Family Assessment: Health and Social Care - Essay Example

Writing Family Assessment: Health and Social Care Customer’s Name Customer’s Grade Course Customer Tutor’s Name 25th August, 2010 Introduction Harley is diagnosed autism in her preschool years and this is a real stress for the mother and the step father too. With the severe conditions exhibited by Harley, Karen Patrick, her mother is presented with a riddle she cannot solve: one, on the best way to cope with the condition, living with Bruce, the step father to her two children and involving their real father to the caring of the children. Karen ex-husband has gone to live with another woman who does not appreciate children living in the house, and this means that Karen has to cope with rearing the children all alone without the help of her former husband. Another stress presenting itself regards Bruce, the new husband to Karen and the step father to Harley and Scott. Even though the bond between Scott and Bruce is a lovely one, the case is different from that of Harley, the girl suffering from Autism. Tom, the biological father to Scott and Harley loves his children, but his job is a demanding one and could not let the children stay more often with their step mother Linda, as she has made it clear that she does not want the children anywhere around, and her proud nature could not allow the children to play around in the home compound. All these problems play around Karen, who now has the sole responsibility of taking care of the two children with minimal help from her former husband. Case Study: Autism Autism is a kind of disorder which is characterized by impairment of communication system of a person and this as well can affect the social interaction of the person. It is more common on young persons but can as well transcend to adulthood if not taken care of. Autism is diagnosed when the patient shows abnormalities and some strange behaviours, incapacitated social development, constrained communication and repetitive behaviour or obsessive interests (Cohen 2004). The Mind Blindness of Autism Disorder Cohen (2004) proposes this theory of autism to explain the cognitive nature of the disorder where he analyzes it as having deficit in the normal process of empathizing, relative the mental age of a person. In this, he argues that the person cannot effectively have sense of agents and decoding of message as well as inability to react properly to the emerging stimuli. It would be difficult to socialize with a person suffering from autism as the person would present himself or herself as a disinterested person thus feeling totally alienated from what is happening around. Autism is said to be caused by the psychogenic and biological point of view; in which, on psychogenic, it is believed that the disorder emanates from a lot of thinking about something (Bolton 2004). On biological perspective, autism is caused by several abnormalities in the brain. Such is caused by certain biological factors like the genes or family line, complications during pregnancy or birth; and some viral infections which touch the brain of the person. Bolton (2004) proposes certain indications of the disease as connected to the biological perspective such as mental handicap, epilepsy and minor congenital anomalies. One of the greatest anomalies of autism is the difficulty to talk to others or socialize in general. According to Sacks (2003), a person suffering from this disorder cannot converse with another person freely and his or her answers are frank enough, short and not elaborate. For example; answering virtually all questions with simplicity like ‘yes, no, yes I have, no I haven’t’. Autism disorder has implications when the person attains adult age, especially in the development of language (Howlin, 2003). Unless the person acquires useful speech by the age of six years, it is probable that the person’s future communication capabilities would be limited. The problem at old age is complex and usually it becomes permanent and this is inhibiting in the effective passing of information to other people. Autism is associated with social malfunctioning according to Howlin (2003) and these social deficits are at the heart of all diagnostic systems. The people suffering from this disorder fail to understand or responding inappropriate to the feelings of the other people and their emotions, and as well lack the ability to share their emotions or experiences. They also lack integration skills in socialization, emotional and communicative behaviours in an interpersonal setting. These problems are gradual and become intense as the person continues to exhibit the qualities of having autism (Howlin, 2003). Asher (2002) notes that, the biggest problem in autistic people is in understanding and knowing how they present their arguments. For example in writing, there are incomprehensible concepts and the ideas are vaguely presented. In speaking, words are mixed in a way that the listeners cannot fathom the real meaning of the spoken word. This the same case in writing where the written work does not follow grammatical rule or there is a mixture of words which, even though there refer to certain objects, but are not arranged in a way one can comprehend. Diagnosis of Autism Autism is said to be a confusing disorder as it presents itself in a most unique way in the individual affected by it. Some of the impairments in the person suffering from this disease are cognitive incapability. Some other people cannot even speak while others have their speech lacking clear meanings to the people surrounding them (Gerlach, 2003). Some insist on sameness in their environment and exhibit some repetitive behaviour; for example, rocking, engage in routinized, unimaginative play and to some extent seem to be totally aloof of what is happening around them. Dawson (1989) presents a more responsive and active treatment in treating children suffering from this disorder. He proposes that the people around a person who is suffering from autism have responsive heart which will help draw autistic persons towards a real nature and see others as people who can help them. Even though such people usually value them comfortable in their own world, they as well recognize what others are doing and may like to be associated with such acts. The teacher should act positively towards these people by becoming a motivating factor to the child. He or she should try to have an attachment paradigm where despite the normal withdrawal of the child, he or she should insist on being close to the child, and eventually, the autistic child would develop some sense of association (Siegel, 2003). Social responsiveness like cooperative responses should be a norm to the parents and any caregiver. The cooperative responses are like sharing of toys, hugging and holding of hands (Dawson, 1989). Other ways include social interaction, social learning and imitation of Autistic children and engagement to the child. Parents are regarded as the best members who can teach children with autism as they are the most closest. Gillberg (1989) notes that, parents should be greatly involved in the therapy, since they are in a position for identify the problems easily. They can be able to encourage the children to adopt some desirable behavioural concepts at a very tender age. Again, parents’ involvement is crucial since their treatment is based at a family context and these therapeutic procedures would help balance the requirements of the child as well as those of other family members (Gillberg, 1989). Joint attentions form the best forms to treat a person suffering from autism especially the children (Cipan, 2008). The joint attention involves non-verbal such as shifting of gazes between an object and a familiar person to the child. Joint attention is some forms of socialization agents which help the children identify some things with an important thing. Share initiatives, strong eye contacts and gestures are some of activities identified under joint attention and proposed by Cipan (2008) to help a child gain some social responses and activeness. Stress in the Family and How It Can Cope With the Situation Autism presents a hard time for the family and is a really stressful affair. Having a child who cannot speak effectively in the family or a person who fears any social places is hard to cope up with in the family. This kind of stress presents itself in large or small occurrences throughout the life of the family members and the life of the autistic child. Each day presents another worry for the child and the thoughts of whether the child will ever come to normal living (Baron, 2006). According to Gabriels (2002), the family should be supported on every aspect from various sectors of the family and the community. Gabriels (2002) also gives encouragement as the best form to support the family members who have the child suffering from autism as this would give precious comfort and have a general understanding that this is a normal kind of ailment which anyone can suffer from. There should be occasional family sessions aimed at making them understand the situations, and this can be offered by the clinicians and other professional experts. Another way a family can be helped to cope with autistic situations is to offer financial help and other material support (Zager, 1999). Another way is for the family members to become actively involved in advocacy on behalf of autistic person by providing a good channel for constructive actions (Schopler, 1984). Gupta (2004) offers guidelines on how to cope with constant stress in the family when there is a child suffering from autism. Such include authoritarian versus permissive discipline, variable sharing of responsibility with the spouse and siblings, partnering with the professionals to guide them and becoming advocates in the community. Reducing effects of autism: from nurse’s point of view Harley, the girl with autism has a difficult time to live if the effects of autism are not mitigated. At age 10 years, the condition is still at its earliest stages and there are early intervention programs that are individually tailored to make the individual gain strengths while decreasing the intensity of the aberrant behaviors. Too, the child can be enabled to develop appropriate communicative and social skills as well as be able to handle activities of daily living. One way of handling the behaviors is the applied behaviour analysis which centers on life and development of play skills. As well, it concentrates on development of academic facets like vocabulary, reading and mathematics. This program is highly structured where a therapists has to work on a one on one basis in assisting the child to master certain skills before proceeding to the next level. For example, the child is first taught how to sit on a platform like a chair and after that, the child can be taught how to lie properly on something. The second program can take 40 hours or a week of therapy, and this is a home based program where parents to the child like Karen and is said to be effective to a point of decreasing the severity of autism by 42%. Another way is by dietary adjustment where the child can be restricted from using gluten or wheat and casein (milk) and this has been seen to be quite effective in reduction of the levels of autism. Critique of the therapies In the case of Harley or the stress in the family of Tom, such a problem could be unique in others, and especially in those perceived to have been studied. Nurses learn of these empirical methods of curing a problem from class, and they perceive that what worked in one child can too work in another. From the case study/stressor, Harley’s problem is unique and it is a worry both to the teachers and the parents. We realize that Harley sometimes does not get sleep after going for a long call or a short call at night, and usually this happens at night. Nurses are taught to diagnose on specialty or generalization and so, if the nurse was to prescribe some things to be done to Harley, the problem may not decline and perhaps deteriorate further. To this end, the three solutions prescribed as a specialist’s guide may not work on all children with special conditions such as Harley. The systematic applied behavior method is not unique and in fact cannot work on Harley. Her case is unique and needs a thorough assessment before even one introduces anything (Baron & Groch, 2006). Recommendations From the critiques above, it is clear that problems are unique and can never be solved by one stroke. The nurse’s prescription is three tiers; one applied behavior, two dietary prescription and the Lovaas program of home based behavior cure. The three could only work if all systems were the same, but it has been seen that what Harley is suffering from is different from what could have been studied before coming up with the three measures. What is best is the approach to unique cases and adopt strategies which only can suit the person. References Asher Jane (2002). Autism: The Problem is Understanding. London: The National Autistic Society Amenta C. (1992). Autism for Children. New York: Magination Press. Baron, M. G & Groch, J. (2006). Stress & Coping in Autism. New York: Oxford University Press Bolton, P. (2004). Autism: The Facts. Oxford: Oxford University Cipan, E. (2008). Triumphs in Early Autism Treatment. New York: Springer Publishing Company LLC Cohen, S. (2004). Autism: Research into causes & Intervention. Cambridge: Autism Research Centre, pp 7, 73-78 Dawson, G. (1989). Autism: Nature, Diagnosis and Treatment. New York: The Guildford Press Gabriels, R. (2002). Autism-From Research to Individualized Practice. UK: Jessica Kingsley publishers Gerlach,E. (2003). Autism, Treatment guides (3rd ed). USA: Future Horizons publishers Gillberg, C. (1989). Diagnosis and Treatment of Autism. New York: Plenum Press Gupta, V. (2004). Autistic Spectrum Disorders in Children (Vol 2). New York: Marcel Dekker Inc Sacks, O. (2003). Autism: Explaining the Enigma (2nd ed). USA: Blackwell Publishing Schopler, E. & Gary, B. (1984). The effects of Autism on the Family. New York: Plenum Press Siegel, B. (2003). Helping Children with Autism Learn: Treatment Approaches for Parents and Professional. New York: Oxford University Press Zager, D. (1999). Autism: Identification, Education and Treatment (2nd ed). New York: Lawrence Eribaum Associates Read More