Case 5 (Down Syndrome)
Name: Mr. A
Age: 14 Year
Gender: Male
No. of siblings: 3
Occupation: Student
Birth Order 1st
Earning Members in Family 1
Socioeconomic Status Middle
Family System Nuclear
Father alive/Dead Alive
Mother alive/dead Alive
Head of Family Father
Presenting Problems
Symptoms
Slow Movement
Easily Frustrated
Speech and Language impaired
Faking
Stubborn
Reason for Referral
Dad reported concerns about slow movements, frustration, speech and language, and
stubborn behavior at the Centre of Profound Education (Neuro-psychiatric Clinic).
Psychological/Psychiatric History:
i. Personal: There is no psychological history.
ii. Medical history:
a. Personal: Turned blue at birth and bleeding from belly.
b. Family: Common deaf and speech delay in the family.
iii. Lifetime history of stressful events: Fall from stairs at age 5.
Behavioral Observations
Mr. A was a cute boy who remained quiet usually, get upset easily if asked any
question. He felt restless most of the time. Easily distracted while doing homework. Rock his
body when sitting alone. He likes the company of others. Started faking when asked to do
something he didn’t like. He also pinches, bites, and hurts himself when gets angry.
Psychological Evaluation
From the history provided, the Montreal Cognitive Assessment (MOCA), and
Communicative Development Inventories (CDI, gestures), were applied which he displayed
very significant impairment and would thus meet the criteria for diagnosis of Down
syndrome.
Tentative Diagnosis
According to DSM-5 TR, (F89) Unspecified Neurodevelopmental Disorder (Down
Syndrome).
Proposed Treatment Plan
Speech and Language Therapy: Both therapies will help him in the initiation of his
speech.
Operant Conditioning: Faking behavior would be reduced through punishment.
Physical Exercises: His obesity would be managed through physical exercises and a
healthy diet.
