Autism spectrum disorders are among the conditions that millions of children across the globe present with. It is understood that 1 in every 59 children has autism in the United States (Baio et al., 2018). One should understand that this ratio is conservative since many cases of autism are undiagnosed. While there are numerous symptoms that define autism, behavioral issues offer the best indication that an individual could be suffering from autism. Therefore, mental health professionals and child behavior specialists should give particular focus to the behavior that a patient exhibits. Once it is established that the patient has autism, the next step involves identifying the goals and objectives that the treatment will seek to attain. The goals and objectives need to be specific and measurable if they are to deliver improvements in the behavior of the patient. In addition to establishing goals and objectives, the plan of action should also identify the interventions to be used while accounting for cultural issues and the demographic background of the patient.
Client Demographics
As noted above, successful management of autism requires that professionals should consider the demographic profile of the client. This paper examines the case of Chadwick Pierce, an 8 year old boy whose mother is worried about his behavior. Pierce is from the African American community and hails from a neighborhood that is ravaged by poverty and under-development. His mother is a single parent who struggles to care for her three children. The hardships that Pierce and his mother face have made it difficult for him to receive proper care. The behavioral issues that he displays have affected his education since he has been unable to attend classes for three months. His teachers found his behavioral issues to be too severe for any meaningful learning to occur.
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It is important to note that Pierce’s racial and economic backgrounds have been hindrances to access to care. His case is not unique as it has been observed that racial minorities and those who are poor lack adequate access to treatment for autism (Becerra et al., 2014). Therefore, as it will be made clear in a later discussion, the treatment that Pierce is offered needs to account for the unique challenges that he faces on account of his race. Another issue that Pierce’s mother mentioned is that her family has refused to become involved in his treatment. The lack of support from the family has compounded the difficulties that Pierce faces.
Presenting Problem
Pierce is similar to other children with autism in that he displays the behaviors that typically characterize this condition. His mother complains that Pierce has difficulty communicating. She has observed with concern that Pierce is unable to string words and form coherent sentences. Moreover, he tends to repeat words and phrases over and over, much to the frustration of those with whom he engages. Another communication difficulty that Pierce presents with is that he tends to dominate discussions. His mother shared that Pierce rarely lets others speak. Other difficulties that the mother reported include Pierce’s inability to respond to and use body language appropriately and his tendency to throw tantrums.
Communication difficulties are not the only problem that Pierce presented with. In addition to these difficulties, Pierce also displays repetitive behaviors which have caused his mother much concern. His mother shared that Pierce tends to flap his hands, jump dangerously, and repeating sounds. Another behavior that he displays is arranging and rearranging items in a particular order. The mother stated that she feels powerless and unable to help her son. As noted earlier, her family does not offer much support and this has only added to her son’s problems. While Pierce’s behavioral issues should worry her mother, they are not unique and are consistent with the behaviors of other autistic children. In the discussion below, the goals and objectives designed to address Pierce’s behavioral issues are outlined.
Goals
The effective management of the behavioral issues associated with autism hinges on the development of clear and specific goals. It is important for the professional attending to an autistic patient to ensure that the goals and objectives reflect the desired outcomes of the treatment. For Pierce, the primary goal will be to improve his communication skills. Since this goal is rather broad, it will be split into a number of more specific objectives whose attainment will result in an overall enhancement of Pierce’s communication skills. The first objective that will be pursued will involve working with Pierce so that he is able to combine simple words to form coherent sentences within three months. This objective is measurable and realistic. Three months is sufficient time to teach Pierce how to construct sentences using simple words. To achieve this objective, the words that Pierce already understands will serve as the primary basis for teaching. Using what he already knows, he will be introduced to more complex words and sentences. Another objective that will be pursued as part of efforts to address the communication difficulties that Pierce face is accurately identify the meaning of such gestures and body language as nods and waves. It is hoped that this objective will be achieved within the first four weeks of treatment.
Apart from poor communication, Pierce also struggles with repetitive behaviors. As noted earlier, he tends to repetitively arrange and rearrange objects, jump dangerously and flap his hands. In themselves, these behaviors are not dangerous and should not be cause for much concern. However, considering that the behaviors adversely affect his relationship with his mother and peers at school, it is important to address them urgently. To fix these behaviors, the objective of getting Pierce to adopt regular 15 minute breaks after intense and repetitive activity will be pursued. This objective is simple enough to be achieved. Furthermore, it will be possible to measure whether the goal has been met by determining the length of time that Pierce rests after intense activity.
Relevant Theoretical Constructs
The academic community has attempted to understand the factors that underlie the development of autism. Efforts by members of this community have led to the establishment of various theories which attempt to explain the behaviors that autistic individuals exhibit. The theory of the mind is among the models that accounts for the behavioral issues among autistic individuals. Essentially, this theory posits that the faculties needed for such functions as communication and social interaction in autistic people are impaired (Begeer et al., 2011). This impairment makes it difficult for the autistic to communicate effectively and to understand the mental and emotional states of those with whom they engage. Due to the impairment, the autistic are also unable to understand their behavior and the behaviors of others (Begeer et al., 2011). As a result, they are unable to engage in mutually fulfilling interactions with others.
It is true that there are numerous theoretical constructs that attempt to explain the development of autistic behaviors and tendencies. However, the theory of the mind has been selected because it offers the best account of Pierce’s behavioral issues. Unlike other theoretical models which offer a step-wise account of the development process of various disorders, the theory of the mind only provides a general outline of this process. That it explains Pierce’s communication skills deficiency is the main reason why this theory is most appropriate. As noted earlier, Pierce displays various communication difficulties. In addition to being unable to use language effective, he also faces challenges with interpreting body language. Moreover, Pierce lacks empathy as he dominates most interactions that he has with other children. All these issues can be blamed on his under-developed faculties. Due to the impairment of the faculties responsible for social interactions and communication, Pierce is unable to accommodate the needs of others in his communication and social engagements. Another issue that makes the theory of the mind appropriate is that it explains the selfishness and lack of empathy among autistic children. As noted above, this theory holds that autistic children are unable to understand the behaviors of others because their faculties did not develop fully. Pierce’s poor communication can be linked to his inability to understand that others wish to be included in conversations.
Generally, the theory of the mind allows one to understand how and why Pierce behaves as he does. However, this theory does not offer a full account of his behavior. It was noted that in addition to having communication difficulties, Pierce also displays repetitive behavior. An examination of the theory of the mind reveals that this model does not account for the repetitive behaviors. While its failure to explain these behaviors erodes the relevance of this theory, it remains a valid and reliable framework for understanding the lives of autistic children.
Intervention Methods
The purpose of treatment for individuals with various disorders is to administer interventions that have been shown to be effective. Different interventions are available for autistic children. However, not all these interventions are appropriate for all cases. Practitioners need to select the intervention that is most in line with the needs of the patient and the goals of the treatment. For Pierce, it is determined that theory of the mind training holds the greatest promise for addressing his behavioral issues. Research shows that this intervention is among the most effective (Othman & Collet-Klingenberg, 2017). Basically, theory of mind training involves training autistic children regarding how to interpret and respond to various emotions. A simple training could involve children being shown images that portray various emotions then being required to identify the emotion. For example, a child could be provided with photos of smiling individuals. They are then to state the emotion that the photos convey. If the child says that the smiling individual is happy, it can be concluded that the training has been effective.
That research has established the effectiveness of theory of mind training is not the only reason why it has been selected for Pierce. This intervention will allow for the resolution of the Pierce’s behavioral issues. For example, difficulties in communicating are one of the issues that require an urgent intervention. The theory of mind training is understood to help children with autism to improve their communication and social interaction skills (Adibsereshki et al., 2015). Therefore, by applying this intervention, it is hoped that Pierce will become a more effective communicator and will be able to establish rewarding relationships with other children. It is true that this intervention was not originally designed to help children who engage in repetitive behavior. However, since the intervention improves communication and social skills, it can also help the children to abandon the repetitive behaviors. For example, after becoming more effective at communicating, Pierce will be able to understand his mother’s frustration and move away from his repetitive tendencies. Overall, when administered properly, the theory of mind training will undoubtedly solve Pierce’s behavioral issues.
Cultural Considerations
When attending to patients with autism, practitioners are advised to make consideration for various social and cultural factors (Ennis-Cole, Duroboye & Harris, 2013). One of the considerations that will be made when treating Pierce is his mother’s perspective regarding autism. It will be established whether his mother believes that his condition is a serious issue that requires the involvement of a mental health professional. In some communities, mental disorders are dismissed as minor issues that do not require treatment (Adewale, Ritchie & Skeels, 2016). The perspectives of these communities hamper the delivery of mental health services. If it is determined that Pierce’s mother does not recognize the importance of treating her son’s condition, efforts will be committed to persuading her that treatment is necessary.
The level of trust in the mental health community is another cultural issue that will be considered. For this community to fulfill its mandate, it needs the full cooperation and complete trust of patients and their families. One of the issues that hinder the delivery of mental health services is that some communities distrust practitioners (Lago, Peter & Bogus, 2017). It is possible that Pierce’s mother does not trust that the mental health community can help her son. If this is the case, it is important to assure her that the interventions administered are designed to improve her son’s situation. In addition to trust levels and perspectives regarding mental health, consideration should also be given to the patient’s socioeconomic background. It was noted earlier that Pierce is from a poor community where social and economic support systems are lacking. By considering his background, steps can be taken to avail the resources and facilities needed for effective treatment.
Use of Technology
Today, technology is playing a prominent role in the delivery of mental health services. In treating Pierce, technology will be used extensively. The main role that technology will play is in the administration of treatment. The theory of mind training has been identified as the intervention that will be administered. This intervention involves training patients on how to recognize and respond to emotions appropriately. Such technologies as computers will be used to display images portraying various emotions. The technology will also be used to record Pierce’s response to the emotions. Apart from facilitating the administration of the intervention, computers will also be used to record and manage information. For example, details of Pierce’s background and the progress that he makes during the course of treatment will be included in the digital records. The integration of technology into treatment delivers a number of benefits. These benefits include accurate measurement of progress and convenience. The main drawback of using technology is that it could make treatment costly.
In conclusion, autism is among the conditions that greatly erode the quality of life of patients. This condition makes it difficult for affected children to communicate effectively and form healthy relationships with others. Pierce’s experiences serve as evidence of the damage that autism causes. He presents with communication difficulties and tends to display repetitive behaviors. The theory of the mind offers explanations for how his behaviors developed. This theory is also the basis for the intervention that will be administered. The theory of mind training will enable Pierce to acquire social and communication skills and abandon his repetitive tendencies. To ensure that the intervention works, technology will be employed. The case of Pierce shows that by carefully analyzing the problem that autistic children present with, it is possible to develop effective and evidence-based interventions.
References
Adewale, V., Ritchie, V., & Skeels, S. E. (2016). African-American and African perspectives on mental health: A pilot study of the pre and post colonial and slavery influences and their implications on mental health. Journal of Communication in Healthcare, 9 (2), 78-89.
Adibsereshki, N., Nesayan, A., Gandomani, R. A., & Karimlou, M. (2015). The effectiveness of Theory of mind training on the social skills of children with high functioning autism Spectrum disorders. Iranian Journal of Clinical Neurology, 9 (3), 40-9.
Baio, J., Wiggins, L., Christensen, D. L. et al. (2018). Prevalence of autism spectrum disorder Among children aged 8 years- autism and developmental disabilities monitoring
Network, 11 sites, United States, 2014. Surveillance Summaries, 67 (6), 1-23. Retrieved July 13, 2018 from https://www.cdc.gov/mmwr/volumes/67/ss/ss6706a1.htm
Begeer, S., Gevers, C., Clifford, P., Verhoeve, M., Kat, K., Hoddenbach, E., & Boer, F. (2011). Theory of mind training in children with autism: a randomized controlled trial. Journal of Autism and Developmental Disorders, 41 (8), 997-1006.
Becerra, T. A., Ehrenstein, O. S., Heck, J. E., Olsen, J., Arah, O. A., Jeste, S. S., Rodriguez, M., & Ritz, B. (2014). Autism spectrum disorders and race, ethnicity, and nativity: a Population-based study. Pediatrics, 134 (1), e63-e71.
Ennis-Cole, D., Duroboye, B. A., & Harris, H. L. (2013). The impact of culture on autism Diagnosis and treatment: considerations for counselors and other professionals. The Family Journal, 21 (3), 279-287.
Lago, R. R., Peter, E., & Bogus, C. M. (2017). Harm reduction and tensions in trust and distrust In a mental health service: a qualitative approach. Substance Abuse Treatment, Prevention, and Policy, 12 (12). DOI: 10.1186/s13011-017-0098-1
Othman, L. B., & Collet-Klingenberg, L. (2017). Theory of mind training in children with Autism: relating the shared attention mechanism to the theory of mind mechanism vs. Understanding beliefs training. Journal of Educational and Developmental Psychology, 7 (2), 75-86.
