方法:Jay是一个6岁的男孩,由于言语/语言延迟和挑战性行为,他被转诊到多学科发育诊所进行评估。他参加幼儿园的个性化教育计划(IEP)支持语音/语言的发展挑战,电机,和学术技能。据报道,杰伊在顺利怀孕后足月出生,并与他的亲生家庭生活了几个月,然后过渡到机构护理。在他第一个生日前不久,他过渡到三个寄养家庭中的第一个。怀疑杰伊经历了营养不良,疏忽,缺乏适当的监督,和不适当的责任级别(例如,在婴儿还是幼儿时提供护理),以及在寄养期间有限的语言输入。他获得发展里程碑的年龄未知,但是他在所有发展领域都表现出了延迟,包括他的主要语言的语音/语言发展,这不是英语。Jay的养父母报告说,他学习英语词汇很好,但被注意到偶尔有单词查找困难和动词共轭错误,代词使用,和英语语法。行为问题包括冲动,多动症,和侵略加剧了新的或响亮的环境和过渡。社会上,他似乎通常与同龄人交往,但对个人空间/界限缺乏了解。他的养父母也注意到他对周围其他人的情绪非常敏感,早上更烦躁,被“可怕”的东西迷住了,似乎害怕被遗弃。在他养家的最初几个月里,他经常夜间醒来,对黑暗的恐惧,睡前的侵略,但是随着时间的推移,所有这些担忧都有所改善。神经心理学测试作为多学科发展评估的一部分完成,Jay表现出低平均认知能力,所有基于语言的领域的延迟学前技能,以及接受性和表现性语言延迟。在评估期间,他参与了社会活动。最终,他被诊断出患有混合性接受-表达性语言障碍,注意力缺陷/多动障碍,合并演示文稿,和未指明的创伤/压力相关疾病。考虑到周杰伦的早期历史,在解决他的父母对他的言语/语言发展和行为挑战的担忧时,你会考虑哪些因素?
Jay is a 6-year-old boy who was referred to a multidisciplinary developmental clinic for evaluation because of speech/language delays and challenging behaviors. He attends kindergarten with an Individualized Education Program (IEP) supporting developmental challenges with speech/language, motor, and academic skills.Jay was reportedly born full-term after an uneventful pregnancy and lived with his biological family for several months before transitioning to institutional care. Shortly before his first birthday, he transitioned to the first of 3 foster homes. It is suspected that Jay experienced malnourishment, neglect, lack of appropriate supervision, and inappropriate levels of responsibility (e.g., providing care to an infant when he was a toddler) as well as limited language input while in foster care. Ages at which he attained developmental milestones are unknown, but he has displayed delays across all developmental domains, including speech/language development in his primary language, which is not English.Jay\'s adoptive parents report that he is learning English vocabulary well but has been noted to have occasional word-finding difficulties and errors in verb conjugation, pronoun use, and syntax in English. Behavioral concerns include impulsivity, hyperactivity, and aggression exacerbated by new or loud environments and transitions. Socially, he seems to be typically engaged with peers but lacks understanding of personal space/boundaries. His adoptive parents have also noted that he is very sensitive to the emotions of others around him, more irritable in the morning, fascinated by \"scary\" things, and seems to fear abandonment. During the initial months in his adoptive home, he had frequent night awakenings, fear of the dark, and aggression at bedtime, but all these concerns have improved with time.Neuropsychological testing was completed as part of the multidisciplinary developmental evaluation, and Jay demonstrated low-average cognitive abilities, delayed preacademic skills in all language-based areas, and receptive and expressive language delays. He was socially engaged during the evaluation. Ultimately, he was diagnosed with mixed receptive-expressive language disorder, attention-deficit/hyperactivity disorder, combined presentation, and unspecified trauma/stress-related disorder.Given what is known about Jay\'s early history, what factors would you consider in addressing his parents\' concerns regarding his speech/language development and behavior challenges?