* Be specific, support your answers with evidence from the case, and be sure to consider your clients' strengths in your treatment planning. 

Tommy is a 10-year-old boy who enjoys baseball, swimming, and baking. He does not like art activities or large crowds. Tommy has a good sense of humor, but he can be irritable. He is fearful around new people and may become quiet and more reserved in those situations. His parents and teachers talk him through exposure to new people. Tommy is highly verbal and speaks in sentences. Tommy is above grade level in reading. He enjoys reading, and his favorite book is the Percy Jackson Lightning Thief. According to Tommy, he dislikes writing. Most of his writing is simple sentences with a great deal of grammatical errors and little detail. He also struggles with math, in which he is approximately 2 grade levels below. He has recently learned how to pitch left-handed. Tommy has a medical diagnosis of childhood-onset bipolar disorder and an educational classification of severe emotional and behavioral disorder. He takes medication for bipolar disorder on a daily basis. He is currently on a new medication. Tommy has a new baby brother who is 5 months old.

Target Behavior

Tommy has been increasingly disruptive the past few months. He has verbal outbursts and pushes classroom materials onto the floor after being given an academic task during quiet work time. His verbal outbursts include yelling that he is not doing the assignment, telling a student to shut up, using profanity, and calling student’s names. His teachers do feel that they spend about an hour per day dealing with the behavior, and they usually respond to Tommy’s behavior by scolding him or by initiating an office referral.

School Classroom Environment

Tommy attends a regular K-5 public elementary school. Tommy is new to the school. Tommy is in the 5th grade. There are 19 students in his homeroom classroom. Tommy has 2 segments in a resource SPED (Special Education) class with 5 other students. Tommy also has 1 co-teaching segment for math. His teacher is very organized and structured. She is loving and understanding with regards to Tommy’s needs.

Previous Interventions

Tommy has attended your school for two months now. Initially, he seemed to acclimate to the new school well. However, things have gotten more difficult for him lately. Tommy’s teacher set up some rewards for him to earn if he does not engage in the disruptive behavior. His behavior has not improved, and it has been difficult for his team to identify “why” he is engaging in the behavior. There is not consensus among his team that the rewards are the appropriate intervention for his disruptive behavior. His team agreed that they should conduct an FBA (Functional Behavioral Assessment) and develop a BIP (Behavioral Intervention Plan).

Instructions: Review the case study given on Tommy.  Then respond to the following prompts/questions in a cohesive written case report as if you are a social worker for the school district being asked to participate in the planning and implementation of care for Tommy.  

1. Evaluate other aspects that need to be explored from a biopsychosocial framework to better understand Tommy’s situation. 
2. Consider how gender influences your analysis of Tommy’s behavior, the school’s response, and the background information provided.
3. What mental health issues do you see factoring into this case scenario that have not yet been identified? 
4. What other assessments do you think are appropriate for Tommy? 
5. What referral resources would you suggest—professional, community-based, school, or other—in response to the case? 
6. Summarize your assessment of needs for Tommy and outline your suggestions/referrals for the care team.