4/17/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed settling into class, finishing breakfast and listening to morning announcements. Client attended to his studies and prepared for group activity. Client was seen interacting well with others and displaying appropriate social behaviors. Client displayed appropriate conversation and voice volume. Client was monitored listening and following directions. Client appeared to be in a good mood, as evidenced by his positive attitude. (PM) Client transitioned to lunch with peers. Client was observed making insightful comments and giving feedback. Client was reminded about his tone and encouraged to use his manners. Client was acceptive and respectful toward his teacher. Client cleaned up his trash and joined psycho social group. Client displayed hyperactive and impulses actions immediately. Client could not stay in his seat. Client had difficulty staying focused and sitting up straight. Client kept fidgeting his thumb and jumping all over the table. Client was directed to stop and pay attention. Client had trouble listening and following directions. Client was able to calm down and refocus when he realized consequences would follow. (EOD) Client participated in individual session and contributed to discussion. Client expressed a lot of excitement about learning and drawing. Client communicated that he loves to color. Client was supported for his cooperation and excellent behaviors. Client returned to class in a positive mood. Client exhibited good teamwork skills during activity, no further redirection was needed. Client prepared for announcements and dismissal, meeting objectives 1 and 3, but failed to meet objective 2, as observed. (AM) QMHP will teach client necessary coping skills to decrease impulses. QMHP will brainstorm strategies with client and encourage self monitoring. QMHP will assist client with self monitoring skills to enable him to participate in fundamental learning. QMHP will provide mediation and relaxation techniques. QMHP inquired about after school activities. QMHP will collaborate with teacher regarding behaviors and performance. (PM) QMHP applauded client for being the bigger person. QMHP will review and give feedback regarding ADHD and its causes and affect toward client well being and academic functioning. QMHP will provide client with support and encouragment. QMHP will monitor, observe, and redirect client behaviors as needed. QMHP will build rapport. QMHP will explore positive self talk, use instruction modeling, and increase social communication skills with positive reinforcement role play activities. (EOD) QMHP will educate client on behavior modification to help client identify what behavior he need to decrease and avoid daily. QMHP will utilize behavior modification system to aid the client with following directions given by authority figures. QMHP will meet with client daily to discuss progress and expectations that are working and not working in school daily. (AM) Client communicated positive affirmations and self talk. Client utilized self monitoring skills in class. Client displayed management of individualized behaviors. The client has not overreacted with anger to minor frustrations or irritants. Client responded in a pleasant manner acknowledging the positive reinforcement that the QMHP provided. (PM) Client was able to reevaluate himself and display a more positive attitude toward peers and authority. Client has become more involved in age appropriate social activities and was given positive reinforcement for these choices. Client demonstrated expectations and responded well to feedback. Client reported a decreased stress level due to her modulation of social contact, and the success of this was reviewed. (EOD) As the client developed understanding of academic expectations, she reported increased satisfaction and function. Client responded well to feedback, interacting well with others. Client implemented her plan for restoring relationships, and this was reviewed.