Biopsychosocial theory

Case Study

Max is a 2-year-old boy who currently lives with his mother Mary and maternal grandparents, given that Mary was 16 years old when he was born, and living with her parents at the time. Max’s biological father is not involved in a relationship with Max. He does occasionally see Max as they all live in the same town, but he does not make any effort to visit Max or provide financial support.

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Mary did not know that she was pregnant for the first three months of her pregnancy. During this time Mary reports that she did drink and smoke cigarettes on the weekends when she was partying with her friends. It was only after she started becoming ill and went to the doctor that she realized she was pregnant. Mary reported not drinking any alcohol or smoking for the rest of her pregnancy. However, she does state that once Max was born, she has gone back to drinking alcohol and smoking cigarettes on occasion when she can get some time with her friends to help her relax.

Max was born eight weeks premature and spent three weeks in the NICU at the hospital due to insufficient lung development. Since his release he has had frequent trips to the doctor for upper respiratory issues and has been diagnosed with reactive airway disorder. Due to this diagnosis Max needs albuterol treatment with a nebulizer a minimum of 2x/day and occasional steroids. At his recent two-year checkup he was noted as being underweight, and did not appear to be vocal. Mary reports that he does not say a lot at home either, although he does seem to understand and respond to things she says based on his actions.

Given that Mary is still working to complete her GED, and is also the main caregiver for her son, she works about 16 hours a week at a local restaurant as a waitress, therefore she uses Medicaid to help pay for healthcare for Max. Mary’s parents have allowed her and Max to continue to live with them as long as Mary works toward getting her GED and maintains her job. They do help provide childcare when she is at work or taking her GED classes.

Given Max’s health issues he does not have a lot of social interaction with other children his age. His contact is mainly limited to Mary and her parents. Her parents do try to play with Max and provide a variety of learning activities. Mary states that she is very busy with work and studying for her GED and does not always have time to interact with Max when he wants to play, and he often will scream and cry when people leave the room and he is left alone to play. He does not sleep through the night, and at least 2x/week wakes up screaming in the middle of the night. Mary reports that he often sleeps in her bed with her so she can get some sleep as well. He also has not been eating well lately, pushing food away.

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