Medical History of Patient With Autism Spectrum Disorder (ASD)

DESCRIPRTION OF THE MENTAL ILLNESS

ASD as a disorder is a pervasive developmental disorder, autistic disorder or Asperger's disorder, not otherwise specified contributed to under development in children. The primary deficits correlated with ASDs are communication and social interaction impairment and presence of unusual interests and behaviors. Autism arises in all socioeconomic, ethnic, and racial groups and occurs more in male children than girls. ASD is commonly referred as a severe secondary disability to the profound implications it has on children diagnosed with autism and their family. Autism as a spectrum disorder is classified as different impairment degrees in diagnostic areas, medical, psychiatric, development, and behavioral problems. The behavioral problems may be related or linked to sensory differences, self-injury, hyperactivity, disruption, and aggression. Bayat, (2007) describes the three functional outcome predictors: age of diagnosis, the age of language for acquisition and cognitive status. These characteristics are referred to as Triad impairments. Individuals with severe ASD are bound to develop a speech with impaired communication skills. Autistic adults have problems around social relationships and appear withdrawn and uninterested in individuals they come across. Such individuals may have friends but look clumsy or awkward in social situations. The problems with social imagination do not allow individuals with ASD to predict and understand other peoples behavior or imagine situations beyond daily routine, for example interpreting the actions, feelings, and thoughts of other people. Such individuals needs access intervention services and appropriate diagnostic referrals before a definitive diagnosis is made to help control his problems in social setting and work. Most studies describe that adults with autistic require consistent therapy. Speech and Cognitive Behavioral therapy is one of the services offered to individuals suffering from autism followed by families using occupational therapy.

PRESENTING THE PROBLEM

The client has problems with initiating and maintaining social interactions and seems not to enjoy interacting and engaging with the social worker because he seems not able to take turns during conversation. Distal gestures, gaze shifting, body language and rules of proximity are lacking with receptive language appearing less expressive than delayed. The client has a typical vocal production with abnormal prosody as he speaks quickly- the speech sounds more robotic than normal. The client has deficits of emotional learning, as he is unable to control his emotions and reactions during the communication. The client was referred by Detective Lestrade because the client has problems dealing with changes in routine while at work, often aggressive, cry, and laugh at inappropriate times or for unknown reason while on duty. The detective also maintained that the client is extremely intelligent and he has unusual ways viewing criminal cases and activities.

The client needs access intervention services and appropriate diagnostic referrals before a definitive diagnosis is made to help control his problems in social setting and work. Psychological therapy and interventions like Cognitive Behavioral Therapy or any other form of psychological intervention can be used in targeting his behavioral and functioning problems to improve his general relaxation and adjustment skills.

LIVING SITUATION

Sherlock Holmes is capable of living independently but instead of being completely self-sufficient, he lives in a rental house together with his friend, John Watson, whom they have a very close relationship. Significant members in his family include his brother Mycroft Holmes, his mother Lydia Mycroft Holmes and his father Robert Holmes.

SOCIAL INFORMATION

Primary/family/Marital/Significant other Support Systems

Lydia Mycroft Holmes-Mother

Robert Holmes-Father

Mycroft Holmes Brother

John Watson-Best Friend

Molly Hooper-close core worker whom she is in love with

Mrs. Hudson-landlord

Detective Lestrade- friend and a core worker

Mary Watson-friend/Johns wife

Pertinent Family History

No MH

No Aod

Strengths and Capabilities

The client is loyal and dependable as a consulting detective because he is conscious, faithful, and devoted to his duties more than anything

He pursues ideas he believes in without being swayed by others opinion.

He is good at noticing and classifying patterns. This gives him the intelligence when working on different cases.

He is sincere, genuine, and positive, making him dependable and loyal.

He is good at noting and recalling details, which make him helpful at work that needs memory, details, and facts.

He has an acute sensitivity to stimuli and unusual sensory experience that give him a different way of viewing the world.

He does not mind engaging in solitary work and is persistent when working on something.

His relationship with his family and friends is free from bias.

Limitations of Activities of Daily Living

He has problems in developing motivation on areas has no interest

He has difficulty in planning long term tasks

He has hard time sticking to the budget due to impulsive spending.

He has no clear vision on his priorities and what he wants to spend money on

He has poor money management especially saving, budgeting and paying bills.

Friendship/Social/Peer/support Relationship

John Watson-Best Friend

Molly Hooper-close core worker whom she is in love with

Mrs. Hudson-landlord

Detective Lestrade- friend and a core worker

Mary Watson-friend/Johns wife

Meaningful activities

The client volunteered to assist detective Lestrade with cases and investigations.

Community Support/Self Help Group

Not Applicable

Religion/Spirituality

Christian (including Catholic Protestants, Church of England, and all other Christian denominations)

Cultural/Ethnic issues/information/concern

There is equality in accessing primary care

Confidentiality of patients can be compromised

Empathy and Engagement may be hard for patients or health care providers to recognize or communicate

The expression of symptoms may be influenced by linguistics or cultural influences

Religious or cultural view on ASD

Health can be explained by socio economic differences

Developmental Issues

Problems in using social skills to connect with others

Repetitive and restrictive patterns of behavior, activities and interest

Trouble with communication skills

Sexual History/Concerns

Not Applicable

EDUCATION/EMPLOYMENT AND MILITARY INFORMATION

Education History

Sherlock Holmes education career began from the first grade until the twelve grade. He later joined college and studied bachelor of Chemistry/Anatomy. Currently, he is studying a bachelor degree in forensic science.

History of Learning Difficulties

No learning disability, mental retardation, or special school placement was reported

Barriers of Learning

No barriers to learning or any other barriers were reported

Special Communication Needs

No special communication needs reported

Employment

Working part time by helping detective Lestrade with cases and investigations

Not in Labor Force

Sherlock Holmes is not in labor force, he only helps detective Lestrade with cases and investigations

JOB PERFORMANCE HISTORY

For the last five years Sherlock Holmes, has only worked part time as an assistant and consulting detective Lestrade in New Scottland Yard. His attendance during normal working hours has been normal and his performance has been exemplary especially with investigations and cases. Sherlock Holmes is satisfied with the job as an assistant and consulting detective. He is not experiencing financial problems because his parents finance him regularly and detective Lestrade pays him a good sum of money.

Comments on Past or Current Employment/Educational skills/interest

Sherlock Holmes current work in helping detective Lestrade with cases and investigations has helped him in spending his uncommon amount of free time. By getting involved in a number of cases, he developed an interest and studied Forensic science. He is devoted in solving and, matching unidentified cases. This is where he gets emotional satisfaction. Apart from helping Lestrade with cases, he spends most of his time helping other detectives in solving other mysterious cases. He is so happy to have the ability to work on criminal cases, but only when private investigators and officers agree to collaborate with him. His skills in chemistry and Forensic science have been so instrumental in his life. Sherlock Holmes has no history of serving in the military.

MENTAL HEALTH TREATMENT HISTORY

Outpatient Mental Health/ AoD Treatment

None reported

Psychiatric Hospitalization

None reported

Previous or Current Diagnosis

Not known by the client

Other Comments Regarding Mental Health Treatment History

No Comments

CURRENT MEDICATION INFORMATION

No primary care received from any physician

PAST AND PSYCHOTROPIC MEDICATIONS

No psychotropic medication reported

ALCOHOL/DRUG HISTORY

The client reported that in the past 12 months he has not abused alcohol or been prescribed by any drug abuse. However, the toxicology screening indicated traces of cocaine in the system of the client. Thus, the only drug or substance abused by the client is cocaine surfing, which he started at the age of 25.

ALCOHOL/DRUG TREATMENT HISTORY

No AoD treatment available

LEGAL HISTORY

Legal Guardian/Custodian

None reported

Current Legal Status

None reported

History of legal charges

None reported

List and Date Most Recent Legal Charges

Not applicable

Convictions

None reported

LEGAL HISTORY

Incarnations

The client has not been prisoned in any time of his life

Civil Proceedings

None has been reported

Juvenile Court Involvement

None has been reported

Child Support Enforcement Orders

None has been reported

Childrens Protective Services Involvement with Family

None has been reported

Name of Childrens Protective Service Caseworker (s) Assigned to Family

None has been reported

ABUSE HISTORY

No history of abuse or violence reported. This, the client was not a victim of self-abuse or perpetuated any form of abuse.

DIAGNOSTIC CRITERIA

Currently, there are no biological markers are reliable for ASD. ASD is mainly diagnosed based on clinical impression, developmental history, parental interview, and behavioral observation (Baker-Ericzen, Brookman-Frazee & Stahmer, 2005). The gold standard tools of diagnosing are commonly used in conjunction with the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. Autism Diagnostic Observation Schedule is a play based semi-structured communication assessment, play skills, and social interaction. It is designed to communicate and elicits social behaviors. Autism Diagnostic Observation Schedule has four different modules utilized based on the language and developmental level of a child being assessed (Stewart, Barnard, Pearson, Hasan & OBrien, 2006). The ADI is used as a standardized caregiver interview utilized in the ASDs differential diagnosis. There are also major diagnostic tools and additional screening tools that are available to physicians to screen autistic children.

INTERVENTIONS

Many approaches and services can be used in treating Sherlock Holmes. Most studies describe that adults with autistic require consistent therapy. Speech therapy is one of the services offered to individuals suffering from autism followed by families using occupational therapy. A number of interventions and strategies can be used by adults suffering from ASD.

Service Delivery system

There are a number of services for adults suffering from autism. These sources of therapy can be accessed through Early Interventions (EI). Early intervention is essential in...