5/25/2023 EnchantaVaughn Approved During morning school arrival, client entered the building with impulsive and hyperactive behaviors running and jumping in the hallway and making loud noises. Client continued to be disruptive even after being told to stop several times. Client was off task as he was observed talking to his classmates instead of being attentive to his instructor. Client struggled to refrain from displaying disruptive behaviors, as evidenced by socializing with his peers during instructional period. Client exhibited negative behaviors as he failed to comply with instructor. Client continued talking until his instructor informed him he would be sent to the office if he continued to do so. Client quickly got quiet and was able to redirect his negative behavior. Client seemed to be irritable as he made a side comment in regards to being bored in the class. Client had trouble following directions. Client failed to appropriately express his feelings, as evidenced by failing to verbalize he did not understand the assignment. Client was witnessed sleeping in class and not getting any of his work done. Client continues to receive zeros for his missing work and shows no motivation of doing it, presenting low participation. Client woke up when QMHP arrived to his structured setting. Client appeared to be struggling to keep up with the speed of the teacher so he failed to complete all of his notes or ask for help. Client failed to complete his assigned task, as evidenced by client continuing to work on it as the teacher came around to collect it. Client became argumentative, as evidenced by attempting to keep his paper. Client struggled to comply with authority directives during middle academic hours, ending his day in a restless mood. QMHP initiated a rapport building conversation with client in efforts to learn more of his likes and dislikes as well as triggers to negative behaviors listed on his ISP. QMHP was informed of the client’s poor behaviors and how he gave his mom and teachers a hard time all morning. QMHP inquired why he was acting out and asked him to explain his intentions behind not listening and being disrespectful. QMHP physically redirected client to an alternative activity offline so he wouldn’t continue to disrupt others. QMHP provided guidance on alternative behaviors and clear instruction on the alternative behavior. QMHP intervened to prevent the negative behaviors from escalating. QMHP encouraged client to list alternative behaviors he could have participated in besides the negative ones that caused him to be redirected. QMHP will continue to assist client with managing anger and frustration by reviewing and modeling effective coping skills. Client explained he likes to be rewarded and praised by others often because it gives him more confidence. Client reviewed goals and objectives listed on his ISP. Client often follow behind others who are being disruptive and has to be reminded to get back on task. Client displayed a few disruptive behaviors in the school setting, due to stressful environment and not being able to take a break when he wanted too. Client did not utilize any of the conflict resolution skills he has learned. Client continued to be defiant when things didn't go his way or if he refused to share. Client would not express what triggered his negative behaviors. Client did not process that he could have handled the situation differently. Although client has difficulty staying focused in class, he is extremely dedicated to building relationships with his classmates and participating in the group activities during recess and extracurricular events.