Before you begin:
In each scenario, clients are presenting difficulty sleeping and/or staying asleep. As a health practitioner, you need to recognize milestones and then hypothesize to the causes for the difficulties sleeping. Understanding the normal physical, cognitive, social, and other milestones for each age/stage, may narrow down the reasons for the potential sleep problems. The client’s history needs to be considered and applied. The Scenario information may, or may not, be relevant to the sleep problem… so be careful in your assessments.
Treatment Plan Examples: 2-3 sentences only (like the Ages/Stages Charts) (cannot be duplicated)
- Physical: Susan (38 yrs.) is taking 3 college classes, working a full-time job, caring for her family, and providing for her aging parents (sandwich affect). Susan eats fast food 5 times a week and is experiencing digestive problems (and headaches) from the decrease in nutrients in her diet. The pain is causing a reduction in restful sleep and increasing the need for medication during the night (pg. #).
- Cognitive: John (9 yrs.) attempted a 500-piece Lego set and “threw a temper tantrum” in the first ten minutes of playing. His mom stated he doesn’t “positive self-talk” and demonstrates a “delay” in his complex “reasoning”. John’s delay in cognitive development may be causing interruptions in his nighttime sleep, as he is overthinking and reasoning in his sleep (pg. #).
- Social: Molly (14 yrs.) is frequently bullied and has begun bullying others. She states, “feeling guilty” and “sees how others are sad” by her actions. According to Kohlberg’s Moral Reasoning, Molly may be transitioning to the Conventional level, leading to “feelings of remorse” for how she treats others. The change in social dynamics and hurtful treatment toward others may be causing her nightmares. (pg. #).
- Emotional (Other): Mrs. Smith (68 yrs.) retired six months ago, and her husband died two years ago. She “feels lonely most of the time” and is concerned about “financially supporting herself”. Her unresolved questions and feelings of “despair” may be resulting in stressful and disturbed sleep. (pg. #)
I. Treatment Plan Barry Overton:
Barry (12 yrs.) was born at 39 weeks, with no complications. His mother breastfed him for eighteen months and stayed home with him full time. He is the older of two children and has a 6-yr. old sister. His younger sister, Carrie, has Autism and continual health problems. Barry’s parents have been married for 18 years and attend church regularly. A year ago, the Overton’s relocated to Clayton (from CA), leaving their family and friends. The relocation was a promotion for Mr. Overton; however, he travels out of NC regularly.
Barry is an honor roll student and on the Baseball team. He is going into the seventh grade and attending his first church camp this summer. He enjoys playing video games, playing baseball, and reading mysteries. Barry tries not to complain and/or burden his parents with his struggles. He cares for his family and knows they care for him. After school he helps his mother with Carrie, attends Baseball practice, plays video games and/or does homework. When Barry’s dad is out-of-town, he tends to help additionally around the house.
Barry has approached milestones with little, to no, delay since his birth. His last well-visit was normal (90% percentile), though he is slightly overweight for his age. His next well visit is in two weeks, since Barry is almost 13 years old.
Barry’s parents are very proud of him; yet, are concerned about his difficulty sleeping. They are completely baffled to the cause, since he is a model child. Barry has no history of disorders and is not taking any prescription medications.
——————————————————————————-
- Before writing Treatment plan statements, think about what you can infer/deduce (video help) about Barry, according to his age? What can we learn about Barry, because we understand this age? Do not look at the scenario but focus on milestones, in development, for this age/stage. For this section, the goal is to understand Barry by what we can deduce about her. Write 10 facts about this age (focus on developmental milestones for a male at this age) and add specific examples.
Number 1-10. Example fact: Boys (11-12 years), in late childhood, can recall memories from when they were younger and can retain memories from significant events (death of a grandparent, moving, first girlfriend) (pg. xx).
For B-E: For this part, the goal is to write Treatment Plan statements. Think of the mostly likely reason why Barry is having difficulty sleeping. Do not use the facts from A. For help, refer to the examples on page 1, consult the textbook, re-read the scenario, and refer to Ages/Stages Charts. These statements need to be original and apply specifically to Barry.
- Write 1 Biological Treatment Plan Statement
- Write 1 Cognitive Treatment Plan Statement
- Write 1 Social Treatment Plan Statement
- Write 1 Other (emotional, language and/or personality development) Treatment Plan Statement
II. Treatment Plan James Bern:
9-month old, James, was born at 29 weeks, due to complications with his mother’s high blood pressure. James spent multiple weeks in the hospital and was released at 42 weeks gestation. James is her only child and she is unable to have more children. Mrs. Bern’s has considered adopting but wants to “wait a few more years”.
James’s mom plans to return to work, as a Lawyer, in two months. Extended family lives far away and support is minimal. Mr. Bern’s works as a Pharmacist, so they have the financial resources to either hire a nanny and/or afford preschool. However, they are unclear of what path is best for their family. They have been married for 3 years and have considered the last year the most challenging.
Mrs. Bern currently takes Diltiazem for her high blood pressure and has dietary constrictions. James alternates between breastfeeding and Gerber formula. Three weeks ago, James began Stage 2 Earth’s Best baby food, for lunch, and diced banana for dinner. Mrs. Bern’s has tried to wean James from his pacifier but finds it hard when he is crying.
James sleeps in his parent’s room and has been co-sleeping since birth. James is fed every 3-4 hours (day/night), waking/crying at 1am and 4am. He has trouble staying asleep and has “fits of crying”. The family is stressed and tired, needing some relief. Mrs. Bern wants to know why James is not sleeping through the night.
——————————————————————————-
- Before writing Treatment plan statements, think about what you can infer/deduce (video help) about James, according to his age? What can we learn about James because we understand this age? Do not look at the scenario but focus on milestones, in development, for this age/stage. For this section, the goal is to understand James by what we can deduce about her. Write 10 facts about this age (focus on developmental milestones for a male at this age) and add specific examples.
Number 1-10. Example fact: 9-month-old babies need an average of 12-14 hours of sleep a day, which may include a 2-hour mid-day nap (pg.xx).
For B-E: For this part, the goal is to write Treatment Plan statements. Think of the mostly likely reason why James is having difficulty sleeping. Do not use the facts from A. For help, refer to the examples on page 1, consult the textbook, re-read the scenario, and refer to Ages/Stages Charts. These statements need to be original and apply specifically to James.
- Write 1 Biological Treatment Plan Statement
- Write 1 Cognitive Treatment Plan Statement
- Write 1 Social Treatment Plan Statement
- Write 1 Other (emotional, language and/or personality development) Treatment Plan Statement
