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© 2021 Walden University, LLC


Ramon is an 18-year-old male who identifies as Latino and African American. He is in his senior year of high school and lives with his parents and two sisters. Ramon has been diagnosed with an intellectual disability and with moderate hearing loss in his right ear. His mother, Angela, reached out to me, the school social worker.

Background and History Early History After gaining consent, I met with Angela and Ramon for background and history. I asked about Ramon’s early history, and she reported that as a baby, Ramon had multiple ear infections as well as seizures. He was hospitalized and put on medication to control the seizures, though nothing was done for the ears. At 5 years old, he became very sick, and it was discovered that his Eustachian tubes were bent, which had resulted in muffled hearing on the right side. Angela reported that if the doctor, who was White, had noticed the issue when he’d been a baby, Ramon could have gotten tubes placed in his ears and would not need a hearing aid. Angela reported skepticism and distrust of the medical community based on this experience. School Angela reported that Ramon adapted over time to a hearing aid. He remained somewhat removed in social situations and was overwhelmed when he entered school. Because of his initial struggle in academics, his IQ was assessed and determined to be below average; throughout the duration of his public schooling, Ramon had an Individualized Education Plan (IEP) based on this identified intellectual disability. Presenting Issue Once I had this background from Angela, I asked what brought them here. Angela mentioned that the college and career counselor at the high school had implied that college was not in Ramon’s future. Angela was furious and did not feel heard by the school administration when she brought up the incident with them. She would like Ramon’s IQ to be reassessed. She felt that the original practitioner who performed the IQ assessment “did not get it right” and that “Ramon has grown so much.”

Session With Ramon I then met with Ramon individually. During the meeting, I observed that he fidgeted and appeared anxious, occasionally biting his fingernails. “How long is this going to take?” he asked, while looking at the time. Ramon reported that he didn’t want to be late for gym class. He hung his head and talked in a low voice but responded to all of my questions appropriately. When I asked how he felt about college, he said he wanted to “go to LSU” and that the college and career counselor had started showing him job listings instead. “Now my mom’s all mad,” he said and rolled his eyes. “Are you mad?” I asked. Ramon said, “I don’t think that was fair of him to do. I’m not dumb.”




© 2021 Walden University, LLC

I asked Ramon how high school had been for him. And he responded that he didn’t wear his hearing aid because it made him self-conscious around his peers. He sat on the right side of the classroom so he could hear clearly from his left ear. This provoked some anxiety prior to each class about whether he would be able to find a seat that would position him well to hear. In cases where he could not hear, Ramon could not fully participate in class; teachers interpreted this lack of engagement as part of him being “slow.” Ramon also reported fear and anxiety around test-taking and social interactions. Other than that, he explained that he generally did okay in school, and his grades back up this statement. Based on my recommendation, the school supported carrying out another assessment for both IQ and mental health. The findings were that Ramon does not have a low IQ but rather generalized and social anxiety disorders. These mental health issues were contributing to Ramon’s social isolation and feelings of extreme worry, which in turn impacted his performance on both the IQ assessment and school tests.


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