Professional Documents
Culture Documents
Start
Part 1
Imagine you have just started as a general practitioner in a rural district in
Norway. The health visitor is worried about 4-year-old Kristian, who has arrived at
kindgergarten several times lately with bruises on his face.
Kristian doesn't play with other children, and he easily becomes aggressive if
disturbed while playing by himself. His interest in adults is very variable. His
vocabulary only consists of a few words, even though he has special language
lessons at kindergarten. He often has fits of screaming during which he may
knock himself in the head or bang his head against the wall.
Part 2
Family anamnesis
Kristian's mother is from a large family with poor social and intellectual abilities.
Like Kristian, she was included in a special-needs programme at school. She was
only 15 years old when she got pregnant. During the pregnancy she moved in
with Kristian's father, a man 10 years her senior, whom she later married.
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2.1 What are the risk factors within this family for the development of
complications during pregnancy and/or psychosocial disorders in the child?
2.2 What are the usual signs of healthy social/interrelational development during
the first three years of life?
2.3 What might have interfered with the attachment process between Kristian and
his mother?
Part 3
Investigating Kristian at age 4
You perform a physical examination in which you try to assess these problems:
bruises, lack of normal play, isolation, aggressiveness, poor contact abilities,
limited language skills. Your findings are: Kristian is small for his age, with a
weight in the 2.5th percentile. He has a bluish bump on his forehead and serious
bilateral otitis, otherwise a normal somatic status. Kristian is clumsy when tested
for both gross and fine co-ordination, and there is a lot of superfluous movement
associated with his motor skills.
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3.1 What child psychiatric disorders are possible now? Which seems most likely?
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