Evaluation Contemporary Social Work

Autism Spectrum Disorder

Children are likely to be faced with neurodevelopmental conditions characterized by pervasive and severe impairment in communication, behavior and social interaction. In particular, a child will have communication problems regarding the use of verbal, and majorly non-verbal language, and behavioral problems are either repetitive, restricted or stereotyped. These symptoms can only lead to a child being diagnosed with the autism spectrum disorders (ASD) when they are less than three years old. In many real world cases, children with these conditions are not diagnosed with ASD until after a few more years than the three-year threshold. This is because parents will most likely miss the symptoms during infancy and it is hard to diagnose a child with ASD earlier than 18 months after birth. Also, the behavioral symptoms of ASD do not emerge clearly during infancy until age 3 (Toth & King, 2008). The autism spectrum is a general term for many other diagnoses with symptoms which are similar such as pervasive developmental disorders not otherwise specified, childhood disintegrative disorder, autistic disorder and the Asperger disorder. This paper targets to critically evaluate a contemporary social work theory in relation to working with a service user with a formal diagnosis of ASD with likely Asperger Syndrome.

Alex’s Condition

Alex has been newly referred to a community adult mental health team and I have been assigned to work with him. He is 19 years old and lives within the family home together with his father, mother and two older brothers. Alex exhibits anxiety and anger towards his family members. Also, he exhibits depression. For several years, he has refused to leave the house and majority of his time is spent in his bedroom. He shows keen interest in gaming. A diagnosis shows that he has ASD, most likely the Asperger’s syndrome.

Autism has a spectrum, which is a continuum ranging from mild up to severe, and Asperger syndrome is part of the continuum. More precisely, Asperger’s syndrome is regarded as the highest functioning and mildest end of the autism spectrum. Compared to other disorders in the continuum, children with Asperger Syndrome have higher cognitive ability and have a normal language functioning (Toth & King, 2008). Their cognitive ability can range from having a normal to superior measure of intelligence. They do not exhibit language delays unlike children with other disorders on the autism spectrum.

What will be noticed to be problematic by people like Alex, is that they will have deficits in pragmatic language. This means that their language in social contexts can either be repetitive or overly formal (Toth & King, 2008). Alex becomes angry and anxious when around his family members because he has a difficult time understanding or talking about the feelings of other people. Alex has stayed in the house for several years because he does not know how to interact with other people (Saraswati, 2018). Furthermore, he gets nervous when in large social groups. He spends most of his time in his bedroom because he has the want to remain alone. His narrow and obsessive interest is playing video games. In addition to his state, Alex will appear to avoid eye contact and speak with an unusual tone of voice (Saraswati, 2018). He will also appear to be awkward or clumsy and have repetitively odd movements (Toth & King, 2008).

The current mission of social work is to increase inclusion and opportunity for the most vulnerable population. This is aligned with high commitment to observing justice in the society. A set of theoretical frameworks and methodologies are established by social work researchers with a goal of fostering change in humanity and the society. The social work practice theory that I will use while working with Alex shall be the systems theory.

The systems theory considers human behavior to be influenced by various factors which work together as a complex system (Friedman & Allen, 2014). Using this theory, the way Alex thinks and acts will be determined by his friends, parents, economic class, home environment and school. The systems theory will target to correct the ineffective of missing parts of the system around him so as to ultimately have a positive impact on his behavior. Also, a change in his autistic symptoms will appear to have a positive impact on the ineffective parts in his system. While working with Alex, I will have to analyze and observe every system that contributes to his welfare and behavior and work to make them stronger. The system’s effectiveness shall depend on Alex’s expectations, rewards, individual needs as well as the attributes of people who are living within the system.

In application of the systems theory, I will have to analyze some of the impacts that Alex’s Asperger syndrome has on his parents, siblings and the environment. This is because ASD is a condition which has a ripple effect on the family system.

Impact on Parents Recent meta-sytheses and meta-analyses support the notion that Alex’s parents face greater stress of parenting compared to parents of a child without any developmental problems or other disabilities (Hayes & Watson, 2013). The stress arises from the challenges they face while caring for Alex’s needs. The main stressor for Alex’s parents was the long diagnostic process that is associated with ASD as many years were required between the first screening and the final professional diagnosis (Hayes & Watson, 2013). During the diagnostic waiting period, Alex’s parents experienced denial, lack of understanding and disbelief. If Alex’s parents are in the middle class of the society, the final diagnosis must have brought some relief to them. This relief arises because of the time and effort they must have taken trying to access reliable healthcare

Recent meta-sytheses and meta-analyses support the notion that Alex’s parents face greater stress of parenting compared to parents of a child without any developmental problems or other disabilities (Hayes & Watson, 2013). The stress arises from the challenges they face while caring for Alex’s needs. The main stressor for Alex’s parents was the long diagnostic process that is associated with ASD as many years were required between the first screening and the final professional diagnosis (Hayes & Watson, 2013). During the diagnostic waiting period, Alex’s parents experienced denial, lack of understanding and disbelief. If Alex’s parents are in the middle class of the society, the final diagnosis must have brought some relief to them. This relief arises because of the time and effort they must have taken trying to access reliable healthcare providers and the eventual ability to seek support services after diagnosis (Ooi, et al., 2016). Also, on a different point of view, Alex’s parents could be faced with negative effect where the diagnosis might have come to them as a surprise. This could have added extra layer of distress to Alex’s parents especially considering that they could be discriminated by the healthcare providers due to their social or economic status (Bishop-Fitzpatrick, et al., 2018).

Also, Alex’s challenging behaviors, such as anger and anxiety, as a child might have caused parental distress and this has a bidirectional impact on their relationship (Bishop-Fitzpatrick, et al., 2018). The more the parents show their distress, the more Alex has challenging behaviors and this will affect my efforts to intervene as it will be difficult and complicated to set up a reciprocal relationship (Ooi, et al., 2016).

Alex’s older brothers are likely to have less satisfaction in their sibling relationship. This low satisfaction can be accompanied with fewer positive behavior and more negative behavior being directed to Alex. Alex’s siblings could also have complaints about being given less relative attention due to having a sibling in need of high relative attention in the family. Alex’s older brothers could also be feeling embarrassed by Alex’s behavior during the moments he is in public (Orsmond & Seltzer, 2007). In some cases, Alex’s siblings may have lacked the opportunity to interact with their peers because of their active involvement in helping to care for Alex (Petalas, et al., 2009).

While working with Alex, I shall take into consideration environmental aspects so as to understand his condition in naturalistic setting. The systems theory maintains that the child’s development is affected by the environment and there also exists reciprocity in Alex’s effects on his surrounding environment. With Asperger Syndrome, Alex is growing within multiple contexts which interact to exert a bidirectional effect on his life. This means that Alex affects his immediate environments and, in turn, those environments affect each other. Thus creating a system of dynamically interacting elements (Fabrizi, 2015, p. 9). Apart from explaining the various ways Alex is affected, the systems theory will aid in developing the different ways in which Alex’s environments can be turned over into intervention methods.

The systems theory also describes separate layers of systems or environmental influence which affect Alex’s development. The primary system is called the microsystem which includes the people that Alex often interacts with. Alex interacted with his family in the initial years of his life and for the several years he has never left home. Therefore, his family is the primary influence. His older brothers, having lived with Alex are likely to have had feelings of isolation, frustration and confusion (Conway & Meyer, 2008). The home and family situation, especially during Alex’s early years, have several effects on his development.

The layer beyond the microsystem is known as the mesosystem. The mesosytem factors in the way Alex’s family and home environment interacts with other settings such as the school and peer groups (Fabrizi, 2015). As aforementioned, Alex’s siblings may have missed out on typical activities due to their responsibility of caring for Alex. His siblings may also feel that their peers do not understand their situation at home and this results in their feeling of isolation.

With the ideology that the systems theory considers human behavior to be directly impacted by complex systems, the incorporation of the family system will be important in setting up an intervention strategy for Alex (Karst & Van Hecke, 2012). Sibling incorporation to the strategies of intervention does not only benefit Alex, but also his siblings. One way for intervention could include Alex’s siblings developing learning strategies that facilitates them such as teaching or modelling skills. Play intervention could be applicable where Alex’s older brothers spend time with him, taking part in some of Alex’s favorite activities, such as gaming. For this intervention to be successful, it will be important to measure the motivation of Alex’s siblings, then developing play sessions with particular objectives for Alex and his brothers (Fabrizi, 2015). Applied Behavior Analysis This involves the approach towards changing one’s behaviors using procedures founded on established learning principles. Considering that I will have already taken time to identify Alex’s problem behaviors, analyzed his needs, the causes and impacts of his behaviors, I will try to modify his behavior using positive reinforcement and conditioned responses (Nee, 2013). The main goal of this approach is the complete elimination of undesired or maladaptive behavior. While observing Alex’s behavior, I will need to note down the antecedent; what comes before the behavior, followed by identifying the behavior which needs to be changes, and the consequences after the behavior. Identifying these three aspects will help in the changing of Alex’s maladaptive behaviors. To reinforce the appropriate behavior, I will require fluency, which is the quick, non-hesitant a

The ABA approach will place high significance to the behavior to be changed, its quantitative traits, the manipulations that will have to be made in testing, so as to clearly analyze the cause of the change and placing a technically accurate description of all the processes that lead to the change (Nee, 2013). The approach insists on measurability, where I would have to review and keep track of the progress frequently. The approach also has seven dimensions: a Applied, b) Behavioral, c) Analytic, d) technological, e Conceptually systematic, f Effective, and g Generalizable dimensions (Nee, 2013). The initial three dimensions give the approach its name and helps in identifying Alex’s behavior which suits this treatment. This behavior could be anger, or anxiety, or depressive behaviors. The rest of the four dimensions will guide me on the effective implementation of ABA (Nee, 2013).

Technological documentation of the intervention procedure will allow another social worker to replicate and produce the same results with them. By being conceptually systematic, the techniques I shall use to modify or eliminate some of Alex’s behaviors will be backed by scientific evidence and proof to work. By being effective, I shall be able to show that my intervention procedure is improving, and this will be presented on charts and other methods of data collection. In the last dimension, my intervention procedure shall prove to have generalizable capabilities on different settings (Nee, 2013).

Bibliography

• Bishop-Fitzpatrick, L. et al., 2018. Autism spectrum disorder and the science of social work: A grand challenge for social work research. Social Work in Mental Health.
• Conway, S. & Meyer, D., 2008. Developing support for siblings of young people with disabilities. Support for Learning, 23(3), pp. 113-117.
• Fabrizi, A., 2015. Effects of Autism Spectrum Disorder: A Closer Look at The Typical Sibling.
• Hayes, S. A. & Watson, S. L., 2013. The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism & Developmental Disorders, 43(3), pp. 629-642.
• Karst, J. S. & Van Hecke, A. V., 2012. Parent and family impact of autism spectrum disorders: A review and proposed model for intervention evaluation. Clinical Child Family Psychology Review, Volume 15, pp. 247-277.
• Nee, J., 2013. Behavior & Developmental Treatment Models forAutism Spectrum Disorders: Factors GuidingClinician Preference and Perceptions. Master of Social Work Clinical Research Papers, pp. 11-16.
• Ooi, K., Ong, Y. S., Jacob, S. A. & Khan, T. M., 2016. A meta-synthesis on parenting a child with autism. Neuropsychiatric Disease and Treatment, Volume 12, pp. 745-762.
• Orsmond, G. I. & Seltzer, M. M., 2007. Siblings of individuals with autism spectrum disorders across the life course. Mental Retardation and Developmental Disabilities Research Reviews, Volume 13, pp. 313-320.
• Petalas, M. A. et al., 2009. "I like that he always shows who he is" : The perceptions and experiences of siblings with a brother with autism spectrum disorder. International Journal of Disability, Development, and Education, Volume 56, pp. 381-399.
• Saraswati, P., 2018. A Review: Asperger Syndrome. BiomedSci & Tech Res, 2(1). Toth, K. & King, B., 2008. Asperger’s Syndrome: Diagnosis and Treatment. American Journal of Psychiatry, 165(8), pp. 958-963.