31685021860697Autism Spectrum DisorderCase Study of JennyBy Lynda Brownlie
00Autism Spectrum DisorderCase Study of JennyBy Lynda Brownlie
This case study concerns a young girl called Jenny who has been diagnosed with Autism, and the issues that Jenny and her family face. Jenny has just transitioned from Primary School to Secondary School. This case study will look at these challenges and explore possible strategies, resources and interventions that could be put in place to support Jenny and her family as she progresses through her Education.
Autism is a neural developmental disorder which affects people throughout their whole life, it affects how people with the condition view their environment and the world. Autism is a disorder and not an illness. While there is research on going there is no cure for it. Learning disabilities, mental health issues and other conditions mean that there are different levels of support required by individuals who have the condition.
Children are usually diagnosed with Autism around the age of 3 but for girls it may be later if they are displaying signs of Asperger’s Syndrome. Asperger’s is a high functioning variant of Autism. Autism affects 5 times more boys than girls. There is about 1 in every 100 affected by Autism. There are more than 700,000 people in the UK with Autism. In 2014, 10,805 pupils were diagnosed with Autistic Spectrum Disorder which is 1.6% of the total pupil population.
Research is being carried out to find the exact cause of Autism but to date there has been no known cause found and Geneticists believe that there are a few causes that may cause Autism such as the late age of the father at conception, whether a mother has been taking epilepsy medication while pregnant or whether there is a genetic predisposition for the condition (a genetic factor could also start with the individual who has the condition). There are many factors which can be attributable to individuals having Autism such as Environmental, Genetics or Brain Structure.
There are many other conditions that are linked to Autism such as Epilepsy, ADHD, Crohn’s Disease, Catatonia, Rhett Syndrome, Tourette Syndrome and Asperger’s Syndrome (there is no delay in language) are to name but a few.
The diagnostic tool for Autism is the Triad of Impairment (as classified by Lorna Wing, 1978) Individuals born with this disorder are characterised by impaired social interaction and communication, and by restricted and repetitive behaviour. This is classed as the Triad of Impairment. For Jenny to be diagnosed with Autism she would have to have meet the diagnostic criteria of the Triad of Impairments which is social imagination, social interaction and social communication.
Children with Autism are unable to see other’s points of view, they are unable to accept changes in routine. They may not be aware of unwritten rules or deal with broken rules. Jenny’s challenges are that she is unable to follow social rules. She has many rituals which she follows and these make her appear younger than she really is. To help Jenny cope with changes to her school routine the school could advise Jenny of any changes that are due to take place so that she doesn’t get upset, stressed out or anxious. Jenny could also be provided an Additional Support for Learning Worker who could work with Jenny daily to help teach her what social rules are by using positive reinforcements.
For young people with Autism social communication means that they maybe non-verbal, only know basic words or speak in unusual volume, pitch or rhythm. They may not understand the meaning of words which could have an impact on their literacy. Jenny’s School has concerns about her communication difficulties and her reluctance to speak and her isolation from her peer group. She is also clumsy in her movements. Jenny’s reading and spelling are good but she has some difficulties with Maths. Some children with Autism are exceptionally talented and in Jenny’s case she has an exceptional talent for Art but likes to choose her own materials and subjects rather than conform to the class curriculum. To help Jenny overcome her communication difficulties then the school could provide Jenny flash cards which could let staff members know that she is requiring help or how she is feeling. The School could also provide one to one additional support for Jenny in Maths to help her overcome the difficulties she has in the subject.
Social Interaction skills vary from each person but most people with Autism are not able to cope with playing games or doing activities, they are unable to share space or resources and are unable to cope with unstructured times such as breaks or lunchtime. They are also unable to see another people’s perspective. For Jenny these issues manifest in that she does not mix well socially, she is isolated from her peers, she doesn’t cope well in large groups and usually sits alone while eating her lunch. Jenny could be provided a quiet room in which she can go to when she feels anxious or stressed during break and lunch times.
Children with Autism usually need to deal with other conditions that go hand in hand with Autism such as Sensory Processing Disorders. Individuals with ASD (Autism Spectrum Disorder) find it difficult to control their sensory input. They may over react or underreact to various types of input such as visual, tangible or aural. This can result in the individual not being able to participate in normal activities. In Jenny’s case she is extremely sensitive to noise and this could possibly be the reason why the school has found Jenny on a few occasions lying on the bathroom floor huddled into the foetal position without any signs of her being unwell or running out of the School. It has also been noted that she has also locked herself in the toilet. These situations could possibly be caused by her sensory issues.
It has also been noted that Jenny has unusual tastes in her food choices and only ever eats in small quantities. Jenny is also classed as a fussy eater and brings the same contents every day in her packed lunch. Children with Autism can at times suffer from issues with food selectivity and this can sometimes be seen as the child just being classed as picky eaters. Food Selectivity is an aversion to food, drinks and medicine. Children with Autism and like Jenny could dislike these food items or medicine due to the look, the smell or the taste. A child dealing with these issues may have nutritional deficiencies.
It has also stated that children with Autism can also suffer from Anxiety. Anxiety is a condition were an individual feels excessive and uncontrollable worry and fear. Symptoms of anxiety include restlessness, fatigue, concentration issues, irritability and sleep disturbances. Anxiety could be the reason why Jenny was having behavioural issues in school. She could have been anxious at the thought of transitioning from Primary School to Secondary School. Jenny has had a few incidents of violent behaviour such as throwing objects or destroying school work in Primary School but since starting Secondary School these outbursts have been under control but her teachers are aware that she has the potential to return to her violent behavior at any time.
FAMILY AND RELATIONSHIPS
Family life is about relationships and communication but individuals with Autism need to deal with communication challenges, not understanding social cues or have emotional understanding. Having a child with these issues can have a negative impact on a family’s life. When a family learns that their child is Autistic they can experience a variety of emotions such as denial (that this is the wrong diagnosis or that there is nothing wrong with their child), relief (that the family finally has a diagnosis), anger (the parents are angry with the situation or why it’s been their child that has been affected by Autism) or guilt (the parents maybe wonder if they have done anything to have caused their child to be born with Autism).
We know from the case study that Jenny’s parent’s marriage ended when she was one year old as her parent’s marriage was abusive and violent. It is not stated whether this behavior started before or after Jenny was born. We can only speculate as to what the reasons are for the violence and abusiveness taking place in their relationship. It has been stated that stress in a couple’s relationship usually starts to develop when they start to realise that their child is not meeting their developmental milestone. The case study indicates that Jenny’s father refused to allow her mother to pick Jenny up and show her any love and affection. There could be many reasons that this was the case such as did her father blame her mother for Jenny’s diagnosis (did she do anything during pregnancy to cause it) or was her father just a psychically and emotionally abusive person. Jenny has not had any sort of interaction with her father since he separated from her mother. The lack of bonding between Jenny and her mother has resulted in Jenny being unresponsive in not showing her mother any physical or emotional affection but Jenny does crave these interactions from other people.
Money issues could also affect a family with a child being diagnosed with Autism. It has been stated in the case study that Jenny had been to several different schools. It could be said that this is down to a monetary issue or it could be due to the violence Jenny’s mother suffered when married to her father.
It is not stated whether Jenny has any siblings, but the issues of having a sibling with Autism can have a positive and negative effect. The circumstances that will allow a sibling to adjust include how big the family is, which part of the spectrum the brother/sister is on, at what age the child was when they received the diagnosis but the biggest effect is how their parents’ respond to the Autism diagnosis and what their expectations are.
Siblings can become more mature and develop a greater sense of responsibility towards their brother or sister, they become prouder in the accomplishments their sibling achieves. It has been stated that siblings of children with Autism are more unbiased to the differences in others and show a greater deal of compassion to those with special needs. However, this may not also be the case and many siblings do feel bitterness at the extra attention their brother/sister receives, they may feel guilty that they are healthy. It’s also possible that when they were little they may have thought that they could catch Autism. Siblings may also feel that they must be higher achievers from parental expectations.
The choices a family need to make when their child is diagnosed with Autism can be very hard and can potentially have a devastating impact of the family’s life. When a child is diagnosed both the parents need to decide as to which one of them will need to give up work. This can have an impact on that person’s mental health as they may feel depressed, anxious or they may feel isolated as it can be very hard for them to go out to socialize with friends or other family members in case the child becomes stressed and starts to become unruly.
As previously stated we do not know If Jenny has any siblings. If a family has more than one child and one of them is Autistic then one of the other choices they would have to consider would be what school their children would attend. Would they be at the same school or would the Autistic child be in an Additional Needs School. The parents would need to discuss the best options for their children. If the children were to attend different schools the parents would need to apply to the Local Authority to see if they could provide transport for the children as it would be impossible for the stay at home parent to go and collect children from different schools. The parents could also look at the Additional Needs School and see whether they offer a school bus to and from school with an escort to make the children feel calm and less anxious.
The following resources, interventions and professional help can be used to help support Jenny, her mother and any other individual working with Jenny.
Here is a list of some of the help and support that is available (this is not a full list).
Autism Resource Centre (Statutory)
The A.R.C is exclusively dedicated to Autism and it helps the needs of individuals with autism, their families and other individual who work for the well-being of this group. The Centre will house a variety of services including: –
An adult Autism team which will offer diagnosis and provide support services which are aimed at improving the health and well-being of adults with Autism.
Various Educational Training Programmes for practitioners for anyone wanting to raise awareness of Autism and to help build their knowledge and skills.
There will also be a resource library which offers information and computer facilities which will be open to all who would like to find out more about Autism and to the families of individuals with Autism.
There will also be a total of 12 staff who will work in the Centre.
The Centre will be staffed by a clinical psychologist, speech and language therapist, local autism co-ordinators, psychiatrist, speech and language therapist, local autism co-ordinators, an information officer and clinical autism co-ordinators
This resource would be good for Jenny and her family as it would provide a one stop centre to help Jenny and her family overcome the issues that they have had to deal with since she was born.
National Autism Society (Voluntary)
National Autism Society (NAS) is a Charity that was started over 50 years ago. They launched the first School fully dedicated to providing an education for children with Autism. NAS find that it is important to provide information and advice to anyone with Autism, their families and friends. The Charity has various ways of providing support to individuals of all ages with Autism. They run social clubs, outreach, residential, supported living, social groups, community day hubs and employment support services for adults and they also provide autism centres in mainstream schools, specialist schools and further education support for children and young people.
This service would be especially good for Jenny as it provides autism centres in mainstream schools which could help Jenny adjust further in her education and it could eventually lead onto Jenny going into further education and getting the support that she would require.
CareWatch is a private resource that could be beneficial to Jenny’s mum. The service offers in house carers. This could help ease the daily living tasks that Jenny’s mum may have to deal with. They aim is to make sure that all their families have the best possible outcomes from their services and the children that they are dealing with are always at the center of their tailor-made approach.
The following interventions could be put in place to help Jenny adjust to being in school and making her education more manageable.
Applied Behavioural Analysis is working with an individual to help develop their skills that will help them to become more independent and successful, they work by establishing an individualised curriculum in which they can address the following skill areas: communication, leisure, academic, social and daily living skills. The only down side to this service is that it is not funded by Local Authorities and must be paid for privately. ABA Scotland is a privately funded intervention that could possibly help Jenny as they work with individuals become more Independent by giving them a personalised curriculum to work from. This could help Jenny’s difficulties in social interaction and social communication.
Makaton is a language programme that uses different signs and various symbols to help non-verbal individuals with Autism. The signs and symbols are used together to help support speech. Makaton can help any adult or child who feels frustrated in being unable to speak communicate more easily and effectively. This intervention could be beneficial to Jenny as she struggles to communicate with her teachers and peers. It could help her express her feelings more clearly and effectively.
As Jenny is sensitive to noise it would be a useful intervention for Jenny to have a pair of Ear Defenders which could help reduce the noise level and in turn reduce the anxiety that she could be suffering from in response.
With all the interventions that could be put into for Jenny, Jenny’s rights must be considered and she must be allowed to participate in placing these interventions. Jenny has a Co-Ordinated Support Plan (CSP) in place in which she will have been involved with right from the start. A CSP will include Jenny, her mother, her school and any outside agencies which Jenny maybe involved with such as CAMHS (Child and Adolescents Mental Health Service) which may include as Educational Psychologist, Occupational Therapist or a Speech and Language Therapist.
These are just a few of the professional services that can be used to help Jenny and her mother.
Speech and Language Therapist
As children on the Autism Spectrum have issues understanding the communication of others and responding to them effectively, it is common practice that they are referred to a Speech and Language Therapist. In Jenny’s case a Speech and Language Therapist would be able to help her develop the communication skills which would help her in school by communicating with her peers and teachers.
Occupational Therapists help to promote active participation in individuals with Autism by helping them to increase their self-confidence, independence, self-esteem and social interaction. An Occupational Therapist would be able to help Jenny with the issues she has with social interaction. We are not aware of how many friends Jenny has but the case study does state that she has the one friend who was at Primary School with her. An Occupational Therapist can help remove any barriers that a student may have in learning to help them become calmer learners.
A Family Psychologist would be to help Jenny and her mother deal with the issues relating to their past. The Psychologist would help Jenny’s mother deal with the trauma of being a victim of domestic abuse. It could also help Jenny and her mother deal with the emotional impact of Jenny’s father not allowing her mother to show her any love and affection during the first year of her life. As the first year of a child’s life is significant as it is then that all the bonds a child develops between parents start to develop. Jenny would also have been terrified witnessing the abuse her mother would have suffered even at such a young age.
This is the case study of a young girl called Jenny who has been diagnosed with Autism, and the issues that Jenny and her family face. Jenny has moved from Primary School to Secondary School. I have linked Jenny’s condition to the Triad of Impairments and explained that for Jenny to have been diagnosed with Autism she would need to have met all three sections which are Social Interaction, Social Imagination and Social Communication. I have listed the difficulties that Jenny has in each of these categories and what sort of resources, interventions and professional help would be required. I have also stated what the impact would be on her family in dealing with child with Autism.