Early Childhood Mental Health in the Care of Medically Complex Children: A Case Report

Abstract

Despite literature highlighting the adverse consequences of unregulated stress little work has discussed this risk factor and related interventions in young children with chronic health conditions. An inability to effectively utilize a caregiver to co-regulate both day-to-day stress and stress related to medical care leaves young children vulnerable to the psychological and physiological consequences of extended and intense stress. This brief case report outlines the mental health and neurodevelopmental trajectory of a young girl with Bartter Syndrome. The child’s medical history is outlined, followed by a description of her presentation to an early childhood mental health clinic for a developmental assessment when she was 3 years old. An in-depth description of the patient’s presenting behavioral, emotional, social, and neurodevelopmental state is discussed as well as dysfunction in the child-caregiver relationship and broader cultural stressors facing the family. A detailed case conceptualization from this assessment and treatment plan are outlined. This case is complemented by longitudinal information on the child’s psychotherapy as well as the results of a neuropsychological assessment when they were 5. This rich case study highlights the role and possible benefit of early childhood mental health assessment and intervention in the ongoing care of children with complex medical conditions.