1. What is this persons diagnosis?

2. What assessment tool will be best?

3. What are some treatment recommendations?

Transcribed Image Text:

Theo is a 6-year-old African American male who is currently in first grade. He is an only child and lives with his parents in a suburban neighborhood in the Midwestern US. Theo was referred to the clinic due to behavioral and emotional difficulties, noted by his parents and his teacher. Theo's parents expressed concerns about his sudden changes in mood, frequent nightmares, and difficulty participating in social activities. When asked why he is at the clinic, Theo reported, "I was scared I was going to die." Theo's parents reported that the family was in a near head-on collision about six months ago. Theo recalled he was sitting in the backseat of the family vehicle, playing a handheld video game, when his father was driving the family home from dinner one night. Theo's mother reported she was yelling at Theo to stop playing his game since he had already reached his daily screen time limit, and his father was yelling at his mother to stop yelling while he was driving. His mother stated they were driving on a two lane, 55 mile-per-hour road and were approximately five miles from home when she noticed an oncoming vehicle swerving toward them. Theo remembered the sound of his mother screaming as the oncoming car's headlights crossed over into their lane. Theo's father quickly swerved to the right to avoid hitting the car head on, and their car veered off into the ditch along the road. When the car hit the ditch, it flipped over and landed upside down. Theo reported all he remembers is that his video game went flying and hit the shattered windshield. Theo's mother reported that all three of them were wearing their seatbelts. Both front airbags deployed, resulting in Theo's mother receiving a bloody nose. Initially, the three of them struggled to move from the overturned vehicle, and Theo's mother recalled that some other passersby stopped to help them out of the vehicle. One of the passersby called 911 and Theo and his parents were transported to the hospital by ambulance. Upon assessment at the local hospital, Theo's parents were treated for broken ribs and contusions. The doctors reported it was a miracle that Theo did not have any physical injuries, other than some bruising from the seat belt. The family later learned that the driver of the oncoming car had been under the influence of alcohol, with a blood alcohol content level twice the legal limit. Since the accident, Theo's parents have noticed several concerning symptoms in their son. He often experiences nightmares, in which he is in a car that is about to crash into another car. Theo reported he always wakes up right before the crash. He stated this makes it difficult to fall asleep because he is afraid, and when he wakes up due to a nightmare, he has difficulty falling back asleep again. Theo's mother reported when he has a nightmare, he will wake her or his father to sit with him until he can fall asleep again. Theo frequently appears restless, fidgeting and having difficulty sitting still. Theo has also become more withdrawn and no longer engages in activities that he used to think were fun. His mother reported that she bought him a new video game after his game was destroyed in the accident, but he has not played with it yet. She stated she is surprised as she used to have trouble getting him to reduce his screen time, and now she almost wishes that she had that problem again. He says he is afraid that he caused the accident because his mom was yelling at him about playing his game too much, and now he is afraid something bad will happen again if he plays the video game. Now, when they are in the car, Theo always Theo is a 6-year-old African American male who is currently in first grade. He is an only child and lives with his parents in a suburban neighborhood in the Midwestern US. Theo was referred to the clinic due to behavioral and emotional difficulties, noted by his parents and his teacher. Theo's parents expressed concerns about his sudden changes in mood, frequent nightmares, and difficulty participating in social activities. When asked why he is at the clinic, Theo reported, "I was scared I was going to die." Theo's parents reported that the family was in a near head-on collision about six months ago. Theo recalled he was sitting in the backseat of the family vehicle, playing a handheld video game, when his father was driving the family home from dinner one night. Theo's mother reported she was yelling at Theo to stop playing his game since he had already reached his daily screen time limit, and his father was yelling at his mother to stop yelling while he was driving. His mother stated they were driving on a two lane, 55 mile-per-hour road and were approximately five miles from home when she noticed an oncoming vehicle swerving toward them. Theo remembered the sound of his mother screaming as the oncoming car's headlights crossed over into their lane. Theo's father quickly swerved to the right to avoid hitting the car head on, and their car veered off into the ditch along the road. When the car hit the ditch, it flipped over and landed upside down. Theo reported all he remembers is that his video game went flying and hit the shattered windshield. Theo's mother reported that all three of them were wearing their seatbelts. Both front airbags deployed, resulting in Theo's mother receiving a bloody nose. Initially, the three of them struggled to move from the overturned vehicle, and Theo's mother recalled that some other passersby stopped to help them out of the vehicle. One of the passersby called 911 and Theo and his parents were transported to the hospital by ambulance. Upon assessment at the local hospital, Theo's parents were treated for broken ribs and contusions. The doctors reported it was a miracle that Theo did not have any physical injuries, other than some bruising from the seat belt. The family later learned that the driver of the oncoming car had been under the influence of alcohol, with a blood alcohol content level twice the legal limit. Since the accident, Theo's parents have noticed several concerning symptoms in their son. He often experiences nightmares, in which he is in a car that is about to crash into another car. Theo reported he always wakes up right before the crash. He stated this makes it difficult to fall asleep because he is afraid, and when he wakes up due to a nightmare, he has difficulty falling back asleep again. Theo's mother reported when he has a nightmare, he will wake her or his father to sit with him until he can fall asleep again. Theo frequently appears restless, fidgeting and having difficulty sitting still. Theo has also become more withdrawn and no longer engages in activities that he used to think were fun. His mother reported that she bought him a new video game after his game was destroyed in the accident, but he has not played with it yet. She stated she is surprised as she used to have trouble getting him to reduce his screen time, and now she almost wishes that she had that problem again. He says he is afraid that he caused the accident because his mom was yelling at him about playing his game too much, and now he is afraid something bad will happen again if he plays the video game. Now, when they are in the car, Theo always

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