| Course | DNRS 6800 Advanced Pediatric Development and Behavior |
|---|---|
| Week | Week 6 |
| Paper type | Case formulation paper |
| Length | About 750 words, 5 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for DNRS 6800 Week 6
Case Formulation: Inattention in a 7-Year-Old, Pulled Together From Six Weeks of Notes and Set Out to Be Audited
Student Name
College of Nursing, Walden University
DNRS 6800: Advanced Pediatric Development and Behavior
Instructor Name
Month Day, Year
Case Formulation: Inattention in a 7-Year-Old, Pulled Together From Six Weeks of Notes and Set Out to Be Audited
The Formulation
Owen, a composite 7-year-old boy in second grade, most likely has attention-deficit/hyperactivity disorder, predominantly inattentive presentation. His difficulty sustaining attention, following multistep instructions, and finishing tasks is present at home and at school, has been noticed since kindergarten, and is interfering with his learning and with morning and homework routines. His development in language, motor skills, and social relationships is otherwise within the expected range, which points to a specific difficulty with attention and executive control rather than a global delay. Two conditions that commonly produce similar symptoms in children his age, disordered sleep and a reading disorder, have been examined and fit the evidence less well. Anxiety does not appear to be driving his inattention, though it was considered. The formulation is held with moderate confidence and depends on the evidence below.
Evidence Ledger
The evidence is kept in three groups because each carries different weight.
Table 1
Evidence for Owen's Formulation, by Source
| Source | What it showed |
|---|---|
| Directly observed | In a 30-minute classroom observation during independent seat work, off task in 11 of 30 one-minute intervals, compared with 3 of 30 for a boy seated nearby. In clinic, needed a two-step instruction repeated twice; completed a drawing task only with prompting. Friendly and conversational with the clinician; no restlessness beyond fidgeting with his sleeve. |
| Caregiver and teacher report | Parent: "He starts his homework and ten minutes later he's looking out the window." Teacher: loses materials, rarely finishes written work, not disruptive. Both report symptoms since kindergarten. Parent reports he falls asleep easily and does not snore. No reported worries at bedtime or before school. |
| Standardized measures | Vanderbilt parent and teacher rating scales: inattentive items endorsed as often or very often, 7 of 9 by parent and 8 of 9 by teacher, with impairment in schoolwork and homework; hyperactive-impulsive items, 2 of 9 on each (Wolraich et al., 2003). Pediatric Sleep Questionnaire below the threshold for sleep-disordered breathing (Chervin et al., 2000). School reading screen at grade level. |
The AAP guideline asks for information from more than one setting and for screening for coexisting and alternative conditions before an ADHD diagnosis is made (Wolraich et al., 2019). The ledger shows both: two settings with consistent reports, and specific checks for the alternatives below.
Rejected Alternatives
Sleep-disordered breathing. Obstructive sleep apnea in children can cause inattention and hyperactivity that look like ADHD (Marcus et al., 2012), and this was the first alternative checked. It fits his inattention. It was sunk by the absence of snoring, his score below threshold on the sleep questionnaire, and a sleep log showing 10 hours a night without reported pauses. On examination, his tonsils were small and he breathed through his nose at rest, both of which lower the likelihood further, since enlarged tonsils and adenoids are the most common cause of obstructive sleep apnea at his age.
Specific learning disorder in reading. A child who cannot read the material will look inattentive during reading work. This fits his difficulty finishing written tasks. It was sunk by two observations: his inattention appears equally during nonreading tasks, such as following spoken instructions and drawing, and his school reading screen is at grade level.
Anxiety was also considered, since worry can consume attention. No worries were reported by his parent, teacher, or Owen himself, and his attention was no better on relaxed tasks than on demanding ones, so it was set aside as a primary explanation.
What sank each alternative is recorded next to it on purpose. If new evidence appears, such as a teacher noticing that his attention collapses only during reading, or a parent reporting new snoring after a winter of colds, a colleague can see which alternative that evidence revives and reopen it without rebuilding the whole formulation.
Uncertainty, Stated Concretely
Two pieces of information would most change the picture. The first is a rating from a third setting, his after-school program, where demands are less academic; consistent inattention there would strengthen the formulation, and its absence would suggest the difficulty is tied to schoolwork. This can realistically be obtained within 2 weeks by sending the program the same rating scale. The second is a full psychoeducational evaluation, which would rule a learning disorder in or out more firmly than a school screen. That is harder to obtain; the district's wait is several months, so it is requested now but the formulation will not wait for it.
References
Chervin, R. D., Hedger, K., Dillon, J. E., & Pituch, K. J. (2000). Pediatric Sleep Questionnaire (PSQ): Validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine, 1(1), 21-32. https://doi.org/10.1016/S1389-9457(99)00009-X
Marcus, C. L., Brooks, L. J., Draper, K. A., Gozal, D., Halbower, A. C., Jones, J., Schechter, M. S., Sheldon, S. H., Spruyt, K., Ward, S. D., Lehmann, C., & Shiffman, R. N. (2012). Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 130(3), 576-584. https://doi.org/10.1542/peds.2012-1671
Wolraich, M. L., Hagan, J. F., Jr., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & Subcommittee on Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), Article e20192528. https://doi.org/10.1542/peds.2019-2528
Wolraich, M. L., Lambert, W., Doffing, M. A., Bickman, L., Simmons, T., & Worley, K. (2003). Psychometric properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a referred population. Journal of Pediatric Psychology, 28(8), 559-568. https://doi.org/10.1093/jpepsy/jsg046
Reading the DNRS 6800 Week 6 instructions
The sixth week usually asks for a case formulation that integrates assessment data into a working explanation of a child's difficulties. You state the formulation, show the evidence for it, consider and reject alternative explanations, and acknowledge uncertainty. DNRS 6800 instructors grade the visibility of reasoning more than the conclusion itself. DNRS 6800 formulations usually take four to six APA pages, citing diagnostic criteria, validated measures and current guidelines. Case material can be composite or drawn from practice with identifiers removed. Some sections want the formulation to include contributing factors at home and school. Medical conditions that mimic the presentation should appear among the alternatives. Name every source of data you used, such as parent and teacher rating scales, the interview, the school report and your own observation. The reasoning should show how those pieces fit or conflict.
How the DNRS 6800 Week 6 example is put together
The formulation itself is a single paragraph near the top, roughly six sentences, naming what the writer thinks is happening with this child and in what developmental terms. Everything after it exists to be checked against it. An evidence ledger follows in three groups: what was directly observed, what a caregiver reported, and what a standardized measure produced, kept apart because they carry different weight. A section on rejected alternatives names two other formulations that fit some of the evidence and explains which observations sank each one. The paper closes on uncertainty stated concretely, listing the two pieces of information that would most change the picture, and on a line saying which of them could realistically be obtained.
Reading the DNRS 6800 Week 6 rubric
The row that separates strong formulations from average ones asks whether reasoning is visible, not whether the conclusion is defensible. A formulation delivered as a verdict, with evidence summarized rather than tied to it, drops that row even when the verdict is sound. The example wires each claim to a numbered strand in the evidence ledger. A second row usually covers the integration of multiple data sources, which is why the ledger separates them in the first place. Points are lost by papers that reproduce every note collected during the term, because a formulation is a selection and a paper that selects nothing has not formulated. They are lost again on hedging that never resolves, where the closing paragraph restates the question the paper was assigned to answer.
DNRS 6800 Week 6 help: mistakes that cost marks
Formulations lose most when the conclusion is delivered with no visible route to it. Tie each claim to a specific observation, rating or report. Another common gap is forgetting medical mimics such as sleep-disordered breathing, hearing loss or absence seizures. Writers also present rating scale scores without saying who completed them or in which setting. Keep the cross-setting requirement visible, since ADHD needs symptoms in more than one place. Avoid treatment planning beyond a brief next step. State uncertainty in concrete terms, such as a pending sleep evaluation. Check that the guideline year matches the citation. Another frequent problem is relying on one informant, usually the parent, without the teacher's view. Report both and say where they agree. Writers sometimes also choose a presentation type without explaining why the hyperactive symptoms fall short. Give the counts behind the choice.
Get a DNRS 6800 Week 6 example written to your instructions
The desk builds a formulation around whatever case material your prompt supplies, or around a composite if the prompt leaves the case open. Send the assignment wording and the rubric and the first sample comes back free within 24-48 hours, laid out with its evidence ledger visible so the reasoning is easy to follow.
More DNRS 6800 papers and DNP samples
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- DNRS 6800 Week 9: Discussion Post
- DNRS 6800 Week 10: Parent Guidance Plan
- DNRS 6800 Week 11: Reflection
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DNRS 6800 Week 6 questions, answered
What is the difference between a formulation and a case study?
A case study reports; a formulation commits. The example is judged on whether it states, in the writer's own terms, what is happening with this child and why the evidence points there rather than somewhere else. Description of history and findings is the material a formulation is built from, but a paper that stops at description has produced the material and not the paper.
Where does the case material come from?
From composites written for teaching, or from whatever vignette your section supplies with the prompt. Nothing here is reconstructed from an actual child, a clinical placement or a preceptor's file. Where students bring their own case, we work from the general shape they describe and keep every identifying detail out of the finished document.
How long should a case formulation run?
The example lands near six pages of body text with the formulation paragraph itself under half a page, which is the ratio that matters. Length is set by your prompt. What is consistent across sections is that the evidence and reasoning sections carry most of the words, while the formulation stays short enough to be read in one breath.
Where can I find a free DNRS 6800 Week 6 sample paper?
Owen's case formulation is reproduced here with the evidence ledger, the rejected alternatives and the concrete statement of uncertainty, with margin notes.
What does the DNRS 6800 Week 6 formulation conclude?
That Owen most likely has ADHD, predominantly inattentive presentation, with every claim tied to a source in an evidence ledger.