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Blaise is 3 1/2 years old. He is physically coordinated, emotionally even, outgoing, friendly, and curious. He especially enjoys playing with toys and games that have many pieces to them and require problem solving and order. Blaise has unusually good language skills for his age and a good ability to express him self verbally.
On Saturday, November 18th, Blaise was at the Annapolis Mall with his grandparents and his mother. The family was in the food court eating, passing time before the movie Happy Feet started. Blaise finished his food before everyone else was done eating. His grandmother took him to the play area behind the ticket kiosk to occupy him while the rest of his family finished their meal.
All of a sudden his grandmother heard three loud bangs that sounded like shots being fired from a weapon, “Bang, bang, bang.” She couldnt tell where the sounds were coming from but the sounds were very loud. She grabbed Blaise and told him to lie on the floor. Then there were three more shots, “Bang, bang, bang.” Blaise experienced complete helplessness and horror in the chaos and confusion in the behavior of everyone around him. It was complete pandemonium. He saw people in the food court area fleeing in all directions, creating complete chaos while screaming and tipping over chairs as they tried to get away. The cages on the storefronts were being slammed shut by employees inside trying to protect themselves. Nobody knew what was going on, increasing the sense of helplessness and fear.
His grandmother grabbed Blaise and ran to the beauty salon near the play area. The employees were shutting the store, but they let her in with Blaise in her arms. They were led to the ladies room in the back of the store, where they sat on the floor. As he sat in her lap, all the color had drained from his face. He became emotionally agitated. He was trembling and shaking. His grandmother could feel Blaises little heart pounding “a mile a minute.”
Afterwards, when everything was back to normal, the family went to see Happy Face. The first signs of PTSD were apparent when a scene in the movie depicted a seal with big teeth trying to catch and eat one of the penguins. Blaise became psychologically overwhelmed and physiologically reactive when he re-experienced the trauma of the fear of death implied in the symbolism of the violent movie scene.
Over the next two weeks, he had difficulty sleeping. He had dreams of falling into a deep cave where he couldnt climb out. He kept calling for his sister to help him, but she couldnt hear him. He dreamed he was standing behind a gate and the gate suddenly opened and water rushed in and swallowed him up.
He began acting out behaviorally in situations where he did not feel safe. He wouldnt put his clothes on to go to school, because he had been transferred to a new classroom. He became so disobedient with his father that they had to leave Best Buy when his Dad took him there for shopping. Blaise had difficulty recalling the events, except in fragmentary pieces. He began humming to block out the sound of his grandmothers voice when she asked him about what happened in the mall.
In therapy, all of Blaises behavioral problems were determined to be secondary to the traumatic event and not instances of intentional behavioral infractions that would respond to punishment to correct them. Blaise meets the DSM-TR diagnostic criteria for PTSD.
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