Please review the Case of Kristopher vignette.

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Case Vignette: 14-Year-Old Kristopher

Kristopher is the only child born as a result of the relationship between his elderly Mexican American father and his much younger African American mother. Kristopher’s parents were never married. His mother began using crack cocaine shortly after her relationship with Mr. Ramirez began and continued to use throughout their relationship and pregnancy with Kristopher. Kristopher was born drug exposed and approximately two months premature, yet there were no major complications. Approximately three months following Kristopher’s birth, his mother began to leave the infant with Mr. Ramirez while on drug binges for days at a time. According to Mr. Ramirez, the relationship ended when Kristopher was six months old. “She left and she didn’t come back.” Kristopher stated, “She left me for drugs. She like that better than me.” He indicated that he presently sees his mother about once a year and stated that she no longer abuses drugs. He asserted that the “past is the past” and that he gives little thought to their history or current relationship. About three months following the termination of his relationship with Kristopher’s mother, Mr. Ramirez described feeling overwhelmed with the responsibility of caring for the infant on his own. He was also evicted from his apartment and subsequently sought out assistance through a local Catholic Church where he met Ms. Johanna Lopez. Ms. Lopez agreed to take Kristopher and his father in to assist with the rearing of the child. The two remained in Ms. Lopez’s home for several years. Eventually, Mr. Ramirez moved out, yet permitted Ms. Lopez to continue caring for his son. Despite the new arrangement, Mr. Ramirez was clear that he wanted to continue to be involved with the rearing of his son. Mr. Ramirez had frequent weekend visits with Kristopher. During those visits, however, Ms. Lopez was concerned about Kristopher’s well being. Specifically, when arriving to retrieve Kristopher, she frequently found “him outside in the street playing at 9 o’clock at night,” while Mr. Ramirez played cards with friends. She indicated that Kristopher “always gave us problems because he was restless. I think he [Mr. Ramirez] would get tired of him and just let him go.” Ms. Lopez described Kristopher as a “normal” infant. However, by the age of three, Mr. Ramirez and Ms. Lopez began to notice significant changes in his behavior. He was more temperamental and increasingly “restless and hyperactive …his behavior was so bizarre.” Mr. Ramirez corroborated Ms. Lopez’s observations, asserting, “Something in his mind that wasn’t right … I would punish him and he will get so mad.” He indicated that his son’s anger was typically beyond an appropriate response for the circumstances. Commenting on the observations of his family, Kristopher asserted, “Yes. It’s always been like that. I get mad … Scream. But more when I was a little kid. I had ADHD but that’s the past. I don’t have it anymore.” Ms. Lopez gave such examples as Kristopher throwing sand at her adult neighbors, hitting children with sticks, urinating on children. According to Mr. Ramirez, at four years old, Kristopher was hospitalized for two weeks to undergo observation due to his behavioral outbursts. Mr. Ramirez reported that Kristopher was diagnosed with Attention Deficit Hyperactivity Disorder. He attributes his son’s behavioral problems to the effects of his mother’s substance abuse. Ms. Lopez stated that Kristopher was prescribed Ritalin and the medication was helpful in calming his behavior. However, she and Mr. Ramirez noticed that Kristopher seemed overly sedated and as a result, they no longer administered the medication and his behavioral problems reappeared. Kristopher was hospitalized a second time at eight years of age due to “aggression.” Mr. Ramirez acknowledged that his son was prescribed medication, however, again due to the effects of the medication (e.g., sleeping in class), the medications were no longer administered. In comparison to his behavior while taking the medication, Mr. Ramirez stated that Kristopher “was a little quieter … I would give it to him if the doctor thinks it will help him … he’s out of control now.” Commenting on his prior hospitalizations, Kristopher simply stated, “The past is

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the past. I was sick then.” He indicated that he did not benefit from the medication, asserting that it made him “sleepy.” During this hospitalization, Kristopher was diagnosed with encopresis. Ms. Lopez stated that Kristopher tended to urinate on himself in the bed and in public places. She added that there were a few instances in which Kristopher defecated, yet maintained that these instances were rare. Mr. Ramirez indicated that his son had problems with bedwetting for “about 10 years … it would be once a week or once every two weeks but not poo poo,” despite hospital records and Ms. Lopez’s report that indicated otherwise. Kristopher maintained that he has not had an incident of any kind since he was in the 5th grade. Mr. Ramirez reported that Kristopher first began counseling and therapy following his first hospitalization as recommended. He stated, however that these services were ineffective in assisting with Kristopher’s behavior. As a result, he and Ms. Lopez stopped bringing Kristopher to his appointments. Kristopher also stated that the counseling sessions were not beneficial, asserting, “I need to talk to someone who’s been in my shoes.” He acknowledged however that he has always had a “bad temper … I have a split personality … Sometimes I do what I’m supposed to and then I fall off.” Kristopher stated that he becomes particularly angry by the imposition of “rules … I don’t want to do it when you tell me. It’s when I want to … teachers, whoever …I’m wrong sometimes but that’s the way it is.” According to Ms. Lopez, throughout the approximately 10 years that Kristopher lived with her, Kristopher became increasingly disobedient, destructive, and aggressive, both verbally and physically, though she noted that the physical aggression was less frequent. She recalled an incident that occurred in 2003 in which Kristopher threw a fish tank at her when he was 11 or 12 after demanding that he complete his homework. In addition to his erratic temper and propensity to act aggressively, Ms. Lopez reported that Kristopher began to steal from her when he was about eight years old. Laughing, Kristopher asserted, “I steal a lot. If you won’t buy me something then I want it so I go get it myself.” Ms. Lopez spoke of a specific incident in which then 10 year old Kristopher stole approximately $1000 in cash. When she confronted him, “He acted like it was nothing. Just said he wouldn’t do it again.” According to Ms. Lopez, the first time Kristopher took her car without permission was about 3 years ago while she slept. Discussing his relationship with Ms. Lopez and behavior in her home, Kristopher stated, “I don’t be listening to her sometimes.” He indicated that they have had numerous arguments yet maintained that he has only acted violently towards her on one occasion. “I threw the VCR and a fishbowl at her … she had to call the police but that was a long time ago. I was in the 5th grade. I was ADHD … I’m not like that anymore.” He acknowledged that as a child, when angry he frequently threw objects. Kristopher however maintained that he no longer engages in such behavior. Ms. Lopez reported that about two years ago, Kristopher moved in with his father due to her changing work schedule, though she often visits on the weekend. Mr. Ramirez acknowledged that Kristopher has more structure while in the care of Ms. Lopez, indicating that she does not allow him to go outside to associate with delinquent peers. He indicated, however that he is unsure of how she was able to accomplish this when he has significant difficulty with keeping Kristopher at home. Kristopher reported that he and his father live alone in a one-bedroom apartment, where the two share a bedroom. “He sleeps in his bed on one side and I’m on the other.” Ms. Lopez reported that Kristopher and his father often sleep the entire day because of Mr. Ramirez’s medical illnesses (diabetes and “heart problems”) and Kristopher having been out all night. According to Ms. Lopez, she notified the Family and Protective Services Department in 2004 due to the unsanitary state of the home and Mr. Ramirez’s inability to provide for his educational needs (e.g., assist with or ensure that homework was completed). She stated, however that no report was taken. Kristopher indicated that his home is often disorderly yet stated, “It’s okay. We clean up … he [Mr. Ramirez] takes out the garbage. I do the dishes, clean the bathroom.”

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Kristopher reported that he and his father argue perhaps twice a week. He stated, “Sometimes I feel like fighting … I would never [physically] fight with him … It’s words.” Mr. Ramirez acknowledged that there have been instances in which he feared his son and notified the police despite Kristopher never having physically assaulted him. Kristopher reported that they argue most consistently about his failure to come home at an appropriate hour. Mr. Ramirez stated that he would like Kristopher to be in the house by 8 or 9 p.m., however, “Sometimes, I fall asleep and then he goes out. Then I put a [pad]lock on the door so he can’t go out but the police say it could be a fire so don’t do it … but I struggle a lot with my child …I continue doing it so he won’t leave because I fall asleep and then he just leaves.” In terms of his education, Kristopher reported that he was never in special education nor retained, despite his current special education status. Ms. Lopez stated that Kristopher often makes “Fs, Cs, Ds … he would do his homework but not follow up. He couldn’t finish the work. It was hard to get him to focus.” Unaware of his son’s classification, Mr. Ramirez reported that his son should be in special education, though he was unable to articulate specifically why he believes this to be so. Mainly, however, Mr. Ramirez conveyed that his child’s academic performance is poor because of his numerous suspensions for misbehavior. Ms. Lopez stated that Kristopher’s behavior in school has always been “very strong.” Mr. Ramirez acknowledged that his child has always had difficulty following rules and respecting adult authority figures. When Kristopher was younger, she indicated that he was often expelled from nursery and preschool because of his misbehavior. She conveyed however, that 5th grade marked the most dramatic change in his school behavior despite his behavior at home. It was at that point that Kristopher started accumulating multiple suspensions for fighting. Kristopher maintained that in most instances of physical aggression, he has been provoked into fighting. Despite consistent physical aggression in school, Kristopher stated that he is primarily disciplined and/or suspended for “talking back, goofing off in class … Say something really dumb to make people laugh.” He acknowledged that the majority of the time, “it be me but sometimes the staff come at me the wrong way … disrespect.” In these situations, Kristopher stated that he is occasionally able to stop himself from becoming verbally aggressive to prevent suspension. Nevertheless, he indicated that he has little concern for how he is perceived and maintained that he is not going to allow “anybody, no adult, no kid to disrespect me.” He also acknowledged that he often fails to think “at the moment” and reacts without anticipation of consequences. When asked to comment on his relationships with peers, Kristopher stated that he gets along with “everybody … I’m popular.” He indicated that he views himself as “both Mexican and Black” though he associates himself most with Latino students. Kristopher stated that he has a girlfriend of three months who is 15 years of age. He maintained that he does not have any problems with attracting the opposite sex. He admitted to touching his female classmates inappropriately “sometimes,” asserting that there was one incident in which he was suspended for “smacking this girl on the ass. I heard she liked me and when I did it she smiled.” Kristopher stated however that the girl or someone who observed the incident informed the principle and he was subsequently suspended. Kristopher stated that he first began to use marijuana and alcohol in 2004. He reported that he smokes marijuana and drinks alcohol “for the hell of it … I don’t need it but I just do it.” He acknowledged that on a few occasions, he has arrived to school intoxicated. He went on to say that preceding his use, he is typically thinking “about stuff I don’t like to think about …Without it, I feel distressed about life … fighting with my dad, keep getting suspended. Making dumb choices.” He stated that when thinking about these circumstances, he feels “nervous. Like I’m tired of all this (e.g., school suspensions, fighting with father, arrests).” He indicated that he smokes marijuana daily and predominately alone. He stated that he typically walks around his neighborhood smoking about three “blunts” one after the other, breaks for two or three hours, “then boom,” he begins this pattern again. With regard to alcohol, he stated that he drinks alcohol “maybe 2 times a month … really just when there’s a party.” At one sitting, he indicted that he will typically drink about a “fifth, really a pint. Usually a

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fifth if it’s me and my girlfriend.” When he drinks, he drinks to become intoxicated yet prefers to smoke marijuana, indicating that he is not fond of the taste of alcohol. He reported that he does not drink or smoke marijuana in his home, maintaining that to do so would be disrespectful to his father. Mr. Ramirez is aware of his son’s marijuana and alcohol consumption and stated that he now only gives his son enough money for “a soda or something” due to fear that he will purchase these substances on his own. With regard to his gang affiliation, Kristopher reported that he joined a local gang in 2004 because he thought it would be “cool” and knew some of the members. According to Ms. Lopez, she believes that Kristopher joined the gang when he was 11 years old. At that time, Kristopher would rarely come home after school, yet maintained that he was with Mr. Ramirez, “but I’m almost sure he wasn’t going there.” Mr. Ramirez stated that on several occasions, the police have brought Kristopher home after engaging in various activities with gang members yet he is unsure of when Kristopher is a member. With regard to Kristopher’s legal involvement, he stated that he has been arrested three times for trespassing, stating that he is typically arrested at school for returning to the campus following suspensions. He also reported that he has been arrested 4 times for battery due to fighting with adults and students during school and twice for taking his godmother’s (Ms. Lopez) car without permission. Lastly, Kristopher reported that both remaining arrests were for violations of probation. He stated that he has been in detention four times and indicated that all arrests occurred within the last year. Kristopher reported that once he became a gang member, his behavior deteriorated further. He was unwilling to comment on his activities with other gang members.