Child Psychology Case Study: Understanding a 10-Year-Old’s Behavior and Emotions
Patient Information
- Age: 10
- Gender: Male
- Background: Aarav (name changed for privacy) is a 10-year-old boy from a middle-class family in Ahmedabad. A bright student with a love for drawing and storytelling, Aarav's behavioural changes began to show during the pandemic years. His parents, both working professionals, at the beginning of this withdrawal and tantrums as common post-COVID effects.
History or Cause:
Aarav's difficulties were noticed when he resumed school after about two years of home-based studying. He indicated strong resistance towards attending school, frequent stomach ailments, and bouts of emotional overreaction. Over time, he started keeping to himself socially, became upset at home, and did not want to engage in play sessions he used to enjoy.
His educators indicated higher absenteeism, inattention, and ongoing difficulties with other children. At home, he became overly clingy with his mother and suffered from sleep disturbances. He would frequently say he didn’t want to grow up or go to school anymore.
His parents were initially unsure whether to take his behaviour seriously. But when there was a disturbing episode wherein Aarav confined himself to a room following a small altercation with his friend and scribbled on the wall, "I want to disappear," they realised that they had to seek help.
They went to see a local psychologist who recommended overall treatment and referred them to Jagruti Rehabilitation Centre in Delhi for child psychiatry and counselling.
Diagnosis :
At Jagruti Rehabilitation Centre, Aarav underwent a thorough psychological and developmental assessment conducted by child psychiatrists, clinical psychologists, and paediatric therapists. Multiple one-on-one child counselling sessions, parental interviews, and play-based evaluations were conducted over a two-week.
Diagnosis:
- Separation Anxiety Disorder
- Mild Childhood Depression
- Social Anxiety
- Screen-Induced Behavioural Delay
The evaluation indicated that Aarav had acquired deep-seated abandonment fears, poor coping mechanisms, and screen dependency during the lockdown. Lack of organized social interaction, lower emotional control, and absence of open expression further intensified his internal anguish.
It was further seen that his emotional lexicon was restricted, and thus there were emotional eruptions as the only means of expression.
Treatment :
Approach:
Aarav was admitted to a 60-day outpatient psychological well-being programme at Jagruti Rehabilitation Centre with a child-focused, family-oriented attitude. The intention was to create emotional strength, tackle his anxieties, and reintroduce wholesome peer and school connections through a well-structured therapeutic and behavioural plan.
Program:
Weeks 1–2: Assessment & Rapport Building
- Development of trust with play therapy and artwork.
- Incorporating early setting of routines in the home environment.
- Orientation on positive reinforcement for parents.
Weeks 3–5: Emotional Identification and Coping Skills
- Introduction to Cognitive Behavioural Therapy (CBT) presented in child-friendly models.
- The use of story-telling, drawing, and flashcards to emotions helped Aarav identify and express emotions.
- Systematic co-play between parents and child helped to identify emotional gaps that needed to be bridged.
Weeks 6–8: Social Skills and School Reintegration
- Role-plays and simulation of social situations.
- Group play therapy with peers who were undergoing similar therapy to improve confidence.
- Encouraging communication sessions for the teachers of Aarav to modify classroom strategy.
Week 9–10: Strengthening Internal Control and Routine Building
- Development of mindfulness and breathing techniques.
- SMART daily goal implementation – e.g., journaling, quiet time, outdoor play, and less screen time.
- Gratitude journaling and daily self-esteem affirmations.
Week 11–12: Preparing for Independence
- Involvement of Aarav in decision-making and confidence-building activities.
- Re-entry school with shadow counsellor.
- Preparation for a "recovery celebration" day to enhance morale.
Medical Treatment (If any):
- There was no psychotropic medication ordered.
- Dietary advice to increase dietary consumption and control mood swings because of deficiencies.
- There were mild deficiencies for which Vitamin D and B12 supplements were ordered.
Therapy Types:
- Cognitive Behavioural Therapy (CBT): Focused on challenging negative thought patterns and building emotional regulation strategies.
- Play Therapy: Guided Aarav to use action toys, narratives, and sketching to express the feelings and phobias he couldn't put into words.
- Parental Guidance Therapy: Made Aarav's parents aware of his needs, enhanced family communication, and improved parenting strategies.
- Group Therapy for Children: Comfortable and non-judgmental meetings with 4–6 children taught Aarav how to share, empathise, and solve conflict.
- Mindfulness in Children: Simple activities such as breathing with a stuffed animal and focus exercises were incorporated to manage anxiety.
Improvements/Recovery Timeline :
| Week | Key Milestones |
| Weeks 1–2 | Established rapport with the therapist. Opened up through drawing and narrative. |
| Weeks 3–4 | Named and labelled emotions such as "scared," "angry," and "lonely." Decreased meltdowns. |
| Weeks 5–6 | Began sharing thoughts freely. Made his first new friend in group therapy. |
| Weeks 7–8 | Attended mock school sessions. Enhanced self-esteem. Decreased school refusal. |
| Weeks 9–10 | Coped with social interactions with less anxiety. Handled a fight with a friend in a peaceful way. |
| Weeks 11–12 | Return to school with structured support. Sleep was better. Spoke of feeling "happy and proud." |
Our Success:
Impact on Aarav’s Life:
Aarav had made significant gains in recognising his emotions, getting along with other kids, and acclimating to school. His vocabulary of feelings increased, and he started controlling his time on his own for homework, play, and recreation.
He began attending school every day again, made new friends, and even competed in a drawing contest—something he had not done in two years.
Aarav’s Words
"Before, I would vanish if my mummy was not around. Now I can attend school and return and share all of it with her. I even made a new friend who also loves drawing!"
Family and Community Impact:
Aarav's parents also became more emotionally aware and ceased to brush his behaviours aside as "just tantrums." They grew closer to each other, and Aarav's better mental health ensured peace in the household. His mother reported that the entire family had altered their routine—more talk, less screen time, and even board games on weekends together.
His teachers also remarked on the massive difference in his classroom participation, behaviour, and relationships with his peers.
Future Steps:
In the future, regular monthly therapy sessions over the next half-year will be necessary to observe Rishi closely for emotional and behavioural development. Ongoing counselling by the school counsellor will be required, particularly with transitions like examination periods or shifting peer relationships. The family should have a structured daily routine with frequent emotional checks at home to maintain a stable setting. If any of these signs of relapse—social withdrawal, irritability, or sleep disturbances, the child psychiatry team at Jagruti Rehabilitation Centre will be on hand for immediate intervention and support.
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