Autism spectrum disorder in childhood: A case study of Joey

Mental Health Disorder

The following is a close examination of the psychosocial status of mental health disorder. There is going to be an examination of the symptoms along with a comprehensive diagnosis of the case.

Mental Health Disorder- Background

Childhood mental health disorder refers to all mental health conditions that affect a person in childhood. The disorder in children is described as critical changes that affect the way a child behaves, learns or even handles emotional situations. Some of the known childhood mental health disorders include (CDC - Child Development, Children's Mental Health -- NCBDDD, n.d):

Hyperactivity disorder/attention deficit disorder (ADHD) (http://www.cdc.gov/ncbddd/adhd/index.html)

Disorders related to behavior

Anxiety and mood disorders

Tourette syndrome

Substance use disorders

Mental health is essential in life. Mental health disorders can persist throughout a person's life (CDC - Child Development, Children's Mental Health -- NCBDDD, n.d). The problem needs to be diagnosed early. Otherwise, children continue to experience problems in many spheres of social interaction, including forming friendships. These effects interplay negatively with their health and could proceed into adulthood. Mental health stretches beyond being mentally ill. It is about thinking optimally, relating to friends and accomplices and the general feeling. Generally, mentally healthy people tend to manifest better physical health and social interactions with others. Mental illness is characterized by mental disorders that can be diagnosed. They are manifested by abnormal feelings, thinking and behavior. Some common examples of mental health disorders include: depression, anxiety and disorders linked with substance abuse (Mental Health: Get the Facts on Common Disorders, n.d). Research shows that there is no single dominant cause of mental health disorders. It is a complex result from a set of interactive factors that include: genetics, environment and psychological factors. Autism Spectrum disorder is one such condition. We shall discuss this disorder in this paper

Identity Information

Joey is six years old (Project One , n.d)

Source Referral

The child was brought in by the parents for diagnosis purpose (Project One , n.d).

Problem Presentation

Joey could neither speak nor signal to indicate what he needed at the age of three. His parents had to grope in the dark by offering several options so that she could pick what she wanted from a range of guesses (Project One , n.d). Joey was like a vegetable. He could not take part in child play or other similar mimics with other children around him.

Current Status

At the age of 6, Joey was evaluated and was reported to have improved significantly. Although he didn't make eye contact when he was greeted by the therapist, he moved into the interview and testing rooms willingly. He even sat on the testing seat (Autism Spectrum Disorders: Case Study, n.d). Although he did not pursue conversations with the examiner, he answered questions whenever he was asked. He echoed the examiner sometimes and quipped "nice job to himself. He engaged in some mimic plays and even pointed at items and uttered words to show his needs. It is observed that Joey participated in a measure of non-verbal intellectual performance and faired averagely in his age range. His expressive and receptive language skills still contrast with this performance as they are notably still below the level of his age mates. The support Joey has received from his therapist, relatives, educators and friends has greatly assisted him. Joey attends school in a kindergarten in an education classroom for general education. There is even a special focus class of Individualized Education Program that facilitates pre-school type speech and occupational therapies. He is assisted to move from one activity to the next by a classroom based assistant with special skills. The assistant also helps him play and interact with other children (Autism Spectrum Disorders: Case Study, n.d).

He performs well when supported with visual schedule aids and given advanced notice. His parents noticed an improvement in the way he reacted to events, his participation level and occurrence of tantrums. Tantrums were prevalent, whenever he was frustrated, as a result of his sensory failure. The parents also observed improvements in his skills to ask for what he wanted. They observed that although he did not always do this in a timely manner and as he needed, he did it at some point. His parents are still concerned about his listening and comprehension skills, the reduced level of socialization, expressive language abilities and his ability to take part in the course of tasks (Autism Spectrum Disorders: Case Study, n.d). Joey loves playing on the computer. When his friends are guided on how to engage with him, he shows a significant level of social and interactive abilities with them.

Summary

Usually, children with ASD but can speak will utter things without meaning or even those that sound irrelevant as they converse with others. There is a tendency to repeat things. For example, they repeat the count from number 1 to 5. A child may also repeat utterances he may have picked as a result of hearing them several times. The latter condition is referred to as echolalia. Children with ASD often develop some language and speech skills. However, this development does not attain the normal expected levels. The progress of these developments has been noted as uneven.

For instance, the children may grow their vocabulary quite fast in a given area that they are interested in. A good number of children remember things they just saw or heard with ease. In fact, some children develop reading skills as early as 5 years or below. However, they often do not understand what they read. ASD children cannot use gestures to accord meaning to speech. They do not like eye contact; a phenomenon that makes them seem defiant and rude, listless or uninterested in what is at stake. Since they lack a language that is meaningful and cannot gesticulate effectively, they become frustrated because their attempts to let the world know their feelings and attend to their needs are futile. Consequently, they will be observed to be edgy and manifest a range of other unusual behavior. Joey has shown all of these signs.

The incidence of Autism seems to be on the rise. A lot of practicing professionals in the child development area in Britain have this feeling. They report to have been attending to more children with autism cases. Kanner was the first to identify autism in 1943. He observed strange patterns of behavior in some children from the point of birth to about thirty months. Kanner referred to this condition as early "infantile autism." Aloofness and repetitive routines that were elaborate were his diagnosis criteria. Studies in Epidemiology have come to demonstrate that autism is not a uniquely and separately occurring condition in children that have normal development trends. Rather, it has been established that autism is linked to a couple of disorders (Wing, 1996). Some of these include Asperger's Syndrome; a borderline or normal IQ; maladjusted social interaction skills and social isolation tendencies. Other characteristics include a lot of interest in a single or two areas, inappropriate intonation or lack of it, a repetitive way of life, uncoordinated body language or lack of it and poor motor skills.

There is a shared triad spectrum of social interaction glitches, imagination and communication that is closely linked to a rigid pattern of repetitiveness. It starts either at birth or within the first three years after birth. There are incidences where the condition has manifested even much later than this. Some signs shown here are the same ones that Joey manifested in the first diagnosis of the Austin Spectrum Disorder. Some of the symptoms he manifested after the diagnosis prove it further (Writer Thoughts, n.d).

Diagnosis

The initial diagnosis of Joey's case showed that he scored significantly in all the aspects on ADI-R (Autism Diagnostic Interview-Revised, n.d). He also received the module 1 of the ADOS (Autism Diagnostic Interview-Revised) and attained scores that were significantly consistent with Autistic Disorder. He could not take part in a standardized test of his intellectual skills (Autism Spectrum Disorders: Case Study, n.d). The examiner tried a non-verbal measure. However, Joey became fixated on a card, instead of making use of the response cards to provide answers to the test items. He was also notably interested in the spiral binding on a stimulus book in the test room. He was, however, not interested in using the test items as directed by the examiner. Joey was consequently diagnosed with Autistic Disorder condition.

Background Information on Autism

Leo Kanner and Hans Asperger are credited with making the condition of autism known mid last century. They pointed out specific psychopathological condition that exists in children. The past 20n years have seen the world delve deeper into the condition and establish a systematic prevalence of the condition. Currently, there is a range of neuro-developmental described and summarized in the (DSM-IV) and ICD-10 (the International Classification of Mental and Behavioral Disorders, n.d) going under the common generic reference of PDD (Pervasive Developmental Disorder) or even ASD: Autistic disorder, Asperger Syndrome, Rett Syndrome, CDD and PDD or classic autism (Klauck, 2006). The main areas of ASD malfunction include a. social interaction impairments b. impairment of non-verbal and verbal communication and c. stereotyped or restricted behavior patterns, activities and areas of interest.

ASD symptoms are usually manifested within three years of birth. These symptoms continue for a lifetime. The tools for diagnosing ASD have been standardized internationally (Klauck, 2006) in order to attain accurate results. The release and development of ADI-R has accompanied this standardized technique. The diagnostic Criteria based on ICD-10 and DSM-IV notwithstanding. There is also a questionnaire for parents and caregivers, the Autistic Diagnostic Observation Schedule; the generic version and a testing tool for the parent's behavior responses. The broader ASDs are represented by a phenotype statistic of 0.3 to 0.6% while the autistic disorder prevalence is between 0.1 and 0.3%. Concerns have been raised for the possibility of an increase in Autistic Spectrum Disorders (ASDs). However, improved diagnostic procedures have made it not easy to compare and interpret the figures in the past 20 years. The Combating Autism Act (2006) triggered a concerted effort to coordinate National Institutes of Health (NIH) that provide funding for research (Communication Problems in Children with Autism Spectrum Disorder, n.d. Such organizations include entities such as the National Institute of Mental Health (NIMH); the key research institute at NIH and the National Institute for Deafness and Other Communication Disorders, the National Institute of Environmental Health Sciences, the national Institute on Child Health and Human Development (NICHD), and the National institute of Neurological Disorders and Stroke. This set of institutions has cooperated in setting up the Austin Centers of Excellence (ACE). This program incorporates research cooperation among universities in the whole country.

Scientists in these programs explore a wide range of areas, including genetic and molecular aspects of ASD. The stretch to transnational studies seeks to check fresh horizons of behavior intervention (Communication Problems in Children with Autism Spectrum Disorder, n.d). Some of these research studies may be of interest to parents with ASD children. The website http://clinicaltrials.gov is a useful resource. Type in a search term and explore the possibilities for treating your child's autistic condition as explored by various researchers in different locations across the country. There is information on who is eligible for trials too.