A Comparative Case Study of a SMTC Resident. Client Background History: Caucasian male; age twelve at the onset of treatment. Experienced parental neglect.

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Presentation transcript:

A Comparative Case Study of a SMTC Resident

Client Background History: Caucasian male; age twelve at the onset of treatment. Experienced parental neglect and abuse from birth to age six. Placed in numerous foster homes since age six.

Presenting Symptoms: Suicidal verbalizations and behaviors Severe impulsivity and explosive anger Severe defiant, disruptive, or destructive behavior Dangerous, self-injurious, or unsafe behaviors Severe deterioration of functioning Serious lack of development of age appropriate functioning Serious depressive symptoms Aggressiveness or assaultiveness Recurrent thoughts, impulses, or images Irritable or labile mood Enuresis

Admitting Diagnoses: Posttraumatic Stress Disorder Attention-Deficit/Hyperactivity Disorder Oppositional Defiant Disorder History of Reactive Attachment Disorder Rule-Out: Mood Disorder Rule-Out: Learning Disorder Rule-Out: Intermittent Explosive Disorder Rule-Out: Complex-Partial Seizure Disorder Suspected History of Child Physical and Sexual Abuse Suspected Fetal Drug and Alcohol Exposure

Treatment History: Multiple inpatient admissions to North Star Behavioral Health System between May and August 2013, with a brief period spent at Palmer Residential Treatment Center in the beginning of August Transferred to San Marcos Treatment Center on October 1, Has also been receiving outpatient counseling services from a local counselor for approximately three years

Neuropsychological Evaluation Results: May 18, 2013 Within Normal Limits: Full Scale IQ (SS=90) Verbal Comprehension (SS=88) Perceptual Reasoning (SS=94) Working Memory (SS=94) Processing Speed (SS=97) Visual Spatial Processing Social Perception Language Skills Sensory Motor Integration Below Normal Limits: Sustained Attention and Concentration Executive Functioning (patterns, sequences, cause & effect relationships) Memory/Learning

Quantitative Electroencephalogram (qEEG) The qEEG is a painless and non-invasive procedure which begins with data collection. The scalp is prepared and measurements are calculated.

Quantitative Electroencephalogram (qEEG) A stretchable elastic electrode cap is slipped onto the head, and the recording electrodes filled with a water soluble contact gel.

Quantitative Electroencephalogram (qEEG) Brain waves are then recorded onto the computer while the client relaxes with eyes closed and with eyes open.

EEG Spectral Analysis: Pristine Pattern

Brain Wave Frequencies:

Brodmann Areas of the Brain:

qEEG Recommended Protocols: Suppress frequency activity Hz at O2. Suppress frequency activity Hz at F3. Reinforce EEG coherence at 8 – 12 and/or Hz between FP2 and F8.

Completed Treatment Protocols: From October 2014 to May 2015: SMR C4 (27 sessions) Suppress 8-10 O2 (14 sessions) Suppress 9-10 F3 (14 sessions) Suppress FP2 (12 sessions) Suppress 8-12 FP2 (10 sessions) Suppress F8 (12 sessions) Suppress 8-12 F8 (10 sessions)

Absolute Power (Linked Ears): February 4, 2014 May 19, 2015

Absolute Power (Linked Ears): February 4, 2014 May 19, 2015

Absolute Power (Laplacian): February 4, 2014 May 19, 2015

Absolute Power (Laplacian): February 4, 2014 May 19, 2015

Amplitude Asymmetry: February 4, 2014 May 19, 2015

Coherence: February 4, 2014 May 19, 2015

Phase Lag: February 4, 2014 May 19, 2015

Predicted Neuropsychological Scores: February 4, 2014 May 19, 2015

Conclusions: Discharged from SMTC in June 2015 His caseworker reported that he has shown significant improvement in many emotional and behavioral domains He continues to exhibit occasional issues with: Hyperactivity Impulsivity Lack of development of age-appropriate functioning Enuresis

Conclusions: Adopted by a family in Alaska Enrolled in regular public school. School is no longer perceived as a trigger for behavioral issues Predicted IQ scores from the qEEG suggest an IQ increase near one standard deviation compared to his May 2013 neuropsychological evaluation.