Assessment of a Teenage with Autism Disorder
6. History of Previous Difficulties
Based on the accounts, prior to Adam’s school age, it seemed that his behavioral functioning continues to get worse. Prior to noticing watch stealing and aggressive behaviors, he has become progressively more inflexible and rigid, and his insistence on elaborate routines causes much difficulty. He was able to develop motor skills at expected times, but the development of his language was significantly delayed. However, he repeats certain phrases from television shows over and over and displays a fascination and later on, obsession with balls and other round objects. He has collected considerable quantities of these items, which he insists on carrying with him. Any attempt to divert him from this unusual interest leads to agitation with periods of body rocking, head banging, or hurting other individuals near him.
In addition, members of the Smith family experience great trouble sustaining a conversation with Adam, who seems interested in discussing only certain television programs and his ball collection. Some members of the Smith family also report that Adam exhibits some stereotyped behaviors when excited and tends to adhere to various non-functional routines, such as always walking around a chair three times before sitting in it. His insight and judgment are poor, but remains to be talkative and friendly. During his teenage years, he was unable to follow simple requests and rules, and had marked difficulties with tasks that involved imitation, especially in school activities. Adam was particularly intolerant to change. He was also very sensitive to the inanimate environment so that, although he often seemed almost completely oblivious to his mother’s voice, he would panic when he heard the vacuum cleaner. Although he remained extremely sensitive and resistant to change in his environment, uneven but steady progress was observed. By the time Adam was 17, his unusual interests and his difficulty dealing with change had diminished somewhat, and he was mainstreamed for a few class periods a day in public school.
7. Family Development
As indicated, both the parents of Adam were of Chinese descent. His father is a Family Doctor and his mother is a Registered Nurse, who are now both Canadian citizens. Both of his parents were born and raised in Hong Kong, and decided to move to Canada to obtain work and career as doctor and nurse. They met at a hospital from which both of them worked and decided to get married. They had two sons, with Adam elder than the other. Because both are Chinese in descent, both families’ household are paternalistic and rely on the major decisions made by the father. In addition, being Chinese, the values and attitudes of the family remain to be traditional and conservative. The family, above anything else, values their profession as their source of income, their tradition, and the education of their children. This is the reason why both the parents of Adam are successful in their own fields.
Peter Lee and Lily Chung met in the same hospital from which they work, and got attracted to one another through the teasing of their parents and family. Being both Chinese, they are more open to the concept of arranged marriage, which is still being practiced in Chinese countries. Due to the fact that both are successful in their professions, with the consent and blessings of their parents, they decided to get married and have their own family.
Lily Chung had no problems with planning pregnancy. In fact, Lily and Peter were excited to have their own family, most especially having children. However, they only plan to limit their children into two, as they do not desire to have a big family. Being a typical Chinese family, both of them are into imparting Chinese traditional values into their children despite the fact that they live in a Western country. They are not willing to adopt or foster children, as they want their own. However, the onset of the aggressive and pervasive behavior of Adam also started the change in the relationship of his parents and the whole family, even forcing them to arrive at the decision of placing Adam in an institution. Because the onset of the autism manifestations of Adam were observed early, they have not seen him develop into an adolescent. In addition, they have also decided to split apart due to individual differences.
8. Personal Development
It has been indicated that Adam was a product of a full-term pregnancy, which was unremarkable, except for his mother’s cigarette smoking. Adam was delivered by forceps, but luckily, there were no other birth-related complications found. He was breast-fed for 3 months, was weaned and tried on different milk formulas. Adam obtained his motor milestones at a normal pace, but his language abilities were delayed. His mother described him as always being very active and difficult to handle. In his toddler years, Adam shows severe lack of language development, as he uses only a few single words that were used for requests for food. He was particularly intolerant to change, as he insisted that his parents, most especially his mother follow the same complicated routine at bedtime each night and would become extremely agitated and irritated if any change in the usual pattern occurred. During his development, his parents also noticed that he is overly active and tended to only focus doing his own thing. He usually plays with the balls he collected and brought them with him anywhere he goes or talks and makes noise endlessly.
During his school age, Adam’s teachers in his nursery and kindergarten schools noted that he had some difficulties in being aware with the personal space and belongings of other children. He also showed difficulties in manipulating objects, such as pencils and crayons, which led to the advice of teachers for Adam to undergo occupational therapy for his motor deficits. In addition, his teachers also noticed Adam’s aggression over his classmates and teachers during tantrums.
The adolescence stage of Adam was not anymore observed by his parents, but by the Smith family. Sexual relationships are lacking and changes in the biological function of Adam remained to be normal. As observed by the members of the Smith family, he seems to be immature in his social skills and his relationships with the rest of the members require assistance.
9. Observations of the Child
It has been observed that there was no outstanding biological issue on the part of Adam. His biological and physical functioning seemed to be all fine, including his physical and physiological appearance. Adam seemed to be conscious with his appearance and with his personal hygiene. However, head banging and rocking can sometimes be observed, most especially if he does not get what he wants.
In terms of his behavior toward other children and adults, he seemed to have control over them and what he wants. He is dominant, as other children become intimated by his actions and behavior, especially if his rage is already developing. He becomes unmanageable when he others seem not to understand what he is trying to express, thus, becoming aggressive and violent.
10. Observations of the Family
From the origin of Adam, it has been emphasized that he came from a traditional Chinese family, with traditional Chinese values and practices. However, when his true family decided to let him undergo placement, he now lives with a Canadian family. In this regard, it can be perceived that the significant differences in both cultures may contribute to the confusion of values being presented to Adam. The differences in values, culture and language may present problems in terms of expressing their sentiments, their comments, commands, and requests to Adam. However, because Adam may already have a Canadian background, somehow he seems to cope with the culture and practice of his new family.
In addition, it can be perceived that the Smith family recognized Adam’s problem and took actions in relation to his condition. This is because they sought professional help in order to assist them in controlling Adam’s behavior. They have also expressed that they are willing to help Adam and provide him with the love and care that he deserves, which his real family failed to give him. In relation to this, it can also be observed that communication serves a good purpose on the part of what the family wants and the welfare of Adam. The Smith family expressed their sentiments and willingness to help Adam, thus, showing affection, love and concern toward him. As a matter of fact, Monique Smith seemed to show too much attention and affection toward Adam in relation to his condition.
From this, it can be assumed that the Smith family is very supportive of Adam, most especially with regards to his welfare and condition. In fact, the family tries its best to provide Adam his needs and wants, regardless of his psychological or mental state. The family was just alarmed to observe that Adam had been stealing their watches, with which he may also be doing with neighbors in the community. This just means that the family is not concerned with the welfare and psychological state of Adam, but with his actions that may affect his relationship with the community.
Credit:ivythesis.typepad.com
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