“Case study of 13 years old boy Suffering from Depression and Stuttering” Abstract

“Case study of 13 years old boy Suffering from
Depression and Stuttering”

Abstract:
A thirteen years old boy’s case study who is suffering from depression and stuttering. Causes of depression are: disorders, emotional distractions and speechlessness of the boy are in his experiences from early childhood. The boy was separated from his mother at the age of three and after the birth of his 2 younger brothers he felt himself ignored and unsecure. The objectives of this case study is to find out the reasons through using different activities like: interview of child, mother report, his drawings and exploration of suicidal thoughts. A qualitative data collection was taken from the respondents.

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Keywords: stuttering, clinical psychology, depression, separation suicide.

Introduction
In clinical practice there is a frequently occurring problem, namely, who has the competence to treat stuttering. Speech therapists recommends that the children who stutter, must go for therapy to therapists because children who are suffering from stuttering are in serious emotional problems. As we know that speech therapy and develop fluency of speech, communication ability, self-expression and finally can reduce or eliminate the symptoms of stuttering.

Childhood depression
Depression affects people of all ages including children and young people. In school age children depression is increasing day by day and it is becoming commonplace. Most of the children tries to commit suicide because of depressive disorder. The common symptoms in common age children are worthless, anxious, empty, irritated, hopeless, loss of interest in activities, hobbies, inability to enjoy activities, change in appetite and having difficulty in falling asleep and difficulty in concentrating or making decisions.
Sigmund Freud suggests that depression also involves guilt and self-criticism, which can be related to loss during childhood. Anger may be focused on parents if they do not give the child love and warmth that is needed for healthy development. These destructive feelings are turned inwards and the child blames itself for the loss, which leads to guilt and self-criticism.

Role of separation for stuttering:
Researcher observed that among 80 children 39 were separated from their mother before the start of stuttering. It is revealed in high percentage of cases that a lengthy separation from mother lead the development of the disorder. To leave the child alone at home or mother having left home can be a cause of stuttering.
According to the other researcher, the speech development can be successful if the relationship between mother and children is uninterrupted. Absence of such relationship can cause this disorder.
The kind of anxiety in stuttering in children can be described as a fear of loss of mother.
As we know that early experiences in childhood have an important influence on development and behavior in later life. I think that children who faced separation in early age are more sensitive than the later separated children and faced many difficulties.
Case study:
A 13 years old boy referred to speech therapy because of having problem of stuttering and he also had bedwetting problem. During the diagnostic process it is revealed that this boy had serious emotional problems. Often his mood was sad, irritable and withdraw from social situations. At this time he lost his interest in school and was thinking to commit suicide.
Research questions:
The present study was based on the following question:
What practical contributes to clinical and researchers does the current literature on childhood depression have to offer?

Aims and objectives:
The objective present study was to conduct systematic review of article regarding the childhood depression.
Sample:
In this case there are 2 participants who provide the all details. First was the bot Aaron himself and second was his mother.
Literature review:
Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment and prevention. Recent scientific literature regarding childhood depression converge to, direct and indirect, highlight the negative impacts of depressive disorders to the children’s quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of defenselessness.

Methodology or research design:
To find out the real cause of his depression the researcher has used different quantitative approach to examine him. Which reveals that what are the causes of his anger and suicidal thoughts.
? first interview
? mother report
? drawings
? Explore his intentions of suicide
First Interview
The first interview is that when a patient comes to visit doctor for the first time and gives the basic information about his problem.
The grandparents of that child called the psychologist. Now the boy and his mother came out from the room to meet the psychologist. The boy was tall and thin but so quit and has no happiness on his face and he looks elder than his age. His mother was a middle age lady about 30 years old with long brown hair, big brown eyes and smiling face.
Psychologist said that the boy said that his teacher complained about his behaviour in the school and most of the time he stays quiet and in anger because everyone in the school teased him and this cause depression for him, to my mother. On other side, one day he was going to the video shop, some of the boys stopped him and gathered around him and when he tried to escape they tripped him up and it hurt his knees. This case made him introverted and he starts thinking to commit suicide. He told all things to his teacher and she called his parents but his parents could not help him out of it.
Aaron thinks that his problems could not be solved and when his class mates make him angry, he could not stop his emotions and starts beating the class mates who teased him. At that time teacher noticed that and punished him instead of those boys. But during the discussion psychologist perceives that only just a few blocks interrupted his speech.
Mother Report
The next time psychologist met the mother to get the data about her child development. From the history the following details are important. The mother got pregnant when she was young in age of 21 years. The pregnancy and birth were normal. Aaron was breast fed for 6 months and starts walking in the age of 9 months and was toilet trained in the age of 3 years. The most interesting thing is that his mother was not aware of his problem of stuttering. In the start of nursery he was unable to fit in but later he fits in it. He stays lonely and have no friends in school. In the age of 4 years he got 2 brothers. When he was in the age of 1 year his brother was born and the birth of his brother shocked him. On the birth of his brother his mother was taken to the hospital unexpectedly and this shocked him very much. His father was busy in his work and he left him to his grandparents’ house to take good care of him. His grandparents did not allow him to go to the hospital to meet his mother and later they rejected his mother and separated him in his very early age which was unacceptable for him.

Drawings
Psychologist used different drawings test in the next period of the diagnostic process.
Draw the Person- House- Tree Technique:
It is a projective personality test, a type of exam in which the taker responds to or provides ambiguous, abstract or unstructured stimuli. In this test the test taker asked to draw houses trees and persons and these drawings provide a measure of perceptions and attitudes.
Draw the person: He draws the figure of a person with a suitable size. The figure was not too small and not too big, it was according to the size of paper. He placed the figure in the center of the page. The lines were tangled specially the head of the figure. It is not for the eye contact and seems that the figure makes a vague step with his left foot.

Draw the house: The drawing of the house was schematic, lines were entangled and house was not in symmetrical.

Draw a tree: The shape of the tree was also schematic. The part of the branches and trunk were suitable, but branches seems more dominant than the trunk. The roots which were not visible symbolized the past which is routine of children because they have focus on present. On other hand the branches represented the relation with people, were entangled.

Family drawing: The drawing of the family always gives us interesting information about the family. The person who draws them shows his unconscious desires and fantasies.
In the picture Aaron (from the left to right) draws his brother Mike, his mother, his second brother Adam, father and himself. He draws himself in the largest one but at the last of the family members. His 2 brothers were standing near to the mother and he stands next to his father.

Fantasy Family: This task is to transform family members into things which the person desired. In his fantasy family he made his father as a house which symbolizes the feeling of security or safety. His mother becomes heart which means affection. Mike, his brother is a pinball machine because he is the winner to get the love from his parents which symbolizes that his parents prefer Mike. Adam, his younger brother is a mouse because he is not brave like his brothers. Aaron is a TV box because he like to watch TV.

Kinetic family: In this type of drawing the family togetherness is shown. In his kinetic family, his mother was washing dishes, his brothers were watching TV, his father was gardening and he was watching TV in separate room.
Mother-child: In this picture the relationship of mother and child was shown. Mother and child reached each other but could not attained each other.

Exploration of Suicidal thoughts

To know how realistic his intentions to commit suicide was, psychologist took one more session to explore the suicidal thoughts. The dialogues between child and psychologist were:
• Since when have you had thoughts like this? Where would you commit suicide?
My suicidal thoughts were started from my school life because of the teasing behaviour of my class mates. Once I was seriously jumping out of the window because of the class mates.
• What would your class mates have believed if you had done it?
They would think that I am stupid. George and Thomas were reflected and otherwise no one will noticed what had happened to me.
• What would your teacher have believed if you had done it?
She would be sad but not surprised because she knew that I stay sad because of my classmates.
• What would your mother have believed?
She would have thought that I have committed suicide because I was sad. She would feel same when my grandmother died. She sat in the garden and cried a lot but for me may be she feels that she ignored me and did not give me proper attention and feel my absence for 2 or 3 months.
• What would your father have believed?
He probably would get through it more easily, but it could be, that he would become more introverted and would start thinking of committing suicide. My mother told me that when my father’s first wife left him, at that moment he was thinking to commit suicide but he never mentioned.
• What would your grandparents have believed?
My granddad consider suicide as taboo. He never expresses his feelings but he would mourn for months and my grandmother would have been very sad.
• What would your brothers have believed?
My older younger brother would not understand it but he would think about the benefits that he will get my room and more care of mother. And my youngest younger brother would think that the fish died in the aquarium.
• Who would go to your funeral?
My dad would surely go to my funeral but I am not sure that my mother and siblings do so.
• Was there someone in your family who committed suicide?
My great grandfather died in hi young age. He drank too much when he was young and he went regularly for the horse races. May be he had thoughts of committing suicide.

Data collection and analysis:
The data collection was taken from the interview of the child than his mother. And the way he think, it was assessed through his drawings. Which shows that he feels loneliness and unable to convey his thoughts to them and also has unable to express his feelings to his parents. And parents were also untrained to understand the needs of their child because they both were busy in their jobs.

Conclusion
Aaron was separated from his mother in his early age when his brother was born. On the other side which was also difficult for him to get separated from his mother and go to nursery school. In the age of 3 years he started stuttering and in age of 4 he had problem of bed-wetting. These symptoms are signal of his anxiety. According to the all examining test, it is proved that his stuttering was due to his separation in early age from his mother.
To fit in into the society was very difficult for him and this process was quite slow for him. And his classmates’ behavior and teasing made him angry. That’s why he stayed alone and sad. His mother changed her work place and get engaged in her work and spend less time at home.
During the diagnostic process I realized that his problems are deeper than his speech therapy. And psychotherapy could help him more than speech therapy. Because speech therapy can only give him fluency of speech but his anxiety and problems will remain, not finished.

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