A referral to a child development centre from a paediatrician Jack is a 26-month-old boy who I have.

A referral to a child development centre from a
paediatrician Jack is a 26-month-old boy who I have been seeing under my
general developmental clinic. He has not progressed beyond babbling yet and is
not compensating for his lack of verbal communication skills with non-verbal
skills, such as consistent eye contact, expressive facial affect and gesture.
He seems to prefer doing things on his own terms. Mother reports that she does
not always know whether he understands what is being asked of him or whether he
is simply ignoring her because he can get quite fixated on spinning the wheels
of

A referral to a child development centre from a
paediatrician Jack is a 26-month-old boy who I have been seeing under my
general developmental clinic. He has not progressed beyond babbling yet and is
not compensating for his lack of verbal communication skills with non-verbal
skills, such as consistent eye contact, expressive facial affect and gesture.
He seems to prefer doing things on his own terms. Mother reports that she does
not always know whether he understands what is being asked of him or whether he
is simply ignoring her because he can get quite fixated on spinning the wheels
of his car or watching TV. Mother is therefore struggling to get him to do
things he needs to do, such as getting ready to go out or going to bed, which
typically results in tantrums. I have spoken to Mother about my concerns
regarding Jacks social communication skills and I would be grateful if you
could see this little boy for further assessment in your clinic.

James Jennifer and Paul are young parents with three
children. Their first son Harry is 8 years of age. He has always been a helpful
and easy-going child, does well at school and has lots of friends. Their second
son James is 6 years of age and is completely different. James finds it very
difficult to sit still for more than a few minutes. He is very distracted and
has difficulty watching his favourite television programme for more than a few
minutes. James is also very impulsive, and rarely thinks before he acts. This
means that he constantly interrupts other peoples conversations and has had
several accidents, including pulling a saucepan of hot water onto himself when
he was 3 years of age. Unlike his older brother who is very patient, James
finds waiting very difficult. He always wants everything straight away, and
would rather give up on a game or activity than wait his turn. James also has
memory difficulties and finds it difficult to remember instructions or lists.
In many ways James behaves just like his younger brother Edward, who is 2
years old. Despite having a very popular older brother, James has very few
friends. Other children find it very difficult to play with him, as he finds it
hard to pay attention to rule changes in their games, always wants to go first
and spoils the game if he has to wait. When he was younger, James didnt seem
to care about his lack of friends, but now that he is a bit older, the lack of
friends and the fact that no one invites him to birthday parties is beginning
to make him feel sad. James has recently been attending his local Child and
Adolescent Mental Health Service and is currently being assessed for attention
deficit hyperactivity disorder. His grandmother says that his dad was just like
him when he was that age. She is also somewhat critical of the way that his
mother deals with his behaviour, and feels that she is far too inconsistent.

Why do you think that Harry and James, who are brothers,
are so different? What do you think might be the causes of James
difficulties? Do you think that James will g

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