Case Study: Brayden

Case Study: Brayden

1. Development delays

   • Poor cognitive development
     • Repetitive play
       • Repetitive behaviours are a common symptom for children diagnosed with Autism Spectrum Disorder (Yoder, Stone, Walden, & Malesa, 2013))
     • Brayden mouthing his toys
       • Studies suggest that prolonged mouthing of objects throughout play “reflects delay”, and may be an early sign of disorders such as Autism Spectrum Disorder (Vig & Jedrysek, 1999).
   • Poor physical development
     • Too small for his age
     • Poor gross motor development
       • Not yet walking
         • Shuffling on bum to move around
         • Michelle being concerned as they have friends with a younger child who is walking
   • Poor social development
     • Many children with Autism Spectrum Disorder require assistance in learning how to deal with various forms of social situations. They often have the desire to interact with others, but might not know how to actually engage, or could be overwhelmed by the experience. (Autism SA, 2019)
   • Poor communicative development
     • He makes no distinct words
       • According to Speech Pathology Australia (2019), at 12 months a child should be able to make eye contact and produce a few words. As Brayden is 17 months old and not producing any words, his oral communication skills are significantly delayed.
     • No eye contact when people enter the room
       • Early signs of Autism, including problems with eyesight, can be seen in infants aged 12-18 months (Yoder, Stone, Walden, & Malesa, 2009).

2. History

   • Health history
     • Early childhood
       • Reccurrent ear infections
         • Sign of Autism Spectrum Disorder
           • A study has determined that “autistic children had a greater incidence of ear infections than matched normal peers” (Konstantareas & Homatidis, 1987).
         • intermittent hearing loss, which may be hindering his language, cognitive, and social development (Konstantareas & Homatidis, 1987).
           • Speech pathology treatment is recommended as it can assist in speech and communication development. Specifically, can provide Brayden with alternate ways to communicate if hearing loss is recurrent (Konstantareas & Homatidis, 1987).
       • Not on hard foods yet, still drinking lots of milk and eating soft foods
     • Neonatal
       • Normal vaginal delivery
       • Small for Gestational Age
       • irritable and has difficulty establishing breast feeding
         • Bottle feeding commenced
           • Typically developing infants, are generally introduced to solid foods at six months old, and by 12 months, they should be eating minced or chopped family foods (More, 2013).
             • As Brayden is having difficulty feeding, intervention by a speech pathologist may be required to develop a healthy feeding routine
           • Brayden's father would like him to begin feeding himself
         • Brayden is a fussy eater
         • Breastfeeding has a positive impact on the development of a child's eating behaviours in infancy and early childhood, as they are introduced to flavours consumed by the mother (Birch, Savage, & Ventura, 2007).

3. Intervention

   • Possible future intervention
     • Potential hearing test
       • A child’s ability to produce meaningful speech may be hindered when they suffer from a hearing impairment (Oller, Eilers, Bull, & Carney, 1985). As children with impairments cannot adequately hear the production of other people’s speech, they are unable to imitate the sounds produced and hence may suffer from a speech/language delay (Lieu, 2004).
         • Appointments with a speech pathologist could assist with developing Brayden's communication and speech skills
     • Autism Spectrum Disorder Assessment
     • Educating parents appropriately to ensure awareness of child development to enable them to track Brayden's development
   • Past intervention
     • GP at 10 months, suggested that Michelle get support from Child & Youth Help for Brayden's feeding
       • Michelle has not managed to follow this advice
         • Brayden’s family have a low socioeconomic status, which may possibly contribute to children’s health care access and communication (Heck & Parker, 2002).
   • Poor education
     • Both parents are unsure of how Brayden should be playing or communicating

4. Family

   • Parents
     • Relationship
       • Mum controls care over the children
         • Exhaustion
       • Father isn't overly involved in the Brayden's life
         • More withdrawn parenting style, due to traumatic events in a parent’s life having long-lasting effects. For example, depression is significantly associated with a more withdrawn parenting style (Sim, 2009).
     • History
       • Father (Paul)
         • Poor parental relationships
           • No relationship with family/ his own father
           • His own parents separated when he was 8 year old
           • Lack of attention from his mother after she re-married and had younger children
       • Mother (Michelle)
         • Lack of present parental relationships
           • Father dying 11 months ago
             • Chronic lung disease
           • Mother dying when Michelle was 15
         • Social networks
           • Limited social support
             • Other family members live interstate
             • Michelle's sister moved to Mount Gambier before Brayden was born
             • A lack of emotional social support from family and friends aids informational support from health care professionals, and provides empathy, which assists in managing uncertainty (Glanz, Rimer, & Viswanath, 2008).
       • Potential poor mental health due to incidents in the past
     • Poor socio-economic status
       • Both parents being unemployed
         • Both patents left school at 15 with a series of unskilled jobs
       • Poor housing situation
         • On the waiting list for housing trust accomodation
         • Currently living in a rental flat
       • Mother has no licence
         • Considered a transportation barrier to Brayden’s lack of access to healthcare. Poor management could therefore be a consequence of delayed care in Brayden’s case, leading to poorer health implications (Syed, Gerber, & Sharp, 2013).
   • Siblings
     • Younger sister (Sienna)
       • Categorised as post-natally at risk
         • A genetic disorder is caused by a change in the DNA sequence. Genetic disorders can be caused by a mutation in one gene or in multiple genes. This can be by a combination of gene mutations and environmental factors, or by damage to chromosomes (National Human Genome Research Institute, 2019)..