CASE STUDY: Preschool Child: Ricky
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?
In addition to the information that is already known, I would collect the following additional assessment information:
- Ricky's height and weight, to assess his growth and development.
- Ricky's dietary intake, to see what foods he is actually eating and how much he is eating.
- Ricky's temperament, to see if he is a generally fussy or anxious child.
- Ricky's family history, to see if there is any history of food allergies or sensitivities.
- Ricky's environment, to see if there are any environmental factors that could be contributing to his food refusal, such as noise or distractions at mealtimes.
- What foods does Ricky like to eat?
- What foods does Ricky refuse to eat?
- What does Ricky do when he is presented with food that he refuses to eat?
- How does Ricky's behavior change when he is hungry?
- What are the mealtime routines in your home?
- How do you feel about Ricky's food refusal?
- Her own experiences with food as a child.
- Her feelings about feeding Ricky.
- Her expectations for Ricky's eating behavior.
- Her strategies for dealing with Ricky's food refusal.