Case study on human development

Introduction

Rutter and Rutter (1992) define lifespan development as “the systematic, intra-individual change that is clearly associated with generally expectable age related progressions and which is carried forward in the same way that has implications for a person’s pattern or level of functioning at some time later.” While the latter definition may not be an all encompassing definition, it generally captures the most essential traits i.e. that development is age specific, that it largely depends on an individual and that it has long term repercussions.

The latter definition will act as a guide in the case study. The essay will use concepts and then apply them in the field of study to assess the problems of a twelve year old boy who lives with a single parent suffering from a somatic illness known as multiple sclerosis.

Hierarchy of concerns & issues that worry me the most

There are a series of issues currently going on in the life of this child. A large number of them can be explained by the bio-psycho-social model of development. It is essential to always start with the most important issues and then follow them up with other details that can be carried forward in this child’s life.

The first point of concern is with regard to James’ psychological needs. Berk (2008) asserts that children brought up by ill parents have high chances of developing psychological maladjustment. Regardless of the diverse challenges that different illnesses present to different children, most of the cases can result in similar emotional and psychological repercussions.

Clearly, this is the case with James. In the case study, the parent under consideration; Cathy has multiple sclerosis; the disease has unique characteristics that generally affect a child in a unique way. Multiple sclerosis (MS) usually starts impairing patients at later stages of life. Usually, this can occur after they have started a family and after their children have grown to a reasonable age. In the case of Cathy, the disease’s symptoms have started manifesting themselves at a time when her son needs her the most. This has numerous repercussions on James’s development owing to the fact that this stage in his lifespan has considerable effects on his future.

Jhyiong (2008) explains that parents with multiple sclerosis tend to feel as though they are burdening their children. This is an issue for James because the symptoms of MS generally impede a parent’s ability to go about her parental duties. Some of the problems that could be hampering Cathy’s ability to perform her parental role include;

·        Cognitive impairment

·        Fatigue

·        Pain

·        Loss of vision

·        Loss of balance

All the latter symptoms could explain the fact that James’s home is in utter disarray. Because of the loss of balance and pain, James’ mom has to use a wheelchair for mobility. This means that she cannot attend to normal household chores as she should. While household chores are not a priority issue, they indicate Cathy’s psychological state. As a mother, she cannot control the nature of her child’s life, additionally; things have spiralled out of control in her son’s life. Consequently, this is reflected by external features such as the broken window that could not be fixed or the piles of clothes and rubbish that have not yet been collected by this mother.

It seems that James may be exhibiting signs of oppositional defiant behaviour. This is a form of behavioural disorder and can be quite dangerous if left unchecked. Statistics show that behavioural disorders are the most common reason for referrals to mental institutions for adolescents (Murphy et al , 2001) the latter authors describe oppositional defiant disorder as a disorder of  psychiatric nature that causes individuals to irritate others or to be aggressive.

Usually, adolescents with such disorders tend to loose their temper very easily; they also defy rules, are angry most times and may also depict cases of spite or vindictiveness. James has already shown some of these signs. His deputy principal called him “naughty” implying that he has exhibited some defiance.

Additionally, he is constantly angry as seen by the fact that he frequently runs away from class and that he often breaks things. These issues are cause for concern owing to the fact that they could cause considerable disturbance in relation to James’s academic, social or occupational functioning both now and in the future. Already, they are affecting his academics and worse things may be forthcoming.

There are a number of social and interactive issues that are still plaguing this family. For instance, James is living in a single parent home. This can already bring out certain negative behaviour even when a child does not have to cope with an ailing parent. However, the situation is further propagated by his lack of a father figure. The bio-psycho-social model of development puts forward the fact that one’s family and culture has a tremendous impact on one’s behaviour during childhood and adulthood too.

Consequently, when one misses this essential component during their growth, then they may develop more problems in the future. James is missing out on important paternal love yet the only parent who is available cannot show her love to her children because she is taken up by the complications of her sickness.

Why there is cause for worry using human development (with regard to relationships)

Many developmental theories acknowledge the importance that parents play in a child’s life. In this case, James is having difficulties understanding his role as a child and his mother is also having difficulties managing her role as a parent. In their journal “Emotional responses of children and adolescents to parents with multiple sclerosis, vol. 11, no. 4. Pp 464-468”, Rivka et al (2005) claim that there may be a need to look at the emotional burdens that come with raising a child with multiple sclerosis. In the case study, James has no one else to turn to in terms of responsibilities in the household.

His mother is not capable of performing her responsibilities and this leaves everything to James. However, because James is too young, then he cannot deal with all the responsibilities that come with running a household. Consequently, the lack of coping mechanisms causes James to act out. This is the reason why he is depicting a lot of anger hence the reason why he was destroying property within the household.

Another issue that Rivka et al (2005) asserted in their journal was with regard to the sense of burden within a home. The latter researchers claimed that children brought up in a home where their parents had MS were overwhelmed by a sense of burden than their counterparts in other homes. According to these authors, such children may depict this sense of burden through mental illness and mental disorders.

Consequently, this is a cause for worry for James. As it can be seen in the first visit, James may have to take care of his meals or to do other things that boys his age may not be ready to do. Consequently, there is a cause for concern because the boy may be missing a crucial stage of development by taking on duties which are not meant for him.

How human development affects assessment of harm and likely harm to this child (interplay of biological sociological and psychological domains of development)

According to the socio-learning model of development, children take up influences from their surroundings. Since most of them are around their parents, then their parents’ behaviours are likely to be reflected on them. (Welch, 2004)The author refers to previous work done by other psychologists who assert that when children are raised by parents with somatic illnesses, then those same children may begin complaining of similar symptoms. But most importantly is the fact that children who have been brought up by depressed parents are also likely to adopt a depressive stance in life.

This maybe the thing that is happening to James currently. James’ deputy principal asserted that the boy had been a very cooperative child in the past. However, he seems to be distracted in class; this could be an indication that James may have started developing a depressive stance in life. If no intervention is conducted, James may grow continue with that attitude throughout his life.

Besides this psychological aspect, the social learning theory implies that children are largely affected by considerable social and psychological factors thus creating diverse outcomes in different children. For instance, their parents tend to care less about the needs of the child and this creates a void which is manifested in deviant behaviour. James’s mother lacks the ability to take care of her child’s needs properly. She cannot monitor his academic progress, his social life or even his basic needs. Failure to meet these needs could lead to certain malfunctions in the boy’s future life.

Poole, Warren and Nunez (2008) explain that certain psychological malfunctions are synonymous with lack of family guidance. Yhiong (2008) further adds that children raised by parents with Multiple sclerosis are more likely than their counterparts to exhibit dependency longings, interpersonal constraints in relationships, false maturity, hostility, anxiety, dysphoric feelings, and body concerns.

These assertions were reached after a study conducted among sixty children who had a parent with MS. The results of the study were compared to a control experiment conducted among two hundred and twenty children. It was found that not all children exhibited these negative reactions, however, a large percentage of them did.

The same harm may befall James in the future even though certain features are already being depicted currently. For instance, James is showing dependency longings by some physical signs. During the first visit, James clung to his mother and looked at the social worker with suspicion. This implies that the boy already has this trait. Additionally, his interpersonal relationships have been affected because his deputy principal reported that he has flight tendencies in class since he tends to ran away from school when confronted with any situation.

Furthermore, James is also manifesting signs of anxiety which are usually attested to children growing up with parents suffering from MS. He depicted these signs in school as seen in his poor school performance and also through constant distractions in the classroom.

Numerous developmental authors have asserted that emotional aspects of growth have a large impact on the physical aspects too. (Berk, 2008). It is quite common to find such children developing physical conditions such as allergies, obesity or malnutrition. In James’s case these physical conditions have been manifested by his small size. Upon visiting James, it was very clear to see that his body size indicated that there were some unsolved emotional issues. His size was too small for a twelve year old. In close relation to physical condition is the recurrence of nightmares. While this symptom was not diagnosed in James’s case, there may be a possibility of the situation developing in the future.

It should be noted that children bought up by parents with multiple sclerosis may be at risk of developing an internalizing disorder. However, the certainty of these issues has not been clinically proven by psychiatrists. Although many writers agree that this can occur in the future as explained by Rivka et al (2005)

In the future, it is also likely that James may develop psychopathological characteristics. This was an assertion made by Decaoiros (2008). In his journal, he explains that such children were at a higher risk than most when it comes to developing the disease. Adolescents who have been brought up in an environment where there are economic difficulties, marital distress & psychological distress are all at a higher chance of getting psychopathological disorders. This means that James could develop these symptoms in the future.

Besides this issue, James may be at a very high risk of developing psychosocial problems in the future because of the negative environment around him. In their journal entitled “Mental health problems in children with somatically ill patients e.g. multiple sclerosis, vol. 16, no. 3, p 23-47” Steck et al (2007) asserts that children brought up in such homes are definitely at a higher risk than their counterparts when it comes to developing internalising disorders.

The research was conducted among a total of one hundred and forty four families and it was found that a large percentage of children from MS backgrounds portrayed symptoms of internalising disorders in comparison to their siblings. In fact, such children had three times as much prevalence of the disorders than their counterparts who came from non MS homes.

Positive and negative consequences for each family member

The first person that could be affected by the current situation is James. As the case is currently, James is living with his mother. This is a positive aspect because she can provide him with the psychological and developmental needs that mothers provide their children. Additionally, for the parent, the positive consequence of the scenario is that she has the opportunity to take care of her son and is made aware of any harm that could befall her son as she is around.

However, there are numerous negative consequences that arise out of this scenario. First of all, James can grow up to be a deviant teenager or even a deviant adult. He may exhibit extreme behavioural difficulties in the future. His mother will also be considered as a failure because she failed to bring up her child in the most appropriate way. Additionally, his father may also be affected because he failed to meet his obligations as a father.

Why intervention is required

Intervention within this family is required as soon as possible because James is manifesting signs of more complicated scenarios in the future. For instance, the boy has depicted mild forms of oppositional defiant disorder. If left unchecked, these could catapult into more severe symptoms or they could even cause conduct disorder in the future. In order to prevent such occurrences in the future, it is necessary to look for strategies that can prevent it in the end. (Liben, 2008)

Intervention strategies need to be adopted as soon as possible because James’s mother has not been able to handle her responsibilities so far. She is divorced and therefore has no help from other family members. Additionally, her ability to look for a job has also been severely undermined by the illness and this could be the reason why she cannot afford transport services for her child. Also, this could be the reason why she could not hire help to take care of other responsibilities within the home like tidying up.

This was depicted by the untidy lawns. If this mother cannot attend to some of these simple duties, then chances are that she may not be able to deal with the more radical challenges like when James falls sick and is need of medical attention.

Aim of the intervention

The purpose of the intervention will be to provide James with all the social, emotional and psychological needs that he may be missing out in his current state. Murphy et al (2001) assert that children with oppositional defiant disorder usually record the most positive responses to family therapy and other intervention strategies compared to their conduct disorder counterparts. It has been shown that early interventions work best for behaviour disorders.  Consequently, the purpose of the intervention will be to tackle these needs.

Additionally, since James’s father is still alive, it may be necessary to involve him in the intervention process. James should be taken for intervention sessions with a well qualified psychiatrist. In those meetings, James can reveal the nature of his frustrations by exposing them through his therapist.

Besides this, it may also be necessary for his father to be involved in his life. His father should be trained on how to cope with his situation through cognitive models of therapy. Thereafter, he should do his best to take care of all the psychological needs of his son as is the case with the rational emotive therapy session. It should be noted that for these intervention strategies to work, James should undergo continuous observations and meetings with his therapist as soon as is possible. (Jhyiond, 2007)

Issues that can be resolved without intervention

One of the problems that can be solved without intervention relates to James’s social environment. Research by Boyd and Bee (2008) found that children who engaged in greater amounts of social activities had higher chances of excelling in their academics. Additionally, such children also reported better psycho-social adjustments in comparison to those who led sedentary lifestyles. This was because after school activities go a long way in dealing with the emotional and social problems that come with adolescence.

In the case study, James does not participate in any after school activities. This may be particularly complicated especially when he has difficulties attending normal classes in the first place. Perhaps the reason behind this is that James’ life is unpredictable. In certain instances, his mother may be fit enough to conduct her motherly duties, however, in other situations she may be too ill to take care of James. Consequently, James may have to avail himself at home instead of focusing on his school work.

The first thing that can be done is by involving James in a structured after school program. The school can arrange this by offering free transport to and from those activities. James can get some positive influences from such an arrangement. Besides that the after school activities can create a sense of predictability in his life. His peers can also boost some of the self esteem issues that he is dealing with currently. (Liben, 2008)

One of the other issues that can be resolved without intervention is the need to open the pathways of communication between the two family members. James’s mother needs to explain some of the reasons why she does not meet all his needs in order to reduce the excessive anxiety/anger/deviance that James has exhibited. Additionally, he can plan her time with her son so that when she feels a little bit strong, she can tackle the problems that her son may be undergoing t nay one time.

The last and most important change should be to deal with negative traits that come with his mother’s disease. It should be noted that having a somatic disease is not a life sentence for parents. It also does not mean that one cannot parent a child. Morrison and Shaffer (2002) assert that parents with such conditions need to look for mechanisms that can help them to cope with the disease more sufficiently.

First of all, such parents need to look for assistance because raising children individually can be quite draining even for those parents without any disease. In this case, his mother should get some hired help through a housekeeper.

This person can be responsible for ensuring that all of James’s needs have been met. Additional Cathy herself needs to spend more time with her son. She needs to assure him of her love for him. Additionally, she needs to take time out to explain to her son why she behaves the way she does in certain situations. When the disease’s symptoms are not too intense, she could participate in certain activities with her son such as doing puzzles or chess. These are all activities that do not require too much energy but will allow interaction with her son.

What is working well in the family in relation to theories of human development

Socially, children require the affection of their parents. Additionally, parents need to know that their children need them too. In the case study, it seems as though James and his mother are in good terms. They seem to communicating with one another and it seems that James trusts his mother. This could be seen in the first visit when he sat close to his mother.

The other issue that indicates that there are still some positive aspects in the relationship is the fact that James has not exhibited extreme behaviour. Research conducted by the Children’s  Medical centre (2001) indicated that oppositional defiant disorder can sometimes lead to conduct disorder. While James may exhibit symptoms of oppositional defiant disorder, this has not yet reached the level of conduct disorder which can be extremely dangerous to rectify. Adolescents suffering from conduct disorder may engage in substance abuse, commit crime among others. (Christopher & Mortweet, 2007)  At least James’s scenario has not reached such alarming levels.

.Human development theories that apply to the situation

Levi son (1978) came up with a four stage theory on human development. He asserted that each stage is characterised by certain aspects that individuals have to learn as they grow. He identifies childhood adolescence, early adulthood, middle adulthood and late adulthood. (Morrison and Shaffer, 2002) The latter explain that it may necessary for a person to address their role in relation to their society at each stage of development. For James’s case, there is a need for him to look at the polarities between himself and the environment with relation to the transition from childhood to adulthood.

The latter authors explain that one’s’ degree of separateness from society at each stage is determined by their experiences. Consequently, if one’s experiences create a negative impact, then they may result in more separateness than attachment to society. (Berk, 2007)This could be the case with James.

Further information needed to answer the above questions

It should be noted that each patient has their own manifestations of the disease. Some patients may have outbursts of the symptoms and recessions. However, in other scenarios, some patients may experience general prevalence of the symptoms continually. In this case, it is not possible to ascertain what Cathy is currently going through at the moment. Consequently, it would be necessary to know more about her disease in order to prescribe the most feasible measures in the future.

Additionally, it may be necessary to know whether James’ father is willing to take up responsibility for his child. This also means that Cathy should be willing to share her parental responsibility with James’ father. By doing this, then James will be receiving the care and affection needed in the family. It may also be necessary to determine some other psychological or biological signs that have been impeded by the family problems he is undergoing. For instance, it would be useful to know if James has any recurring nightmares or other anxiety related manifestations.

How to obtain this information and impediments to obtaining it

This information may be obtained by directly assessing James. However, one can only reach reasonable conclusions after working closely with James himself. It may be a problem trying to get James to open up to therapeutic sessions. Consequently, this may hamper the process of obtaining information and it may therefore be difficult to assist him.

In the first visit, James’s mother was flat, she may have difficulties trusting social workers and may assume that they have negative intentions. Consequently, it may be difficult getting useful information from her. In that visit, here answers were short and unanimated. This implies that she is only saying what she has to and may be hiding a number of issues from the department of children.

Conclusion

James’s situation is an ideal example of the role that social, biological and psychological factors have to play in an individual’s life. The negative situation that James has undergone could lead to developmental inadequacies and they necessitate intervention.

Reference

Rivka et al (2005): Emotional responses of children and adolescents to parents with multiple sclerosis, vol. 11, no. 4. Pp 464-468

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Steck et al (2007): Mental health problems in children with somatically ill patients e.g. multiple sclerosis, vol. 16, no. 3, p 23-47

The Medical Centre (2002): Child and adolescent mental health, retrieved from http://www.mccg.org/childrenshealth/mentalhealth/bdhub.asp. Accessed on 2nd October 2008

Murphy, M., Sederer, L., Cowan, R. (2001): Disorders of Childhood and adolescence, Blackwell, p 142

Christopher, R. & Mortweet, L. (2001): Treatments that work with children, American Psychological Association, 12, 34, 67

Pole, M., Warren, T. and Nunez, J. (2007): Story of human development, 1st edition, Prentice Hall

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Rutter, M. & Rutter, M. (1992): Challenge and Continuity across the lifespan, Penguin Publishers

Levinson, D. (1978): The season’ of man’s life; Knopf Publishers

Decairos, C. (2008): MS and Children, retrieved from http://www.travellercompanion.com/OverviewMS.htm accessed on 2nd October 2008

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Jhyiong, J. (2008): Can a Multiple Sclerosis Patient Parent a Child, retrieved from http://ezinearticles.com/?Can-a-Multiple-Sclerosis-Patient-Parent-a-Child?&id=1483993 accessed on 2nd October 2008

Berk, W. (2007): Development through the lifespan, 4th Edition, Allyn & Bacon Publishers