Diagnostic Case Scenario – Graduate Assistants

Multidisciplinary Evaluation Team (MET) Case Study

Student: Scott
Grade: 1st
Age: 6

Background Information

⦁ Very small for his age, constantly in motion.
⦁ Usually looks very serious. When he is unhappy with something, he will scowl and make a high-pitched and long-lasting shriek; this happens 8-10 times every hour.
⦁ Asks many questions, such as “Why?” “Where did that come from?” “What does this mean?”
⦁ When engaged in something in which he has an interest, he becomes lively and animated and asks relevant questions as he is trying to figure out what is happening (lasts up to 7 minutes at a time).
⦁ Enjoys trains and collecting coins; likes to build things with Legos or Lincoln Logs.
⦁ Knows everything about local public buildings (city hall, library, schools) – number of windows and doors, when built, building materials, number of bricks each contains.
⦁ Developed very particular likes and dislikes with food, e.g., he will only eat white or light colored foods, and nothing can be mixed together; he refuses to eat meat and many vegetables and fruits.
⦁ Behavior problems surfaced about 15 months ago – easily frustrated, which resulted in throwing things, hitting, kicking, biting, and disrespect shown to parents, especially his mother.
⦁ Mother has used timeout chair – can take from 5 minutes to 2 hours for him to regain control.
⦁ Parents report that they do not take him out into the community, e.g., grocery store because of behavior. One parent stays home with Scott while the other goes out to do errands.
⦁ Scott is extremely active. He stopped taking naps at the age of about 2½ and he cannot fall asleep until three or four hours after he is put to bed. He spends the time looking at books and playing with the toys in his room. As long as he stays in his room and is quiet, his parents leave a dim light on.
⦁ Lives with his parents and older sister. The family goes on recreational outings together, including summer camping trips and weekend trips to visit family in another area of Wisconsin.
⦁ Scott’s parents describe Scott as “interesting.” They have worked through many issues with their daughter (medical diagnosis of ADHD and bipolar disorder, she is not in special education) and feel that Scott will develop appropriate behaviors as time goes by.
⦁ Defiance is an issue – incidents 10-15 times per day of yelling, stomping his feet, throwing things if he does not get his way.
⦁ Scott will wander away from the yard – has gone up to six blocks away, crossing busy streets. This happens 3-4 times per month.

School History

⦁ Mother requested district screening when Scott turned 3 years old because he refused to follow rules, and would throw a tantrum when he could not get his way. Scott also showed a lack of interest in activities like coloring or drawing with markers or crayons, cutting paper, and repeating nursery rhymes. He would refuse to do these activities.
⦁ Parents did not want to consider district early childhood programming and enrolled him at a structured preschool at age 4. His day was subsequently shortened to 2 hours and his parents had to pick him up early 1-3 times per week because of behavior (yelling, screaming, and refusing to follow directions; would not participate in any activities that involved drawing, coloring, or writing).
⦁ Community summer programs were tried, but he was asked to leave because of behavior (ran out of the room, yelled, screamed, threw things).
⦁ During the summer before he started kindergarten, his parents did not enroll him in summer school. They planned many family activities, but Scott was not in any kind of a structured program. They report that the number of tantrums decreased to 1-2 per day. However, the tantrums were more severe with longer recovery time.
⦁ Placed in a blended kindergarten (5 special education and 11 regular education students with general kindergarten and special education teacher team)

Concerns/Reasons for Referral

⦁ Aggressive and disruptive behavior. Displays tantrums, which include kicking and hitting staff, screaming and throwing himself on the floor. Scott will also throw books and chairs at staff and other students. These behaviors occur 4-6 times daily within a two-hour period.
⦁ Unwillingness to follow directions for social or play activities. Scott says, “No,” or “I won’t.” He often refuses to speak and sits with arms crossed and head down when not wanting to follow adult directives. He will also run and hide under a table.
⦁ Refuses to do any activities involving scissors, paper, pencil, crayons, or markers.
⦁ Isolates self in a corner or under a table during structured and unstructured activities.

Note. Adapted from “Doing it Right: IEP Goals and Objectives to Address Behavior,” by M. K. Oudeans and L. Boreson, 2002.

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