Tuesday, July 8, 2014

July 8 Post Seven

Hannah finally convinced Ali to see a doctor, since his symptoms had grown worse.  The results revealed that Ali had Lyme disease as well as pernicious anemia. Studies show that hemoglobin issues are prevalent in people of Arab descent.  One specific genetic disease is sickle cell anemia which is usually diagnosed in infancy or early childhood. Other studies have shown incidences of pernicious anemia in Arabs as well.  The clinical symptoms matched the symptoms Ali had been experiencing. The treatment involved vitamin B-12 shots. The Lyme disease, which also presents with similar symptoms, was treated with antibiotics. His doctor felt that Ali’s case of Lyme disease was mild but was compounded by his pernicious anemia. The cultural attitudes of Arabs surrounding health care make it problematic for health care providers. These include obtaining adequate information, “demanding behavior” by patient’s family, conflicting beliefs about planning ahead and different patterns of communicating grave diagnosis or “bad news.” (NCBI).
  This added to the stress surrounding their financial difficulties since Ali had to take a pay cut and they were having trouble meeting monthly expenses.  In addition, Ali’s health issues placed more responsibility and stress on Hannah which affected her ability to be consistent with the ABA techniques with Aaron at home. In addition, Ali’s health issues kept him from attending counseling, and Hannah’s increased responsibility and stress caused her to stop counseling. In the absence of counseling, and increased stress posed by Ali’s illness, and financial problems, the Shakur’s marital issues resurfaced.
Aaron entered middle school and behavioral issues had begun to escalate. Aaron had begun to demonstrate aggression toward peers and staff. The behaviors included hitting, kicking, and throwing objects out of frustration. These aggressive behaviors posed problems for Aaron’s suitability for continued participation in the inclusion program. It is not uncommon for students with autism to require a small class setting with greater staff to student ratio. Fewer students and an increase in staff facilitated better behavior management. The smaller class offered a less stimulating environment, continued use of ABA, as well as augmentative communication such as communication boards and wallets, and electronic communication devices. In addition, the small class setting provided the continuity of structure that students like Aaron require.
Aaron had been reevaluated, and entered a small class setting at the beginning of seventh grade. The program would focus on behavioral and social skills with an emphasis on functional academics and life skills. Aaron’s IQ of 45 placed him in the moderately deficient range and would require a functional/adaptive track in special education until the age of 22. This placement served to increase the stress for Hannah and her family because it reinforced the stigma attached to special education. Up until this change, Aaron was in a general education setting as part of an inclusion program, so the stigma was not as great. In addition, Aaron was older and the increase in negative behaviors became a source of embarrassment in public places. For Muslims, intellectual disabilities are believed to be caused by “mental illness, possession by Jinn, supernatural phenomena, and punishment for previous sins.” (Muslim Village). Such beliefs only serve to reinforce the stigma, negative attitudes and discrimination.
            In order to deal with Ali’s pay cut, Hannah had found a new part-time job which paid more. Ali’s B-12 shots have helped to increase his energy level and the antibiotics have succeeded in treating his Lyme disease. This has enabled him to return to work and be more available to Hannah at home. Ali’s family helped them meet some expenses until Hannah found the new job. The added stress on Hannah, Ali’s illness, along with Aaron’s need for special class placement had contributed to an increase in depression and a change in her antidepressant medication.
            Positively, Kayla and Amir remained active with school and have moved on to high school. Since they have matured, there is less competition for attention from their parents. They are more supportive and helpful since they learned of their father’s illness and their mother’s increased depression. With their support, Hannah’s new job, and Ali’s improved health, it has served to unite the family and have them function more as a unit. This has been extremely helpful in relieving Hannah’s stress level and focus on managing Aaron as a family.
            After completing his first year in the small special education class, Aaron has begun his last year in middle school.  Aaron had begun to demonstrate some improvement in his behavior as well as his communication skills. He had begun to use a communication board which had served to reduce his frustration.  Aaron learned to identify and count money receptively, learned to tell time receptively, and receptively identify common sight words in his environment as well as simple words in picture books. His arm flailing had been reduced to a minimum, and his obsession with fire alarms was constructively used to teach fire safety. It was discovered that his obsession was rooted in his fear over the sound of the alarm. Fire drills are common in schools and the sound of the alarm can upset students with autism due to their sensory integration issues. Students with autism have a difficult time blocking noises in their environment. They are often hypersensitive to noises and often respond negatively.  Efforts were made to prepare Aaron for a drill and prepare him for the alarm. In addition, the staff worked on desensitizing Aaron to the noise.  This helped in reducing his obsession and negative reaction to the alarm itself
            Unfortunately, Aaron’s improvement in behavior did not transfer to his home life. He continued to be aggressive at home, which at times frightened his family. Unlike the small elementary school boy, Aaron was about to enter high school and his physical stature was tall, heavy, and powerful. When he became aggressive, he had the power to hurt someone.

Questions:
1.     Given Aaron’s moderate intellectual deficits, would a child like Aaron have been better served in a special education program?
2.     How do cultural beliefs impact decisions in education, medical treatment and socialization?
3.     What is the prognosis for children like Aaron to live an independent life?

Decision Question:  Do Aaron’s parents seek residential placement for Aaron?




1 comment:

  1. Questions:
    1. Given Aaron’s moderate intellectual deficits, would a child like Aaron have been better served in a special education program?
    Special Education programs can really benefit children with moderate intellectual deficits, and Aaron could have been better served in one. Special education is needed for children with moderate intellectual deficits. It can assist a person with becoming more self sufficient in life (Go Mentor 2014). A special education program would help Aaron more in school and could potentially have a good benefit on his home life as well as his future.

    2. How do cultural beliefs impact decisions in education, medical treatment and socialization?
    Cultural beliefs definitely impact education, medical treatment and socialization. In education, differences may cause teachers to inaccurately judge students from a culture as poorly behaved or disrespectful due to the way a child has just been brought up in their own culture. Also, cultural differences can be hard to perceive so students may find themselves getting in trouble but fail to understand what they did that caused their punishment. For medical treatments, different cultures have different ideas of what causes illnesses, how they can be treated and who should be involved. For example, in a lot of Middle Eastern countries, families aren’t accepting of diagnoses of mental or emotional illness because it reduces the chances of other people in the family of getting married (Euromed Info).

    3. What is the prognosis for children like Aaron to live an independent life?
    In order for a child like Aaron to live an independent life, a few things need to happen. He needs to learn manners in order to function properly in society. He has to learn turn taking a sharing, as well as expanding interests into skills and services in order for him to eventually have a job. It would also be helpful for Aaron to find a mentor because this can really influence him to do well and would be of good guidance for him.

    Decision Question: Do Aaron’s parents seek residential placement for Aaron?
    It may be beneficial for Hannah & Ali to look into residential housing for Aaron if things continue to go the way they are. A few of the benefits include care into adulthood, jobs, social life and safety. Residential facilities will provide care into adulthood to people with Autism. Most parents worry about their children not having the right care, but a residential facility will provide this. While living in a residential facility, people with Autism are taught skills and trades that will qualify them for a job and a lot of these facilities contract with local employers. Also, residential facilities provide recreational spaces for their residents as well as communal spaces in order for them to engage in more social activities with others. There is also a lot of supervision in these homes for the more violent people, they also provide a safe and structured environment for families to come visit. Newer facilities help children with Autism learn behavior modification and life skills as compared to the facilities from back in the 70’s. They used to be ignored and institutionalized but things have come a long way.

    http://autism.answers.com/schooling/benefits-of-an-autism-boarding-school
    http://www.autism.com/grandin_independence
    http://www.euromedinfo.eu/how-culture-influences-health-beliefs.html/
    http://www.ncld.org/students-disabilities/iep-504-plan/benefits-individualized-education-program
    http://www.gomentor.com/articles/moderate-intellectual-disability.aspx

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