Language-based learning disorder

Danielle is an eight-year-old female who lives with her mother and five-year-old brother.  She fights with her peers and doesn’t have any friends. She has a very difficult time interacting with other children and has displayed significant aggressive and assaultive behaviors at school and home. It has been reported that on a few occasions this behavior has resulted in injury to others. These behaviors prevent her from being able to participate in any recreational activities.  She attends a school for youth with emotional and behavioral challenges.  She struggles academically and has an individual education plan (IEP) that addresses learning and behavioral needs. She has language delays characterized by limited receptive abilities and she is impulsive. Danielle has been diagnosed with ADHD, ODD, and a language-based learning disorder.  The school professionals have offered multiple services to help Danielle function better at school.

Danielle’s mother describes her daughter as a “terror,” with behavior that is verbally and physically aggressive toward her displayed on a regular basis. She says she has a hard time understanding Danielle’s emotions and feelings.  She also notes that Danielle’s brother is afraid of her. Frequently, Danielle doesn’t follow her mother’s directions and is defiant. When she is asked to do something, she refuses and her behavior escalates, becoming aggressive and including the throwing of objects. Danielle’s mother has expressed her concerns about being able to keep Danielle safe at home and has asked about alternative placements. She doesn’t understand why Danielle acts like she does and her discipline is not effective.

Her parents are divorced and have a difficult relationship that at times escalates to hostile arguments.  When her parents were living together, arguments were constant and there were several incidents of domestic violence during which the police needed to intervene. Prior to the divorce, Danielle’s father was arrested for hitting her mother during an argument in which both children were present. Since then, whenever there are any arguments with lots of yelling, Danielle appears to go into a trance which her mother describes as ‘daydreaming’.   During these times, Danielle doesn’t seem to hear or see anything that is happening around her.

Danielle’s mother has a history of alcohol abuse and is in recovery, attending meetings.  She has been treated for depression for many years and is currently managing her depression with medication. Given her own struggles with her depression and the stress of dealing with Danielle’s behaviors, she has not advocated for additional services at Danielle’s school. For example, even though she attends all meetings, she never challenges the IEP team even when she believes the services in place are not working.

Both parents are employed and share physical and financial responsible for child care needs. Danielle’s relationship with her father is strong; they appear very connected.  At this time, he is not able to care for her full-time because of his job as a long distance truck driver.  Danielle’s father reports that when she is with him, Danielle does well. He acknowledges that his daughter is challenging due to her delays, but reports being able to manage her behaviors.  He frequently goes to therapy with Danielle but is not always sure how to participate.  Her therapist reports that Danielle has offered some ideas for her treatment plan and that her father is supportive but needs support himself.  She like spending time with her father because they do various art projects together.  She reports that doing art makes her feel better and relaxed.  She hopes to be a professional artist when she grows up.

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