Leslie was 19 years old, working evening hours at a restaurant and living with her boyfriend, when she learned she was pregnant.

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Week 2 Scenario

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Week 2 Scenario

Leslie was 19 years old, working evening hours at a restaurant and living with her boyfriend, when she learned she was pregnant. As the pregnancy progressed, Leslie had difficulty managing the late hours at work and eventually quit. Thereafter, she became increasingly isolated and suffered from episodes of severe depression. She did not seek any prenatal care. Money was extremely tight, and the mainstay of her diet was inexpensive fast food. She occasionally drank alcohol to escape the stress of her situation.

Alexandra was born 3 weeks premature, weighing only 5 lbs., 6 oz., but otherwise, she appeared healthy. Leslie was nervous about caring for the baby and quickly found the demands of childcare overwhelming. Because she wanted her boyfriend to help with feeding, she chose not to breastfeed the baby.

The stress of their situation took a toll on the couple’s relationship, and they argued constantly. Leslie’s depression worsened, and she became increasingly withdrawn. She had little energy for Alexandra, who was often left in her crib for long periods during the day. Alexandra suffered from frequent ear infections and colds. She was fussy and slept poorly. Exhausted herself, Leslie often dozed with headphones on to drown out the baby’s cries.

When Alexandra was 2 months old, Leslie realized she needed help and moved back home with her parents. Her mother willingly helped care for Alexandra and established a close bond with her. The family settled into a stable routine, which greatly reduced Leslie’s stress level and provided Alexandra with consistent care and attention. At her parents’ urging, Leslie sought treatment for her depression. As her mood improved, she took on a more active interest in her daughter. She began taking Alexandra for regular check-ups to track her health and development.

At age 3, Alexandra was enrolled in a high-quality preschool program. She quickly adapted to this routine and enjoyed participating in many different activities. Although she often had problems paying attention and following directions, she was generally happy, friendly, and compliant. Leslie participated in parent-education activities at the school on topics such as child-rearing styles, effective discipline, age-appropriate play, and healthy nutrition.

Alexandra continued in the preschool program until she was 5 years old, at which point she made the transition to kindergarten. She lagged behind classmates in acquiring early literacy skills but did well in all other areas. She was especially fond of make-believe and storytelling activities.

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