The Patient Evaluation for Best Treatment Remedy - Case Study Example

Name: Professor: Course: Date of Submission: Psychology Case Study This case scenario focuses on the psychological process that psychologists pass patients in order to determine the patient’s health concerns and device remedies for treatment. Generally, the patient evaluation for best treatment remedy is underpinned by analysis of patient’s medical history, interview transcripts with family members of caregivers, and other relevant bits of information crucial for preparation of the measure of treatment. This report is a critical analysis of Melissa’s condition that details the relevant facts in her history, interpretation, diagnosis and prognosis. In the preparatory stage for Melissa’s surgery, the doctor settled down the patient and tried to comfort the accompanying mother who seemed composed and well versed with the child’s health problems. Particularly, it is by interrogating about Melissa’s health history that all necessary information leading to the correct diagnosis, prognosis, and remedial treatment were established. Melisa’s History The track of health information of a child is crucial for determination of a child’s treatment decisions. At the time of birth, Melissa was quite normal showing normal development despite being born with signs of mild jaundice, a problem that was successfully managed through light therapy. Her medical report or information indicates that she had a severe fever at the age of six which she also overcame successfully. Melissa had normal childhood development as indicated by features such as the normal crawling, walking and talking steps. However, it was later established by a specialist that she suffered stroke before her birth, a condition known as Hemiparesis attributed to the noticeable minimum use or less activeness of her right side. The interauterine cerebral vascular accident somehow affected the left side of Melissa‘s brain which further explain the adverse effects on her right hand side motor function. Melissa’s language skills development at first appeared to be normal change with time as reported by her mother, Mrs. Franks. At the age of 3 years, Melissa started to show signs of epilepsy depicted by noticeable tendency to stare into space before experiencing fits on her right arm and leg. Doctor’s report indicated that the stroke experienced before birth had an association with the epilepsy condition. After identification of the damaged section of the brain, carbamazepine which managed to put the seizure experience under control for approximately five years. The seizure problem became persistent as from the age of 8 years despite being put on various medications topiramate which saw her get sick and shed-off a lot of body weight and increased word mix ups. Melissa experienced significant social issues at the age of 6 years with incidences of aggressive behavior also reported in her life. Her teachers’ behavior assessment revealed the she had significant challenges in expressing herself as well as interacting with fellow students. Incidence of easy distraction currently observed during her assessment interview was also noted by the teachers. Her child’s behavioral checklist report also revealed that she had slightly high scores on attention and somatic complaints problems. The CT scan performed on the Melissa revealed mild damage of the left side of the brain as result of the accident that led to the pre-birth stroke. After recurrence of the seizures at age 8, Melissa continued to experience this problem throughout with the seizures mainly experienced during morning hours and evening hours. She continues to experience recurrence of the seizures up to moment when she was being assessed. She was enrolled for therapy in which she engaged in physical activities such as basketball. However, the seizure problem which became serious at age 10 saw stop engaging in further physical activities. Neuropsychology tests at age 6 based on the Wechsler Intelligence Scale indicated that she had a Verbal Comprehension Index core of 98, perceptional index score of 84, working memory index of 65, full scale IQ score of 78 and processing speed index of 78. Her Wide Range Achievement Test scores were quite high with the scores for reading, spelling and Arithmetic being 101, 95, and 94 respectively. Test Interpretation Attention Performance The over attention performance as reported by both parent and the teachers was at 7, an indication that Melissa was experiencing significant attention problems. This could be perhaps due to the reported as well as observed distract. She had a high score of commission errors of 76, at tail-making test score of 74 , low perseverative errors score of 34, and verbal fluency score 74. With the Boston naming test score being 37, her ability to name object was approaching the standard score of 55 though slightly lower that of a normal child. Her symbol digit modalities test were above average with score being at 86 and at the 18th percentile. Language Melissa’s language capabilities were above average with her verbal fluency test score being at 74 out of the upper limit of 100. This is also supported by her token test which was way above the average score in which she managed to score between 106 and 107. The Wide Range Achievement Test on the other hand supported her language abilities through high score of 101 in reading and a score of 95 in spelling. Despite her speech being characterized by circumlocutious and tangential traits, the language assessment test revealed that had language capabilities above average especially upon relating her abilities with her developmental issues. The test findings are supported by her experience during the interview in which she was able respond to issues with limited difficulties. Memory Performance Melissa’s memory functionality was not adversely affected by the pre-birth stroke as evident from the Wide Range Assessment of Memory scores in which her story memory was at the verbal learning, recall, recognition which were found to be at the average percentile or the 50th percentile. However, delayed recall was significantly high with a score of 74. Her recall capability was somehow interfered with as evident from the scores which were slightly above average. However, her memory processing rate was slightly slow with a score of 56. This score is supported by her slow response to interview questions requiring recollection of things or events in the past. It was noted that Melissa was able to remember past events when provided with adequate time to ponder over the issue. According to the test findings, Melissa’s working memory skills and processing speed were above average as indicated by the high score arithmetic of 94. She also scored above average letter-number sequencing, digital symbol, vocabulary and matrix reasoning among others. Her Full Scale IQ was found to be 78 which is above the average limit of 70 and below. Motor Skills Her motor testing indicated significant right-sided weakness with the left hand having grip strength score of 77. On the Grooved Pegboard, her right hand performance was below performance for his age despite being left handed. This is supported by the increased left hand performance, specifically to compete the experience right-sided hemiparesis. Melissa’s performance on the VMI was acceptable, with her left hand being within the normal range of the standard score of between 74 and 115. On the other hand, her executive function assessment indicated slightly below average performance on the Wisconsin Card Sorting test. Diagnosis Melissa’s history and test results closely relate to left hemiparesis. The left side of the brain is responsible for language control, speaking, and ability to express oneself. The condition is attributed to injury to the left hemisphere of the brain or stroke aftermath. The medical history of Melissa in which she experienced interauterine cerebral vascular accident is a strong support for condition diagnosis. The reported stroke and consequent injury on the left hemisphere of the brain can be attributed to the various symptoms associated with Melissa. For example, Melissa had difficulties in expressing herself, social skills, slightly impaired ability to grasp objects, poor coordination as identified in her walking style, and reduced right hand activity. Prognosis and Recommendations Owing to the damaged left hemisphere of the brain, Melissa’s condition is likely to worsen without appropriate interventions to correct or manage the damage section. However, admission of Melissa in a rehabilitation unit for specialized rehabilitation intervention can significantly help her in overcoming some of the limitation associated with condition such as poor coordination, working memory skills, visual memory, reading and writing. Nevertheless, the problem of decreased attention is likely to progress with time. The problem cannot be completely resolved but with proper management of the condition, can enable Melissa to overcome some of the challenges and lead a better life. Cognitive rehabilitation is particularly efficient in overcoming or reducing the intensity of the left hemisphere brain damage. This is particularly because changes in motor control, coordination, social interactions and behavior control associated with brain damage are closely related with the cognitive function hence the possibility to minimize or overcome such changes through cognitive rehabilitation. Since, Melissa’s condition has been deteriorating despite pharmacological interventions and physical activities therapy, it is important for the parents to consider enrolling her for specialized rehabilitation in order to enable her overcome difficulties associated with the condition as they also prepare her for the surgery to address the problem of epilepsy as proposed by the neurosurgeons. Read More

The CT scan performed on the Melissa revealed mild damage of the left side of the brain as result of the accident that led to the pre-birth stroke. After recurrence of the seizures at age 8, Melissa continued to experience this problem throughout with the seizures mainly experienced during morning hours and evening hours. She continues to experience recurrence of the seizures up to moment when she was being assessed. She was enrolled for therapy in which she engaged in physical activities such as basketball.

However, the seizure problem which became serious at age 10 saw stop engaging in further physical activities. Neuropsychology tests at age 6 based on the Wechsler Intelligence Scale indicated that she had a Verbal Comprehension Index core of 98, perceptional index score of 84, working memory index of 65, full scale IQ score of 78 and processing speed index of 78. Her Wide Range Achievement Test scores were quite high with the scores for reading, spelling and Arithmetic being 101, 95, and 94 respectively.

Test Interpretation Attention Performance The over attention performance as reported by both parent and the teachers was at 7, an indication that Melissa was experiencing significant attention problems. This could be perhaps due to the reported as well as observed distract. She had a high score of commission errors of 76, at tail-making test score of 74 , low perseverative errors score of 34, and verbal fluency score 74. With the Boston naming test score being 37, her ability to name object was approaching the standard score of 55 though slightly lower that of a normal child.

Her symbol digit modalities test were above average with score being at 86 and at the 18th percentile. Language Melissa’s language capabilities were above average with her verbal fluency test score being at 74 out of the upper limit of 100. This is also supported by her token test which was way above the average score in which she managed to score between 106 and 107. The Wide Range Achievement Test on the other hand supported her language abilities through high score of 101 in reading and a score of 95 in spelling.

Despite her speech being characterized by circumlocutious and tangential traits, the language assessment test revealed that had language capabilities above average especially upon relating her abilities with her developmental issues. The test findings are supported by her experience during the interview in which she was able respond to issues with limited difficulties. Memory Performance Melissa’s memory functionality was not adversely affected by the pre-birth stroke as evident from the Wide Range Assessment of Memory scores in which her story memory was at the verbal learning, recall, recognition which were found to be at the average percentile or the 50th percentile.

However, delayed recall was significantly high with a score of 74. Her recall capability was somehow interfered with as evident from the scores which were slightly above average. However, her memory processing rate was slightly slow with a score of 56. This score is supported by her slow response to interview questions requiring recollection of things or events in the past. It was noted that Melissa was able to remember past events when provided with adequate time to ponder over the issue. According to the test findings, Melissa’s working memory skills and processing speed were above average as indicated by the high score arithmetic of 94.

She also scored above average letter-number sequencing, digital symbol, vocabulary and matrix reasoning among others. Her Full Scale IQ was found to be 78 which is above the average limit of 70 and below. Motor Skills Her motor testing indicated significant right-sided weakness with the left hand having grip strength score of 77. On the Grooved Pegboard, her right hand performance was below performance for his age despite being left handed. This is supported by the increased left hand performance, specifically to compete the experience right-sided hemiparesis.

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