calming toys into the different exam rooms, such as twisty toys and calming jars, to provide children with a sense of safety and a connection that is age appropriate to them. Calming jars are a great way to reduce children’s anxiety of shots, needles, and general lack of comfort with the doctor. Adding a playful atmosphere to exam rooms for the child client also benefits doctors with better opportunities to discuss their concerns regarding the child’s behaviors. Integrated health care is an excellent way of providing

intervention to children who might otherwise fall between the cracks of the mental health system due to lack of severity, parental awareness, or overall costs of mental health treatment. A particular client comes to mind that demonstrates the usefulness and need of such a model. Six-year-old “Clara” was brought to her PCP for a well-child checkup. Clara’s mother shared her concerns with the doctor regarding symptoms of ADHD and aggression occurring at both school and home. After completing the exam, the doctor asked the Behavioral Health Consultant (BHC) to visit the exam room. During this discussion, the BHC discovered that the family had recently moved to Michigan from out of state, that Clara was beginning public school for the first time after being home schooled, and that Clara’s father had remained behind to conclude a job. The BHC suggested that the family meet with me on their way out.

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Clara, her mother, and her maternal grandmother met

with me for an evaluation. I did not observe the ADHD symptoms that the mother had shared with the doctor, although I was concerned about other symptoms that I sensed but was unable to describe. As sessions continued with Clara, I scheduled an individual session with Clara’s mother. In gathering additional information, without Clara present, I learned that Clara had been born with hydrocephalus, also known as water on the brain. Her mother had been concerned with her behaviors for a number of years and had recently, in addition to the ADHD symptoms observed, had also noticed a number of autism- related symptoms such as challenges with sensory processing, walking on her tippy toes, to name a couple symptoms. As a mental health professional, I lack knowledge in

physical health ailments. Thankfully, being part of an integrated office I was able to confer directly with Clara’s doctor about hydrocephalus. Through additional research, I came to learn that some children who are born with hydrocephalus could later have developmental delays such as Autism (Lindquist, Carlsoon, Persson, & Uvebrant, 2006). After discussing my research findings with Clara’s PCP, we were able to find the family resources and referrals for further evaluation for autism and occupational therapy.

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www.a4pt.org September 2014 | PLAYTHERAPY 9 $109.99