Child’s Development in School
1. What
do you see as the major problems Raul is exhibiting? (If you had to take a
guess at a possible diagnosis, what would it be? Anything?)
2. Identify
all the risk factors and identify all the protective factors affecting Raul’s
development.
3. What
strengths or resources in Raul and his family would you emphasize as a way to
improve his chances of a good developmental outcome?
Case Study: Raul Salazar —
10-year-old boy
Raul Salazar, a 10-year-old boy,
has just started the fourth grade. He was referred to the school’s
multidisciplinary team because of reports of difficulties in school and
concerns about his home situation. Teachers are questioning whether he has a
learning disability. They are also asking the team to determine whether he is
an appropriate candidate for medications. He often does not follow instructions
well. However, his current teacher is “surprised by his vocabulary.”
It is “much better than many of the other Puerto Rican kids in his
class.” However, his performance in school has steadily deteriorated. He
especially has problems with reading and mathematics and on occasion comes to
school with dirty clothing and falls asleep in class.
His performance in the third grade
was average, but his records indicate that the teachers at the other school
considered him to be a very anxious child. These teachers reported that Raul
constantly moved in his seat and had problems with writing but did well in
other fine-motor tasks.
Another fact that stands out in
his school history is that his performance was better when he was attending a
smaller parochial school for Grades 1 and 2.
Raul has two other siblings. He
has an older brother who is 13, and a younger sister who is 9 years old. Raul’s
father works for the city of New York as a painter, and is mother is a teaching
assistant. She completed two years of college but had to leave her education
because she got pregnant with their oldest son.
Raul’s mother’s family moved to
the mainland when she was eight years of age. Her father was a teacher and they
were not very pleased when she “had to marry” Raul’s father. Raul’s
father’s family came from a poor rural area on the island. His own father had a
history of alcoholism and left the family when Mr. Salazar was very young.
Mrs. Salazar reported to the
social worker that she had serious problems with her nerves throughout her life
and that they become worse whenever she is pregnant. Otherwise she felt her
pregnancy with Raul had been normal. However, school staff learned that there
had been some fear that she might lose Raul during the pregnancy, and this is
why she was prescribed bed rest during the last trimester.
Mrs. Salazar’s third child, her daughter
Maria, was born prematurely, but Mrs. Salazar did not have any problems with
her first pregnancy. She told the social worker that her daughter’s premature
status really hit the family hard because Maria required so much care when she
finally came home.
Unfortunately, Mr. Salazar was
released from his job shortly after Maria’s birth, and he was out of work for 9
months. The mother reports this was possibly the most stressful period in her
life. When Maria was about four months old, Mrs. Salazar had a seizure. Mrs.
Salazar’s doctor considered placing Mrs. Salazar on medication after she had
that seizure; however, testing did not reveal any evidence of the presence of a
seizure disorder. She reports a history of fainting and other seizure-like
experiences when she was a teenager.
Mrs. Salazar says that she has
always had problems with her nerves and has been very sickly throughout her
life. She also told the social worker that “she was always the weakest one
in her family.” When Raul was about eighteen months old, Mrs. Salazar’s
closest brother was killed in a car accident. She reports not being able to get
out of bed for weeks following the news of his death. Raul’s medical records
indicate that it was approximately around this time that he started banging his
head in order to fall asleep.
This habit continued until he was
about six years of age. He also developed some other habits that persist to
this date. He still bites his fingernails very often. Raul’s history also
reveals that he was extremely frightened of the dark as a child and has an
extreme startled response for which he is often teased by his brother and
father.
The family moved to New York City
one year ago, in order for Raul’s father to take a job as a city-employed
painter. The move is why Raul had to switch schools.
Raul’s father is a strict
disciplinarian. He told workers that he often loses his temper and yells at the
children, but he says that he has never physically abused them. He reported to
the social worker that he cannot tolerate the kids being noisy. When he comes
home from his new job, his wife is often in bed, and things are a mess. Mr.
Salazar is under lots of pressure at work. His supervisor does not like Puerto
Ricans and gives him all the worst job assignments. The family no longer lives
near other family members because they moved for Mr. Salazar to get his city
job. Mr. Salazar told the social worker that the family is willing to pay for
any services that will help his son do well in school.
