Male Age: 8

Background:

Daryl, age 8, comes to your office with a severe sore throat, difficulty swallowing, and a fever of 101. During your exam, the third-grader mumbles his answers. “Now baby,” Daryl’s mother says, “Dr. Reveles will help you feel better. I bet she can even figure out why you’re so tired all the time. Do you want me to tell her about your bad dreams, too?”

Daryl shrugs and looks at the floor. His mother continues: “His grandfather died a few months ago. We’re all sad, but it’s been really hard on Daryl.” Daryl’s grandfather had provided daily after-school care for Daryl while his mother worked. Now, Daryl is in an extended care program that doesn’t have any other boys his age. She tells you that Daryl often seems sad and tired, has difficulty sleeping, and has nightmares. “Truth is,” she says, “we both have bad dreams. I guess that’s normal after you lose someone you love.”