they are drifting away from the reconciliation. However, each parent spends 50 percent of their time with Sarah and their home to avoid disrupting the child. However, Sarah worries about the anticipated divorce of their parents. The couple acknowledges that they have challenges with their parenting styles. Although the mother
acknowledges the important of psychiatric evaluation of their child, the father is resistance of the services citing that what Sarah was undergoing was a normal developmental stage. However, the father agreed that the child should seek psychiatric services in fear of a potential divorce. The mother is a dentist while the father is a database manager working in a large IT firm
The child is a average student at school. She sometimes scores poorly because of her inattentiveness. She cites that her mother is her primary source of support. She has a dog that likes playing with. Her best friend is her next door child and they have known each other since kindergarten. She gets into trouble with her friends because she can be over excites and impatient waiting for her turn while playing. Sarah is good at 1:1 friends and likes interacting with other children. The parents reports that their divorce may negatively impact or worsen the condition of their child. Her inattentiveness at school
and home has caused both couple and individual stress for these parents. The father relates her condition as behavioral issue because Sarah has full attention while playing video games, but has reduced attention while doing her attention. On the other hand, the mother things that her inattentiveness is something more than just a behavior by a mental issues that should be addressed with urgency. The father also noted some fluctuation in social activities because the child scores very well in some while at home and misses almost every pass while at away field.
Medical History: All childhood vaccinations up to date including flu shot, tetanus booster, Tdap. No history of chronic conditions such as asthma. No history of hospitalizations or surgical history.
Current Medications: none
Allergies: Penicillin allergies-causes rash. No food allergies or cold allergies.
Reproductive Hx: Deferred
ROS:
GENERAL: No weight changes, appetite changes, fevers, chills, or changes in energy levels.
HEENT: No headaches or head injuries. No eye pain, double vision, vision changes, eye drainage or eye redness. No ear pain, ringing ear, or ear drainage. No nasal congestion, runny nose, or changes in smell. No sore throat, mouth sore, or ulcerations
P a g e 2 | 8
