Assignment Instructions: Answer with minimum 2 paragraphs each the following questions based in the bellow clinical case: 1. What is the behavioral approach if you have a child (patient) that present with autism or ASD? Explain 1. What type of special diets you can recommend, or there is any research supporting a special type of diet? 1. What type of resources you can offer to the parents in term of programs at school or what kind papers you can offer to them, so they can have a better experience? ** At least 2 references per question** Subjective: CC (chief complaint): The child has problems with communication in social gatherings and at home and does not enjoy the company of others. HPI: Patient 11 is a 9-year-old male Caucasian American child brought into the hospital on the seventh day of December 2022 for psychiatric assessment from 8:00 AM. The mother has been worrying over her child’s inability to communicate at home and in other social spaces. Further, she states that she has noticed her child's unusually easily irritable state in the past months but has not been worrying as much about it, stating that it is what children are like sometimes. She adds that her son does not enjoy the company of others, even at school, and she thinks that it may be why he is not doing well in class. Substance Current Use: The client denies using illicit hard drugs like marijuana. No alcohol or tobacco abuse. Medical History: · Current Medications: Daily multivitamin supplements once daily orally. · Allergies: no known food, drug, or environmental allergies noted. · Reproductive Hx: No history of sexually transmitted diseases. He has not fathered a child. ROS: · GENERAL: denies weight changes and chronic pains. Sometimes feels fatigued · HEENT: No eye pain or conjunctivitis; swallowing is okay. Denies sore throat. Denies any alterations in head physiology. No changes in the sense of taste. · SKIN: Denies skin redness. Denies alopecia. · CARDIOVASCULAR: Denies murmurs, arrhythmias, and lower limb edema. · RESPIRATORY: Denies chest pressure, congestion, cough, hemoptysis, and wheezing. · GASTROINTESTINAL: Denies bloating and constipation or GERD. Denies nausea, vomiting, or abdominal pain. · GENITOURINARY: Denies dribbling of the bladder and itching. · NEUROLOGICAL: Denies visual changes, muscle loss, changes in reflexes, and no balance problems. · MUSCULOSKELETAL: Denies numbness or tingling and muscle or joint strength loss. · HEMATOLOGIC: Denies easy bruising. · LYMPHATICS: Denies neck, axillary or inguinal swelling or lymphadenopathy · ENDOCRINOLOGIC: Denies known endocrine disorders. Objective: Physical exam: Vital Signs: B.P.: 118/78,  Pulse:94,  RR: 20, non-labored, Temp: 36.0, BMI: 19.1 General: Alert and oriented, pleasant and cooperative. Not in any acute distress. HEENT: No head or neck anatomical disruptions. No redness o.

1. Assignment Instructions:
Answer with minimum 2 paragraphs each the following
questions based in the bellow clinical case:
1. What is the behavioral approach if you have a child (patient)
that present with autism or ASD? Explain
1. What type of special diets you can recommend, or there is
any research supporting a special type of diet?
1. What type of resources you can offer to the parents in term of
programs at school or what kind papers you can offer to them,
so they can have a better experience?
** At least 2 references per question**
Subjective:
CC (chief complaint): The child has problems with
communication in social gatherings and at home and does not
enjoy the company of others.
HPI: Patient 11 is a 9-year-old male Caucasian American child
brought into the hospital on the seventh day of December 2022
for psychiatric assessment from 8:00 AM. The mother has been
worrying over her child’s inability to communicate at home and
in other social spaces. Further, she states that she has noticed
her child's unusually easily irritable state in the past months but
has not been worrying as much about it, stating that it is what
children are like sometimes. She adds that her son does not
enjoy the company of others, even at school, and she thinks that
it may be why he is not doing well in class.
Substance Current Use: The client denies using illicit hard
drugs like marijuana. No alcohol or tobacco abuse.
Medical History:
·
Current Medications: Daily multivitamin supplements

2. once daily orally.
·
Allergies:
no known food, drug, or environmental allergies noted.
·
Reproductive Hx: No history of sexually transmitted
diseases. He has not fathered a child.
ROS:
· GENERAL: denies weight changes and chronic pains.
Sometimes feels fatigued
· HEENT: No eye pain or conjunctivitis; swallowing is okay.
Denies sore throat. Denies any alterations in head physiology.
No changes in the sense of taste.
· SKIN: Denies skin redness. Denies alopecia.
· CARDIOVASCULAR: Denies murmurs, arrhythmias, and
lower limb edema.
· RESPIRATORY: Denies chest pressure, congestion, cough,
hemoptysis, and wheezing.
· GASTROINTESTINAL: Denies bloating and constipation or
GERD. Denies nausea, vomiting, or abdominal pain.
· GENITOURINARY: Denies dribbling of the bladder and
itching.
· NEUROLOGICAL: Denies visual changes, muscle loss,
changes in reflexes, and no balance problems.
· MUSCULOSKELETAL: Denies numbness or tingling and
muscle or joint strength loss.
· HEMATOLOGIC: Denies easy bruising.
· LYMPHATICS: Denies neck, axillary or inguinal swelling or
lymphadenopathy
· ENDOCRINOLOGIC: Denies known endocrine disorders.
Objective:
Physical exam:

3. Vital Signs: B.P.: 118/78, Pulse:94, RR: 20, non-labored,
Temp: 36.0, BMI: 19.1
General: Alert and oriented, pleasant and cooperative. Not in
any acute distress.
HEENT: No head or neck anatomical disruptions. No redness of
the tympanic membrane on otoscopic examination. Moist throat.
No cervical lymphadenopathy. No cobblestoning pattern of the
oropharynx.
Chest/Lungs: Expansion of both lungs is equal. No chest
congestion or pressure. Lung and voice sounds are present and
equal in all auscultated lobes, and lung fields are clear.
Heart/Peripheral Vascular: Regular rate and rhythm noted. No
lower limb edema. No murmurs. No palpitations at time of
interview. The internal jugular vein is not distended.
Gastrointestinal: Purcussed regions of the abdomen are
tympanic. No abdominal mass was noted or palpated. Normal
bowel sounds in all four quadrants of the abdomen.
Genital/Rectal: Continent bladder and bowel.
Endocrinologic: No increased perspiration.
Skin: No tenting.
Lymphatics: No lymphadenopathy.
Diagnostic results:
· Childhood Autism Rating Scale: this is an observational
ranking used in assessing additional ASD manifestations
through a caregiver/parent interview, professional observation
of the child's behavior, a case-narrative examination, or a blend
of these elements. It comprises 15 items designed to adequately
differentiate features of autism spectrum disorder from those of
developmental delays without autism (Moulton et al., 2019).
· Social Phobia and Anxiety Inventory for Children (SPAIC):
evaluates cognitive and behavioral aspects of social phobia.
This tool is intended for individuals in late childhood and early
adolescence (between the age of 8 and 14). It comprises 26
items scored on a three-point Likert scale ranging from 0-52

4. and a cut-off at 18 points, indicating probable social anxiety
disorder (Bunnell et al., 2015).
1. CARS scores - 48 - severe autism.
2. SPAIC - 28 - increased likelihood of social phobia or social
anxiety disorder.
Assessment:
Mental Status Examination: the client is a 9-year-old well-
groomed for the weather and event. His speech was clear and
appeared focused on the topic of the interview. He maintains
eye contact but wanders most often throughout the interview.
Generally, he is relaxed throughout the discussion. Affect is
suitable for the topic of dialogue. He rejects experiencing any
visual or auditory hallucinations. Intact and judgment are
grossly intact and readily appreciated.
Differential Diagnoses:
1. Autism Spectrum Disorder - is a neurodevelopmental health
condition marked by deficiencies in contact (initiating or
reciprocating) that can occur in different situations and
impairments in social restriction (Soto et al., 2016). The child
may also demonstrate little interest in engaging others in their
play and often want to play alone.
2. Social phobia - persons with social anxiety often have
difficulties encountering or engaging with others. They also
have a finite number of companions and evade circumstances
where they may be the center of concentration. This is a
probable diagnosis since the child does not engage actively with
peers and has academic challenges (Colonnesi et al., 2016).
This may be caused by inadequate class participation from fear
of embarrassment when mistakes occur.
3. Social Communication Disorder - pragmatic communication
disorder is marked by difficulties in verbal and non-verbal
communication patterns demonstrated by impairments in the
capacity to transform communication to correspond to various
contexts, using communication for social purposes, or
challenges following rules of conversation. These elements may
result in functional limitations in contexts that require exceeded

5. capacities in communication, according to the American
Psychiatric Association (American Psychiatric Association,
2013).
The primary diagnosis for the client is ASD which presents at
any age of the child's developmental period. Challenges in
social interaction and poor communication mark it. Further,
associated behavioral concerns, such as irritation and
impulsivity, may cause maladaptive behaviors. A pragmatic
communication disorder may be ruled out since it is a condition
that is often noted earlier in the developmental period. Children
should possess satisfactory vocabulary and speech capabilities
by five years to allow the diagnosis. The longer time taken by
the manifesting symptoms would mean otherwise.
Reflections:
Looking back at the evaluation I did for this patient; I realize
that I should have followed the patient's lead by allowing him to
talk until he ran out. I assumed he had most likely gotten done
speaking after the occasional long silence, which was not the
case. Allowing and encouraging the patient to complete their
speech helps acquire all the necessary information to diagnose
correctly.
Case Formulation and Treatment Plan
1. Psychotherapy - Applied Behavioral Analysis is a valuable
behavioral treatment method in improving the self-care, contact,
and play dexterities of kids with ASD to manage their
behaviors. It may also reduce other co-occurring behaviors,
such as irritability and impulsivity, and limit the occurrence of
aggression.
2. Pharmacology - Risperidone (an initial 0.25mg P.O. QDS) for
managing impulsivity and irritability, thus reducing the core
signs of ASD. The dose will be titrated every two weeks to the
maximum dose.
3. Health Promotion - Promoting physical activity in the client.
Patients with ASD have low levels of physical activity.
Promoting exercise, regardless of the type, improves executive

6. functions and self-management (Lydell et al., 2022).
4. Patient education - should involve information on drug
prescription and administration to prevent medication errors.
5. Social Determinant of Health - community understanding of
ASD will be vital to improving client support through
treatment, thus improving patient outcomes of health and life.
References
American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental disorders: DSM-5. (5th ed.).
American Psychiatric Association.
Bunnell, B. E., Beidel, D. C., Liu, L., Joseph, D. L., & Higa-
McMillan, C. (2015). The SPAIC-11 and SPAICP-11: Two brief
child- and parent-rated measures of social anxiety. Journal of
Anxiety Disorders, pp. 36, 103–109.
https://doi.org/10.1016/j.janxdis.2015.10.002
Colonnesi, C., Nikolić, M., de Vente, W., & Bögels, S. M.
(2016). Social Anxiety Symptoms in Young Children:
Investigating the Interplay of Theory of Mind and Expressions
of Shyness. Journal of Abnormal Child Psychology, 45(5), 997–
1011. https://doi.org/10.1007/s10802-016-0206-0
Lydell, M., Kristén, L., & Nyholm, M. (2022). Health
promotion partnership to promote physical activity in Swedish
children with ASD and ADHD. Health Promotion
International, 37(6). https://doi.org/10.1093/heapro/daac169
Moulton, E., Bradbury, K., Barton, M., & Fein, D. (2019).
Factor Analysis of the Childhood Autism Rating Scale in a
Sample of Two-Year-Olds with an Autism Spectrum
Disorder. Journal of Autism and Developmental
Disorders, 49(7), 2733–2746. https://doi.org/10.1007/s10803-
016-2936-9
Soto, T., Giserman Kiss, I., & Carter, A. S. (2016). Symptom
Presentations and Classification of Autism Spectrum Disorder
in Early Childhood: Application to the Diagnostic Classification
of Mental Health and Developmental Disorders of Infancy and

7. Early Childhood (DC:0-5). Infant Mental Health Journal, 37(5),
486–497. https://doi.org/10.1002/imhj.21589
PAD 630 Module Two Short Paper Guidelines and Rubric
The reading and resources for Module Two discuss how
intergovernmental relationships that are based on program funds
affect functions, services, and citizens
at all levels of government. For this short paper, write a
response to the following:
As the city manager of Anytown, Michigan, you are assigned
the responsibility of developing and submitting a community-
development block grant for
a neighborhood revitalization project that has been a high
priority for the city council, the county board of commissioners,
the local nonprofit housing
agency, and the governor’s office. A critical part of the grant is
obtaining letters of support and nonfederal funds to meet the
block grant’s match
requirement. Discuss who you would contact about generating
the local match and letters of support. Explain your rationale.
Guidelines for Submission: Your paper should be about 1 page
in length with double spacing, 12-point Times New Roman font,
and one-inch margins. Sources
should be cited according to APA style.

8. Critical Elements Exemplary (100%) Proficient (90%) Needs
Improvement (70%) Not Evident (0%) Value
Main Elements Includes all of the main
elements and requirements
and cites multiple examples to
illustrate each element
Includes most of the main
elements and requirements
and cites many examples to
illustrate each element
Includes some of the main
elements and requirements
Does not include any of the
main elements and
requirements
25
Inquiry and Analysis Provides analysis that
demonstrates complete
understanding of multiple
concepts
Provides analysis that
demonstrates understanding of
some concepts
Provides analysis that
demonstrates minimal
understanding of concepts
Does not provide analysis 20

9. Integration and
Application
Correctly applies all of the
course concepts
Correctly applies most of the
course concepts
Correctly applies some of the
course concepts
Does not correctly apply any of
the course concepts
10
Critical Thinking Draws insightful conclusions
that are thoroughly defended
with evidence and examples
Draws informed conclusions
that are justified with evidence
Draws logical conclusions, but
does not defend with evidence
Does not draw logical
conclusions
20
Research Incorporates many scholarly
resources effectively that
reflect depth and breadth of

10. research
Incorporates some scholarly
resources effectively that
reflect depth and breadth of
research
Incorporates very few scholarly
resources that reflect depth
and breadth of research
Does not incorporate scholarly
resources that reflect depth
and breadth of research
15
Writing
(Mechanics/Citations)
No errors related to
organization, grammar and
style, and citations
Minor errors related to
organization, grammar and
style, and citations
Some errors related to
organization, grammar and
style, and citations
Major errors related to
organization, grammar and
style, and citations

11. 10
Total 100%