As a social worker in mental health practice, one of the job requirements is to assess various mental health issues. The most important diagnostic tools used to make an accurate diagnosis include the mental status examination and the family history. These measures begin the moment a patient enters the office. This was the situation in my office last week when Alex’s parents visited the clinic to diagnose their son’s behaviors which they only described as weird. The parents were adamant Alex was suffering from a mental health issue since his behaviors were contrary to society’s accepted norms and behaviors subject to his age. After deliberations, I asked Alex’s parents to point out behaviors that seemed abnormal while I also observed Alex in the office environment.
Mental Status Examination
Alex’s parents were particularly anxious to figure out the issue with her son. The mother was 40 years old while the father was in his late 50s. Alex’s mother explained Alex’s weird habit of crying hysterically when his routine was slightly altered. For example, Alex would become angry and start crying when his favorite food was not served on a specific plate. During the interview, Alex began to get anxious and seemingly upset by the office environment. After inquiring from the parents, they described the behavior as normal. Each time they traveled to a meet family and friends at locations different from their homes, Alex portrayed similar behavior.
At that point, Alex had begun repeating the word, toy’ while being completely distracted from the conversation I was having with his parents. Alex was sitting in a chair since he had resisted being cuddled by his mother; thus, his mother pulled a toy from her purse and handed it to Alex, who immediately changed his mood. Alex started playing with his toy and became fixated on the spinning wheel of the toy car. I suggested taking him to the children’s court to play with other children, suggesting the parents refuted since Alex was prone to playing alone and was at peace at his seclusion (Hodges, Fealko, & Soares, 2020). Alex’s parents had also given up on their attempts to have Alex play ‘make-believe’ with other children in the neighborhood since he ended up playing with his toy car alone in a secluded corner.
Alex’s parents also described his slow reaction or sometimes inability to respond to someone calling his name. His reaction would be to continue playing with his toy repeating the same maneuvers each time one lap on the artificial race track was completed. An attempt at instructing him to come and eat his meal would be met by aggressive behavior such as head banging until one would leave him alone. A peculiar reaction was his emotions after the head-banging where he would continue his activities rather than cry due to the excruciating pain when one heads his head.
Alex’s parents were also concerned with his inability to express his needs. Alex would stare at his parents when he needed something but was not specific in his requests. The fulfillment of his needs posed unique challenges since he did not respond to gestures nor look at objects in his vicinity when his parents pointed at them. Occasionally, he spoke few words indicating his needs in a robot-like sound characterized by repetitive words. Alex was also extra sensitive to light and noise, preferring a dark room devoid of loud noises. Alex lived in a suburb; thus, the street was well lit and occasionally loud cars, a phenomenon which led to difficulties in sleeping. I inquired about the family history and discovered that Alex’s grandfather had similar behaviors that led him to be admitted to an elderly home care setting. At the end of the discussion, I noted Alex had avoided eye contact throughout the entire office stay as he was completely unbothered by our conversation (Hodges, Fealko, & Soares, 2020). After the mental status examination and enquiring about the family history, I advised the parents to seek help since I evaluated Alex as having autism spectrum disorder.
As I interacted with Alex’s parents, who were now terrified of the discovery, I gave them hope by looking at insight into the Bible. According to the Christian perspective, God created humans in his own image (King James Bible, 2017). Every human has the status of being created in God’s image, no matter how much the image is marred by illness. The yearning to know why Alex was born with a developmental disorder would only conclude in judging God rather than bringing satisfaction in life. In addition, the Bible commands humans to love each other as God loved us. I reinvigorated their belief that God will provide everything for them to love and care for Alex.
Evaluation and Treatment
There is no defined cure for autism spectrum disorder; thus, the goal of treatment is to improve the ability of the child to function by suppressing the symptoms and supporting developmental changes. First, Alex should de medically diagnosed for developmental disorders at a well-child preventive clinic as recommended by the American Academy of Pediatrics. This screening is due to high-risk factors such as old parents and genetic hereditament. Second, Alex’s parents should enroll Alex in behavioral therapies such as applied behavior analysis (ABA), speech therapy, and cognitive behavior therapy (CBT). Applied behavior therapy helps improve communication and social living skills. ABA focuses on observable behavior such as abilities that would help the child in the long term and help them learn through repetition and reinforcement (Sherifi, 2018). Speech therapy is used to teach non-vocal children such as Alex the purpose of communication. Children are coached to comprehend communication breeds positive responses through gesturing and vocalizing requests. Cognitive behavior therapy is used to help children recognize the anxiety triggers for children with autism thus practices a different behavior to offer practical counteractions.
Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics, 9(Suppl 1), S55–S65. https://doi.org/10.21037/tp.2019.09.09
King James Bible. (2017). King James Bible Online. https://www.kingjamesbibleonline.org/
Sherifi, E. (2018). Therapies and Treatment for Children with Autism Spectrum Disorder:(Case Study). Mediterranean Journal of Social Sciences, 9(6), 157.