The Condition of Hayley Who Suffers From Autism with Regard to the Health Aspects - Case Study Example

CHILD AND FAMILY NURSING Being focused on to the important aspects of life is one of the main functions of the brain. In some disorders this special function of the brain is either lost or diminished. One such disorder which diminishes the functions of the brain is autism. Hayley who is only 8 years old also suffers from this condition. Her mother Karen who is 34 tries to take care of her as much as she can. She has two children Scott who is 10 years old and Hayley and they stay with Bruce who is Karen’s partner since 2 years. The condition of Hayley has proved to be very challenging for the family especially for Karen but she does her best to meet all her needs. This paper will discuss the condition of Hayley with regard to the health aspects and the impact it has on the family. It will analyse the strategies that can be utilized to deal with this condition. Autism is a disorder which is caused because of neuronal impairment. It leads to lack of social interaction and communication in the individuals who suffer from it. The signs of autism can include repetitive behaviour in children, lack of communication, lack of understanding and lack of self-esteem or confidence. Individuals who suffer from autism need a caretaker at all times (Glasson et al 2008 & Parry 2005). This can be seen in Hayley’s case very clearly as she is not able to interact with other children in school. She has not even gotten along with Bruce and she is very agitated as well. She would not be able to do well without her mother Karen who puts in all her efforts to do her best for Hayley by changing her working hours and taking care of her. All of these above mentioned factors clearly show that autism is a disorder which needs to be cured to have a better society. The question now arises for the impact that this condition leaves on the family of the sufferers. The incidence of autism has increased in Australia over the years with the better diagnostic evaluation and awareness. The incidence is higher among young children than in older age groups (Williams et al 2005). It has also been concluded that the condition has a genetic predisposition (Matuszek et al 2009 & Glasson et al 2008) which means that Bruce would need to consider regarding his wish to have another child as the child might also suffer from autism. The loss of social interaction of Hayley also indicates the fact that she is having decreased development according to her age as by the age of 3 years a child should be able to effectively play with his age group children and by the age of 7 years a child should be involved in team games (Parry 2005). It is believed that 15 to 25 hours per week for the therapy of the child are essential for the treatment and hence this can require the parents to take out time for the child. Such therapies can have an effect on the economic aspect of families and also result in stress (Wray et al 2005). It has also been concluded by research that siblings of children with autism have stress and hence it can affect their performance (Smith et al 2010) and thus this can be a challenge for Scott. Hence many aspects of the family unit are vulnerable to disruption due to autism. The family has coordinated and done their best to deal with the condition of Hayley. The family lives together and enjoys the concept of togetherness as they all live together as a unit with Bruce, Karen, Scott and Hayley. Bruce who is their step father is well aware of the needs of both of the children and takes care of them like his own children not making them feel any difference. He provides support to the children as well as to Karen. He tries to communicate with the entire family and has a strong relationship with Scott but due to Hayley’s condition he has not been able to get close to her. He also does not stop them from visiting their real father Tom and hence is very devoted towards the family. Karen also does her best to provide support to the family and she takes care of Hayley in the best possible manner. She has changed her working hours so that she can be available for Hayley when she gets back from school. Despite of the difficult time that Hayley gives her which includes giving her a shower or making her eat food, Karen does her best and does not leave her. The family thus follows many of the essential characteristics that are a part of the strengths as demonstrated in the Australian health model. “Togetherness, affection, support and commitment” is all present in the family model with Bruce and Karen doing their best to keep the entire family unit functioning effectively (Smith 2008). The problems of each other and the children are understood by them properly. Cefai and his colleagues (2008) have clearly demonstrated the fact that the involvement of parents in the condition of the child has provided with good results. The family is supportive in all means and thus these strengths can be helpful in treating Hayley’s condition. Autism is a condition for which different treatment modalities have been suggested and researched upon. A publication of the American Psychiatric Association in the year 2005 showed the results of the use of risperidone in the treatment of autism which is associated with outbursts or agitated behaviours or self harming characteristics. The research provided for the success of the treatment after it was continued for six months. But a drawback of this treatment is also indicated in the research that risperidone withdrawal after 6 months resulted in the return of symptoms in most of the patients. This indicates the fact that the treatment can be successful for a very small proportion of the patients and it can also relieve symptoms temporarily. On the other hand, John Wray and his colleagues (2005) pointed out to the fact that pharmacological therapy is not very useful and helpful in the treatment of autism and other therapies should be employed as they would be more beneficial. The paper points out to the fact that families who use “contemporary and alternative therapies and diet” should not be directly discouraged, but it needs to be understood that there is not concrete evidence supporting these strategies. It is also explained in the paper that risperidone should only be used in cases of autism when the aggressive behaviour is beyond control by any other approach and medications. Pharmacological treatment if any needs to be directed to specific symptoms which include melatonin for disturbances in sleeping patterns and selected serotonin re uptake inhibitors for anxiety and carbamezapine and valproate for stabilizing the mood and relieving aggression. The best treatment is that therapy should be advised for autistic children for 15 to 25 hours every week. This therapy should include therapy in school playgroups, involving family therapy and focus upon improving the behaviour of the child. Behavioural therapies also include understanding the problems in the behaviour of the child and focusing upon one particular aspect and work towards changing that habit by therapy. The family should be guided towards the autistic associations in the country and carer’s allowances are also provided for these families for their assistance (Wray et al 2005). Myers and Johnson (2007) provided for a very intense program for autistic children to improve their living and quality of life. They presented a paper in which they argued that support should be focused for the children as well as for the families of these patients. They argue that at least 25 hours of therapy are essential for these children. Educational intervention was the first step which included sending them to classes with fewer students so that the interaction of the children with the teachers increased. Methods should be employed to increase their interaction with other children. Thus the communication and social skills of the children needs to be boosted via therapies like speech therapy. They also explain the same fact that pharmacological therapy is only meant for the specific symptoms which the child presents with rather than for curing the condition autism itself. The paper also explains the fact that the “contemporary and alternative therapies and diet” have not been proved on the basis of much evidence. Support for the families and siblings via state run agencies as well as interaction with the families of other patients can be of help. The interventions explained can be very helpful for the Patrick family. Hayley can be provided with pharmacological treatment for her sleep disturbances as well as for her agitation when she gets back from school. Her school should also be made aware of her condition so that they might enrol her in special classes that are meant for autistic children. 15 hours per week of therapy can be of help for their family unit considering the fact that Bruce and Karen both work. Speech therapy is also essential for Hayley so that she can interact at school as well as with her family. Family intervention for the others is also important based on the fact that they might be undergoing stress due to the problems that they face as a result of Hayley’s condition. Karen should be actively made a part of the therapy for Hayley because parenting interventions are successful and help overcoming the problems effectively (Myers & Johnson 2007). Karen’s decision of visiting the school Nurse is a very good step for her as well as for her family. The nurse can be of assistance to the family in many ways. She can inform Karen about the carer’s allowance which she can attain and will be of benefit to her financially. The nurse can also inform Karen about the different associations for autism in Australia in the state where she lives, which she can visit so that they can also provide assistance to her and her family (Wray et al 2005). The nurse will listen to all her problems and provide her with proper guidance. She will inform her about the condition that a very certain cause of autism has not been reached as yet and she should never blame herself for the condition of Hayley. The nurse will explain to Karen everything about Hayley’s condition so that she knows how to handle her problems. She will also explain to Karen all the interventional therapies that are available for Hayley. She will explain Karen that her assistance in therapy for Hayley will be of much benefit to the child. An important aspect that the nurse would explain to Karen is that the condition of Hayley might be causing stress to Scott. The nurse will listen to Karen’s problem and she will analyze that if Karen is under severe stress, she will recommend her to a psychologist who can help her as well. The nurse can also arrange group meetings of their family with other families of autistic children so that they can discuss and analyze their problems. Also she will explain to Karen that such sessions for Scott might also be useful because they have proven to be helpful for siblings of autistic children (Myers & Johnson 2007). The nurse should arrange meetings with the entire family including Bruce and explain to him the fact that genetics is believed to have a slight role in the causation of autism although no definitive cause has been concluded. Hence they should be very careful when considering having another child for the well being of their family as well as the child (Matuszek et al 2009 & Glasson et al 2008).T Hence, autism is a condition which affects the everyday life not only of the affected individual but also of the entire family unit. Hayley is an 8 year old girl who is suffering from the condition and she is experiencing difficulties at school as well as at home but she is receiving extensive support from her family. Different treatment modalities are suggested for this condition. They include interventional and behavioural therapies. Family support and understanding is very essential to cope up with this condition. Behavioural therapies, family sessions along with special programs initiated by the government can prove to be very helpful for the patients and their families. Nursing interventions can also serve to be of support for the entire family unit as they serve to be helpful in explaining the condition properly to the family and teach them of how they are supposed to deal with the condition. REFERENCES Smith, LM (2008) Family assessment and the Australian Family Strengths Nursing Assessment Guide. In: Child, Youth and Family Health: Strengthening Communities. Elsevier, Australia, pp. 11-18. ISBN 978 0 72953 799 5 Glasson, E. J., MacDermott, S., Dixon, G., Cook, H., Chauvel, P., Maley-Berg, A., & Wray, J. (January 01, 2008). Management of assessments and diagnoses for children with autism spectrum disorders: the Western Australian model. The Medical Journal of Australia, 188, 5, 288-91. Bottom of Form Top of Form Top of Form Cefai, J., Smith, D., & Pushak, R. (January 01, 2010). Parenting Wisely: Parent Training via CD-ROM with an Australian Sample. Child & Family Behavior Therapy, 32,1, 17-33. Bottom of Form Bottom of Form Top of Form Williams, K., Glasson, E. J., Wray, J., Tuck, M., Helmer, M., Bower, C. I., & Mellis, C. M. (January 01, 2005). RESEARCH - Incidence of autism spectrum disorders in children in two Australian states. Medical Journal of Australia, 182, 3, 108. Bottom of Form Top of Form Bottom of Form Top of Form Matuszek, G., & Talebizadeh, Z. (January 01, 2009). Autism Genetic Database (AGD): a comprehensive database including autism susceptibility gene-CNVs integrated with known noncoding RNAs and fragile sites. Bmc Medical Genetics, 10. Bottom of Form Top of Form Parry, T. S. (January 01, 2005). MJA PRACTICE ESSENTIALS -- PAEDIATRICS - 12. Assessment of developmental learning and behavioural problems in children and young people. Medical Journal of Australia, 183, 1, 43. Bottom of Form Top of Form Wray, J., Silove, N., & Knott, H. (January 01, 2005). MJA PRACTICE ESSENTIALS -- PAEDIATRICS - 7. Language disorders and autism. Medical Journal of Australia, 182, 7, 354. Bottom of Form Top of Form Bottom of Form Top of Form Smith, L. O., & Elder, J. H. (January 01, 2010). Siblings and Family Environments of Persons With Autism Spectrum Disorder: A Review of the Literature. Journal of Child and Adolescent Psychiatric Nursing, 23, 3, 189-195. Top of Form Myers, S. M., Johnson, C. P., & American Academy of Pediatrics Council on Children With Disabilities. (January 01, 2007). Management of children with autism spectrum disorders. Pediatrics, 120, 5, 1162-82. Bottom of Form Top of Form Top of Form Risperidone Treatment of Autistic Disorder: Longer-Term Benefits and Blinded Discontinuation After 6 Months. (January 01, 2005). The American Journal of Psychiatry,162, 7, 1361. Top of Form Bottom of Form Read More