Clinical Team: Astrid's Communication

1) describe the types of difficulty that individual with an autistic spectrum condition may have with language and other ways of communicating with others

The client appears to be dressed appropriately for his age. Luis is able to dress with some of his mother’s assistance. Luis has a restricted affect. The client easily gets upset and angry when he is refrained from his preferred activities and objects. Luis displays a good motor functioning. Normally, Luis use a few words to articulate his needs and wants. With a moderate support, he can articulate his intentions in four to five word phrases. Luis is able to relate to the therapist with some restrictions. For example, he needs at least 30 minutes of interaction in order to fully engage in social interaction with the therapist. Alternatively, the therapist has to amplify reactions and animate gestures for Luis to relate to the therapist.

2. What should a therapist be aware of when taking note of a clients manner and content of talk?

Dual diagnosis refers to the co-existence of a developmental disability (DD) and a mental health problem, and those who present with this type of diagnosis receive support from a number of different experts on CAMH’s interdisciplinary team. Before any client is admitted to the inpatient unit, the team attempts to collect as much information about the individuals as possible (i.e. past diagnoses, family history, psychological/behaviour assessments, etc.) and document this information on their online database and in separate client binders located on the unit. In order to build a rapport with each other clients, I started by first reading each of their binders and files. This information gave me a better understanding of their strengths and needs, as well as the best ways to communicate. For example, client PC, presenting with ASD, DD, and ADHD, was mostly nonverbal and communicated by touching your hand and guiding you or by using loud vocalizations. While becoming familiar with his file, I learned that he could read, write and understand basic math equations at a grade 3 level. Using this information, I prepared a package filled with different worksheets and sat with him in the lounge while he completed them. Although he was nonverbal, he would communicate that he wanted me to mark his math homework by passing me the sheet and handing

Describe the types of difficulty that individuals with an autistic spectrum condition may have with language and other ways of communicating with others

Intervention: Ms. Smalls (MHP), Santonias and Ms. Givens (MHS) discussed Santonias complying with the rules of the home. MHP and Santonias had a discussing about his NFL football team as a way to build rapport. MHP requests feedback on possible goals from Santonias and MHS for Individual Plan of Care. MHP, Santonias and MHS discuss and process an incident that happened at the school’s gym.

1. This observation took place in the facility’s gym between the Occupational Therapist (OT) and an 8-year-old boy named Jacob. Jacob has been diagnosed with Autism. Jacob was standing on the balance beam, he had a claw in his hands picking up small been bags while maintaining his balance. The OT was standing a foot away from him and she (OT) was walking along side in case he was to fall. Jacob was telling the OT that he did not want to do it anymore, stepped off the beam and sat on the floor. The OT asked him to stand up, get back on the beam and finish what he was doing. Jacob said no and that he was tired. The OT told him that if he finished then he would pick what they were going to do next. Jacob looked at the OT smiled and asked if they could play the Wii. The OT said only if he got off the floor could they then play with the Wii. He got off the floor and then went to sit in a chair and still refused to continue the balance beam. The OT told Jacob that the session was about to be over and that they were not going to play the Wii because he did not follow directions.

The nursing role in this setting was screening of preschools and early head start children for developmental delays and abnormities. The different here is everything is brought to the children. The children/patients are pulled in groups of three, and some of them were pulled out one at time. The nursing students and Dr. Lee looked for signs like how do the children walk up steps compared to their age group. How do they hold a crayon? Can they throw a ball? Are they overweight for their age group? Do they have any signs of ear infection? We also assessed for lead toxicity in the blood. Many of these children did not like this. We found that distraction at this time results in the child not crying. The only requirements here was consent of the parent/ guardian and bring their child to daycare/school.

QP provided Maunica with a skill building activity geared towards medication management. QP explained to Maunica that the activity will provide her with information to take control of her medications and educate her on the side effect and important of take her medications as prescribed. QP asked Maunica, when was the last time she has seen her doctor. QP asked Maunica if she is taking any new medications. QP asked Maunica if she is taking her medications as prescribed. QP asked Maunica to list some of the side effect of her medications. QP discussed with Maunica the health goals of her medications. QP asked Maunica, what her personal health goals is. QP educated Maunica on medication management. QP explained to Maunica that she can talk to

“Nearly half of all American adults – 90 million people – have difficulty understanding and acting upon health information” (Institute of Medicine 2004). Communication is the number one tool in the health care system. Without communication patients will not receive the best care possible and their health will decline. When listening to the World’s Apart videos, I first noticed that each story had their own problem. When it came to Robert Phillips story, I felt like he was the most educated of them all. He was very informative of his disease and he understood what needed to be done for him to get better. However, he felt that due to him being a minority, he wasn’t receiving the best treatment possible. Furthermore, when it came to Mohammad’s

Organizations must respond to their internal and external environment. Therefore, organizational success heavily relies on leaderships ability to manage change. Unfortunately, many leaders struggle to effectively lead change initiatives. In fact, Ashkenas (2013, para. 1) reported 60 – 70% of organizational change initiatives fail to meet their objectives.

The simulation exercise presented a complex situation when Charge Nurse Janice didn’t have enough nurses in her unit and the VP of Support Services called and her about the scheduled meeting. At the start of the shift, she responded unprofessionally to the situation by giving directions to the staff while on a personal call and reacting negatively to any patient update provided by the staff. Janice also created a bad impression to Elise, the new nurse, when she asked about her assignment. Janice addressed the patients’ names with the procedures they had. Knowing that there was a situational problem, Janice should have communicated properly and emphasized to the staff about teamwork to facilitate the workflow in the unit. Elise is new and inexperienced, but Janice could have utilized her help with basic tasks as long as she had been directed and coached properly.

Teamwork and communication are very important in providing good quality care, especially in the healthcare field. A team is described as a group of people that works together and cooperatively, between each member of the group to reach a common goal (Sullivan, 2013). For a team to function, communication is essential. A report by McKay and Crippen (2008), as stated by Alfaro-LeFevre, (2013) showed that when collaboration is in place, hospitals can decrease their mortality rate by 41%. When mortality rate is lower, hospitals does not only decreased cost, but it also means that patients are receiving good quality care.

A~ presented as a related adult. He exchanged social greetings, showed affect readily, and was cooperative throughout the evaluation; however, he did not exhibit a flexible eye gaze and appeared nervous. A~ frequently looked down toward the floor and shook his left leg during the Understanding Spoken Paragraphs subtest of the CELF-5. He understood humorous language and responded by laughing or smiling. In addition, when discussing his hobbies, personal strengths and weakness, and favorite movie, he was verbose and used fillers (i.e., uh /ʌ/; um /ʌm/; like). He responded to the examiners, but failed to build on conversations, demonstrating a lack of social reciprocity.

You are concerned about the behaviour of one of the children with whom you are involved. You believe that this is due to learning development problems, and suspect this may be due to underlying medical issues.