Child and Family Nursing in the Modern World - Essay Example

Running Head: CHILD & FAMILY NURSING Child & Family Nursing Name Institution Date Introduction Family assessment is the process of collecting and gathering information concerning a particular family. It is aimed at helping a family avoid problems and at the same time to solve the existing problems. The aim of family assessment is to fully understand the family and not only its problems but also its strengths, values and goals (Jacob, 2007). Family assessment gathers information such as family health and other challenges facing the family, which is useful to helpers such as nurses and other families. Complete information about all areas that are important for the development and functioning among all members of the family are examined in the assessment process. This enables the family helpers to make accurate decisions regarding the family (Conoley, & Werth, 2005). This paper is a discussion of a family of Karen, mother of Scott and Hayley aged 10 and 8 respectively. The family lives together with Bruce, who is Karen’s partner and step father to the children. The children’s biological father is Tom, who is also married to Linda. The main issue in the family is dealing with Hayley who was diagnosed with autism during her preschool years. The essay looks at the various difficulties experienced by the family and the best ways to deal with them. The assessment also focuses on building a relationship between an autistic child and the family members with the help of the nurse. It also looks at the strengths in the family that could help in improving the child in the case. Case Study Hayley has problems interacting with her own family members and also her peers in school. This has contributed to the many difficulties in dealing with her since her mother is the only one who understands her and therefore has to spend much of her time with Hayley. Autism is an unpredictable disorder of neurodevelopment that may start during infancy and may continue without any decrease. The disease has affected many children in all parts of the world. According to the report released by the Australian Advisory Board on Autism Spectrum Disorders indicates that in every 160 children aged between s6 to 12 years, one child is suffering from Autism Spectrum Disorder. Other areas such as U.S have prevalence of one child in every 150 children in the same age bracket. This number is still continuing to increase as more children are experiencing the condition. According to the American Psychiatric Association (2004), the common symptoms of autism such as seizure disorders, mental retardation and mental illness may continue to increase even through adulthood although in a manner that is not rapid. Kids with autism may experience the world in a different way than how other kids experience it. For example, some kids may pull away when someone tries to hug them, others may try to close their ears even when there is constructive noise so as to create a world conducive for them. This is because their nervous system gets overwhelmed by sensory inputs that they receive and therefore wish to run away from them. They may have problems in talking to other people and even eating. Such a kid may even have problems in interpreting the meaning of words and this may also prevent her from expressing her own thoughts (Albano, 2003). Autism affects the child’s ability to communicate, and to interact with other people. Children may also have difficulties to engage in leisure activities and prayerful activities. Such a child may pose great stress to the family especially due to difficulty in communicating (Weiss, 2004). Autism varies in the range at which the symptoms express in different children. They may be experienced form mild to severe cases depending on the individual. The severe cases mostly occur in combination with other conditions. The most severe is referred to as Pervasive Developmental Disorders. This category is characterized by severe impairment and is diagnosed differently from other disorders. The mild category of symptoms is the Pervasive Developmental Disorder, and is not very common (Lorna, 2003). Dealing with such a child is very difficult especially to her mother and the entire family. However, this mostly happens where the family does not understand the child properly and does not give what is required in caring fo an autistic child. Hayley is however a problem due to her limited communication ability where it is hard to understand her needs. A family with an autistic child should go through medical counselling by professionals to enable them cope with the situation (Lynn, 2005). Autism affects the bio-psycho-social development of the child since it involves the nerve coordination within an individual. There is poor development in child and the child may therefore fail to achieve optimal growth especially in the area of speech. Autism also hinders an individual's ability to socialize (Bock, & Goode, 2003). In the saes of Harley, she can't socialize at home and also in school. When talked to she hardly responds. A child with autism has got serious social difficulties that involve inability to interpret other people's emotions, inability to reciprocate to communication and use of socially undesirable gesture (Harold & Sadock, 2008). They also don't like routines that keep changing. They may like things to work in a similar way all the time and they get upset when there is change. The family members should therefore try to maintain what the autistic child wants. Tarakeshwar & Pargament, (2006) explains that any family having a child suffering from autism experiences serious stress. This is because an autistic child needs a lot of attention from the parents and siblings. The child also lacks social skills and this may emotionally drain the family. Autistic children also have difficulties in expressing their needs. Family members have to be aware of the implications of various responses of the child. Karen had to adjust her work schedules to have time in the afternoon to look after Harley and she really experiences stress when with her and likes sending her to the father regardless of the difficulties the children may experience.  The family of Hayley has got several strengths that have enabled them to cope well with the child. One of the family strengths that Karen and her family possess is appreciation and affection. Regardless the fact that Bruce is not the biological father of the children, he has taken the role of their step father seriously and cares for the children as if they were his. He shows affection to the children including Hayley who does not respond to this. The mother also shows a lot of affection to the children she has devoted her tome for her care and all her energy. The family appreciates Hayley's condition and they live with it. Tom, the real father of Hayley and Scott has also maintained contact with the young ones and takes care of them. Such strengths help avoid exhaustion of one person due to dealing with Hayley. Everyone gives her attentions and this makes the issues to be less difficult for the mother. Another family strength that is enabling them cope with Hayley's condition is commitment (Holman, 2003). The mother is committed to help the child and to cope with all her demands. She goes to the extent of changing her working hours to create time to be with Hayley. Tom is also committed to her children but this is being hindered by her job which occupies much of his time. According to Stinnett (2009), members of a strong family are always concerned with each other's wellbeing and they invest their time and energy in family issues. Another strength that has enable Karen's family to cope with Hayley's condition is their ability to manage stress and crisis successfully. Stinnett (2009) states that strong families are not resistant to stress but they do not get affected by stress like the troubled families. They have the capability of managing stress effectively (Gunsalus, & SDSCA& MA, 2006). Karen and Bruce are not getting affected by the condition of Hayley and they are not letting it to ruin their marriage. These are considered to be strengths because they are the qualities that have enabled the family to live comfortably with the autistic condition of Hayley. Autistic children usually have behaviours that are very upsetting and annoying. Scolding the autistic child may however not help the condition. The most imperative thing to do with an autistic child is to understand her (Stahmer, Collins, & Palinkas, 2005). In the case of Hayley, the mother understands her and she is therefore committed to her because she is the basically one who can deal with her properly. But on the other hand, Linda does not like Hayley and she gets upset with the mess they cause in her house. The autistic child may be difficult to deal with since she will always like doing what is in her mind and may therefore end up causing a mess. Autistic children may have undesirable behaviours and they don't do them intentionally. The best way to manage such a child is to understand that she is unique and she can do anything (Michael, 2007). Another strategy that can help in managing Hayley is for her mother to be clear and consistent in rectifying her behaviour. One needs to set expectations. This is by starting with small goals such as trying to make her eat a small serving of food, making her sit for half an hour, or what the child can manage. Once this target is reached, then one can try for another higher target. Ellis (2010) states that once the care giver chooses to end a particular autistic behaviour in the child, she should not turn back. Karen may choose to stop Hayley from going to the toilet at night and net getting back to sleep. Since this is a regular habit she has formed, Karen may find means of ending it such as refusing her from waking up and once she is consistent with this, Hayley may stop the habit. Modifying the behaviour of an autistic child should be done consistently (Lorna, 2003). Another strategy that Karen may apply is to reward good behaviours and punish the wrong ones immediately. The autistic child may have problems of relating events once they have happened and reward should therefore be done immediately. To curb the habit of going to the toilet in the midst of sleep and also refusing to eat lunch, Karen should punish her immediately so that she can be able to relate the punishment and the wrong thing she has done. When the child does a good thing, she should reward her appropriately and immediately. This will help Hayley to relate good behaviour with better rewards and bad behaviour with unpleasant punishment. This may therefore make her to eventually give up the habit that earns her a punishment (Baron-Cohen, & Bolton, 2003). Once the desired behaviour has developed in the child, the use of reinforcement should be decreased. This is because the ultimate goal is to change the behaviour and not to make the child behave well when the reinforcement is there. The other important thing that Karen should do is to find out what stimulates the autistic behaviour in Hayley. An autistic child may act is some manner in response to some sensory stimulation. The environment of the child may also be a stimulating factor to some autistic behaviour (Volkmar, 2007). For example, Hayley refuses to eat lunch in school and becomes upset while in school. The school environment or the presence of other children may be the stimulating factor to her refusal to eat. Karen may therefore try to change her school and family environment to see whether there is behaviour change. Kever (2005) family unity and love are the most essential facets of dealing with autism. All members of the family should be united in dealing with an autistic child (Gullotta, & Blau, 2008). Family unity is a family strength that enables members to maintain family identity and ensuring a balance between family priorities and supporting individual needs. A family with autistic child should try to avoid divorce between parents as in the case of Karen and Tom. This is because it may change the family environment of the child (Williams, & Evans, 2003). The nurse may also play a very important role in assisting the family of Hayley to cope with the situation bearing in mind their family strengths. However, to achieve this, the nurse should first assess the situation of the family and of the child. This includes the communication and the behavioural strengths and weaknesses that the parents have. This should then be followed with healthcare visits where the nurse should asses the ability of the child to follow commands (National Autistic Society, 2004). Bearing in mind the strength of commitment in the family of Hayley, the nurse can help them to use the ABC model of behaviour analysis. This means, Antecedent, Behaviour, and Consequence. This is used to assess the relationship between what causes certain behaviour and the events that take place after the behaviour. In most cases, what happens after the behaviour determines whether it will recur (Happé, 2005). If the nurse explains properly to the family on how to apply the ABC model, thus can help the caregivers to identify the areas in Hayley that need special attention. With this they can help her to avoid those behaviours with undesirable consequences.  The nurse can also offer counselling to Bruce on how to improve his relationship with Hayley. This can be by use of things that entice her, or generally doing good things to her. Another party that the nurse can involve is Linda. This is because Hayley needs a change of environment that is better. The only option of environment they have is Linda's house that is not comfortable with the children. The nurse can help counsel her to improve her relationship with the children (Furneaux, & Roberts, 2007).The other option that the nurse may sue is medication. Psychotropic medication can be used to treat the undesirable behaviour such as aggression if the other interventions do not work (Tsai, 2008). Autism is a serious mental and health condition that can affect the whole family of the affected person. The family of an autistic child needs to maintain family strength so as to cope with the autistic child properly (Shore, Ratselli, & Grandin, 2006). However, the family strength should apply to all people who get into contact with the autistic child even if not a close family member. The strategies for coping with an autistic behaviour are also very important. The most significant of them all is to understand the child. This will help the family to improve on their commitment towards the case. Nurse's intervention can also help if the nurse counsels the family and gets them involved in helping the autistic child. However, the family of Hayley is well committed and ready to understand her and will be in position to deal with her condition without much difficulty.    References Albano, A. (2003).Through Different Eyes: How People with Autism Experience the World. 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