CASE STUDY: Preschool Child: Ricky

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Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father,
who both work full-time, and his infant sister. Their extended family lives in a different state
more than 100 miles away. Both parents are of average height and in good health. Ricky’s
mother mentions that Ricky often expresses frustration, particularly in regard to food. Conflict
over food occurs every day. Mealtime is a battle to get him to eat, unless his mother feeds him.
Ricky’s baby sister seems to tolerate all baby foods but requires her mother to spoon-feed.
Ricky’s mother is quite frustrated and concerned that he will become malnourished.
Reflective Questions
1. What additional assessment information would you collect?
2. What questions would you ask, and how would you further explore this issue with the
mother?
3. In what ways does the distance of the extended family influence this family’s approach
to health promotion?
4. What factors would you consider to determine whether malnourishment is a factor in
this family?

Sample Solution

If I were assessing this situation, the additional information I would collect would include Ricky’s medical history, eating habits and nutritional intake, as well as his family dynamics. It could also be beneficial to explore possible underlying causes of why Ricky may be exhibiting frustration towards food, such as exposure to stress or traumatic experiences within the home environment (Naimo & Kliegman, 2019). Additionally, it is important to understand if there are any cultural factors that may be influencing Ricky’s behavior around food.

I would ask questions related to the development of his current eating habits and what methods have been tried in order to encourage him to eat. For instance: When did you first observe that he wasn’t eating? What do you offer during meals? How does he respond when you attempt to feed him? What type of reinforcement do you use when trying to get him to eat? Questions regarding Ricky’s developmental milestones can also help provide insight into his current behavioral patterns at mealtimes. Questions such as: Does he demonstrate any other behavioral patterns similar or different than those observed at mealtimes? Is there a particular reason why meal times are so difficult for Ricky?

Questions directed toward exploring family dynamics will help aid in further understanding why Ricky may display certain behaviors around mealtime; such as asking whether there is anything occurring within the home environment which may contribute towards this issue – for example high levels of tension between parents or siblings (Naimo & Kliegman, 2019). Examining how parents interact with both their children during mealtimes and general interactions can provide valuable information on how best support them through this issue. Lastly, examining parental expectations surrounding mealtime etiquette and adherence can give further insight into whether these expectations could potentially contribute towards escalating tensions during meal time.

stating, “I don’t want to be a writer. It’s stupid. It’s a stupid waste of time.” Chris responds, “That’s your dad talking.” Chris notes that Gordie is repressing his American dream because his father does not want him to be a writer. He then states that he wishes he was Gordie’s father because if he were, Gordie would not be considering taking shop courses instead of his college courses. Chris acts as a father figure to Gordie, who finds comfort and solace in his friends following his brother’s death. He resents the idea of taking college courses because he knows that it will isolate him from his friends, leaving him completely alone. When the boys finally make camp for the night and go to bed, Gordie is awoken by a nightmare of his father telling him “it should’ve been you” referring to Denny’s death.

Chris’ American dream is to prove wrong the people that believe he will ultimately end up bad because of his family. When Gordie mentions that Chris could take college courses too, he states that no one would let him because they all think of him as “one of those lowlife Chamber kids.” He then explains how upset he was at being suspended from school. Chris was suspended because he stole the school’s milk money, not because he wanted to, but because he was expected to. When he became guilty and tried returning the money, his teacher used it to buy herself a new suit. He explains to Gordie that even if he tried to tell someone that story, they wouldn’t believe him because he’s nothing more than a kid brother to Eyeball Chambers. Deep down, Chris is a good kid whose dream is to succeed in life. His American dream is to make the adults in his life see him not as a punk, but as the intelligent, caring, boy that he is.

 

 

One of the most important scenes in the film occurs when the four boys reach a bridge. They must decide whether to cross the bridge or walk an extra five miles to go around the bridge. This entire film represents the journey of childhood into adulthood, thus making the train tracks a symbol of the journey from one stage of life to another. The bridge, as well as the tracks in general, demonstrate that the path towards adulthood can be adventurous, dangerous, and downright scary. When the boys are about halfway across the tracks, a train comes along, forcing them to run. In this instance, the train symbolizes the trauma that the boys have experienced that have ultimately forced them to grow up quicker than average boys their age.

When the boys get close to finding the body, they again are forced to make a decision regarding the direction they take. They can either walk the train tracks or cross a field into a forest and ultimately decide to walk through the field. By choosing this path rather than the tracks, this shows that the boys desire to make their own destinies rather than follow the path that has already been paved for them by their family members, community members, and society itself. When the boys finally find the dead body, Gordie decides that they will not take credit for finding it, as that is not the way to prove themselves to their community. They report the body anonymously and return back home. Gordie and Chris say goodbye to the other boys a

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