Copy - Customer Empathy Map

challenges of client/family

identifying info

strengths of client/family

clinical impressions

Presenting issue

background info

Gianni , 3 yr 11 m

"gianni SiT Down:"

"Gianni Dont do that

Assesments

Obser vations

Play therapy themes

Difficulting Attening when:

An Dynamic Attential Sp an title

nergetic, enthusiastic, and engaged in both structured and unstructured activities

Warm engaged with clincian, invites her to play

Independnet, creative has own ideas, minimal help

Observations

Difficulting Attening when:

Attends Well When:

Dynamic Attential Span

- Unstructured Playtime - No Instructions where to go - Finishes a task quickly - Not receieving feeeedback - If task is not engaging/stimulating/ of interest - Waiting her turn - Transitina time - Doesnt recieve feedback

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- Unstructured Playtime - No Instructions where to go - Finishes a task quickly - Not receiving feedback - In the Absence of Social Engagement - If task is not engaging/stimulating/ of interest - Waiting her turn - Transition times

- Structured Activity - Interactive activities with others - When task is interactive/ provides feedback - in Public Spaces - In Preferred activities

Individual Play therapy

• Allow her to be a child
• Uncondional postive regard
• CONSITENCY
• Allow herself to make mistakes

• Role Reversal - Nurter/Nurtering
• Reflective Statements
• “You’re making sure the baby is safe and cared for. That’s so important to you.”
• “You’re making sure everything is okay after something bad happened.”
• “You’re inviting me to join your story. I can see how much you like sharing it.”
• Modeling Sharing behaviors/ providing support in classrroom

• Self-regulation strategies
• “While we wait for your turn, you can hold this fidget toy” or “Let’s practice taking deep breaths together while the others finish.”

Treatment

Teacher:

• Positve Reinforcemtn

• I love how you stayed with your art project and glued everything so carefully!” or “You waited so patiently for your turn—great job staying calm!”
• Breaks/Get up Allow her short breaks get up to which may improve attention in other tasks
• Sensory Integration Techniques: Use tactile materials in learning tasks to maintain her engagement.
• Teachers should respond promptly when Gianni seeks validation (e.g., “Ms. Marshall, look!”), so she feels seen and valued. Even a quick response—“I see that you’re working so carefully!
• Unconditinal positive regard

Home: .

• Nurter
• What will happen i she doesnt do chores?
• Growtt mindset priase the effort
• Model Vulnerability / Mistakes
• Peer Groups
• Postiive reinforcemnt
• Practice 2 step directionsAsk her to repeat instructions to ensure comprehension.

If a flower isn’t blooming, you don’t blame the flower—you check the soil, the sunlight, the water. Children are no different

Gianni’s attention challenges appear linked to self-regulation difficulties. She frequently seeks feedback and engagement from others, relying on external cues to sustain motivation and remain engaged. Elevated anxious/depressed scores on the CBCL, combined with observed behaviors such as thumb-sucking and foot-tapping, suggest possible underlying anxietyGianni’s strong memory and verbal skills reflect strong cognitive abilities, which enable her to participate meaningfully in conversations and tasks. These strengths can sometimes create a mismatch between her developmental capabilities and the expectations placed on her.Her play themes of caregiving and nurturing may reflect internalized expectations to meet adult-like standards, as she assumes roles of responsibility even during imaginative activities.Additionally, as an only child, Gianni also has limited opportunities for consistent peer interactions at home. Her frequent invitations for the clinician to “come over to play” and her reluctance to leave therapy sessions likely reflect a strong need for emotional and social connection.Impact on Attention and Emotional Needs:

• The expectation to act maturely and responsibly might limit opportunities for Gianni to fully engage in unstructured, childlike exploration and play, which are essential for her developmental stage.
• Over time, these responsibilities might shape her view of self-worth, making her feel she is only valued for what she can do rather than who she is.
• This role might contribute to her reliance on external validation, as she looks to adults for reassurance that she is "doing things right."

Clinical impression

Reliance on external validation--> Impact on self-wroth---> anxiety/self conciousness/ restlessness

Family Dynamics

• Mom (23), Dad (39)
• "Everyithing is good"
• "full of love"Outdoors actiivies
• Dad works full
• timeParents started chores with her

Mental Health/ Susbtance hustory

• None

Background

Living ArrangemntIt’s

• Lives with mom and dad in studo apt

SES

• Low SES neighborhood in south LA

Medical Hx

• Induced delivery, full term,
• Sleep challenges
• Last medical exam about a yr ago

Develeopmental Hx

• Babbling: 4M, 1st word: 4-6M, 2 word statements: 12M, Sentences: 1.5yr, Pull up/Crawling: 6M, Walking 1yr, Running: 14-15 M
• Mini Adult"

School Hx

• August 2023- TCCI King San Pedro M-Fri 8-2pm

Specizlied Services

• None

Social

• Close to moms friend daughter

Difficulting Attening when:

Nurturing in play

Adult Activity in Play

Rescue Activity

Doesnt allow herself to be a child

Play Therapy Themes

- Unstructured Playtime - No Instructions where to go - Finishes a task quickly - Not receieving feeeedback - If task is not engaging/stimulating/ of interest - Waiting her turn - Transitina time - Doesnt recieve feedback

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Parents:

• Does not ofllow two ste step directions
• Active at home unless you sit with her
• Difficulty get ting her to sleep

Teachers:

• Limited attention span, restlessness, and “always on the go."

Challenges

Clinician

• Challenges with attention in unstructured activities/ no social reinforcement/engagement
• Seeks validation from adults.
• Sellf-consious / Sensitive to feedback
• .Difficulty. managing internal regulation without external support.
• Restless when waiting, tranisions or Low-Stimulation Moments:

• Has not developed social skills for sharing/cooperating with others
• Possible Anxiety
• Only child / limited peer engagement
• Family has missed 3 sessions
• Father can be guarded. Paints picture of "perfect" family
• Father works alot- (limited time at home)

CBCL

Assesments

Parent Report CBCL

Teacher Report CBCL

ASQ

Parents:

• Does not ofllow two ste step directions
• Active at home unless you sit with her
• Difficulty getting her to sleep

Challenges

Clinician

• Restlessness During Wait Times and Transitions:
• May struggle with understimulating/ standardized task completion tasks (cleaning) due to preference for engagigng in acitiiviies
• Often seek validation
• Has not developed social skills for sharing/cooperating with others
• Possible Anxiety
• Only child

Parents:

• Independent/ Good adapative skills
• Good at variety of activities (painting, singing, dancing, running, & soccer.)
• Can iniate play with others
• Great memory
• "Likes to to mimic" and do what her parents do
• "Mini adult"

Strengths

Teacher::

• Gianni is very independent, helpful, & ready to assist.
• "always happy.”

• She is very observant & is curious about her personal surroundings.
• Very social and will play with anyone

Clinican

• Warm/Friendly
• Resilience
• Energetic Perssonality
• Empathy/ Social Awareness

• Strong creative thinking/imaginary play
• Problem solving abilities

• Strong expressive and receptive langugae akills
• Capacity to focus and finsinh tasks that are engaging, stimulating and interactive for over 15-20 mins
• Active Family - outdoor activities
• Both parents involved

Referred by head teacher at TCCI- King San Pedro Presenting Concerns:

Presenting Concerns:

high activity levels

difficulties sharing

Difficulty with 2-step directions

Functional Impaiments

"Gianni constantly moves from one activity to the next ""She cant stay for longer then a minute on one thing! " "Shes always moving around!"

Challenges in peer relationships

Disruptions in learning

Ability to follow through

• 3 yr 11M
• Hispanic
• Female
• English

Gianni