Part 4 The Lewis Family
4.2 Lewis family case study 1: Neurodiversity
Nicola Whiteing
Introduction to case study
Learning Objectives
By the end of this case study you should be able to:
- Articulate what resources are available to support individuals with autism spectrum disorder (ASD) and their families.
- Discuss ways in which nursing practice may need to change to accommodate people with a different style of thinking.
- Define the different style of thinking someone with ASD has compared with someone without ASD.
- Discuss which health professionals may contribute to caring for someone with ASD and how the interprofessional team can collaborate to promote person-centred care and positive outcomes.
Scenario
Sally worries that Luke is lonely without any friends. He was the only child not invited to a birthday party last weekend. Luke’s pre-school teachers have discussed with Nigel and Sally how he struggles to build social relationships with his peers. Last week, Luke was playing on the mat with his cars, lining them up in ‘car parks’ according to their colour. One of the other children (Theo) sat next to Luke and picked up one of the cars and ‘parked’ it in another area. Luke said “No” and put the car back in its spot. Theo moved it again and Luke got increasingly agitated and upset, pushing Theo away. The teacher came over and suggested Theo play with the diggers in another area. Theo moved away, upset he could not join in Luke’s game. Luke continued to place his cars in the coloured car parks, ensuring all of the wheels were aligned. Luke’s teacher talked calmly to Luke to explain that Theo wanted to play with him and was now feeling sad. All the time, Luke continued with his cars, not looking at his teacher and not acknowledging Theo or that he was upset.
Sally has bought Luke a Spiderman costume as a surprise for the upcoming book week. On the morning of the parade, Sally surprises Luke with his costume. Luke refuses to wear it saying, “I am Luke, I am not Spiderman”. As Luke becomes increasingly upset, Sally puts the costume in his bag, drops him at day-care, telling the teachers where his costume is. When all of the other children are changing into their costumes, ready to go to the ‘big school’ for the parade, Luke again refuses to dress up, despite the excitement from his peers at being a policeman, a fireman or a nurse. While his teachers try to encourage him, Luke chooses to sit in the corner of the room with his cars. He does not want to leave the pre-school room to go to the parade.
Luke is due to start at the primary school where his sister Ella goes in 5 months’ time. Sally is worried how Luke will cope at school. When she tries discussing with Nigel how to plan to help Luke before he starts, Nigel does not feel this is necessary, saying ‘he’ll be fine once he starts school with all the other kids.
Case study questions
- Following Luke’s diagnosis of autism spectrum disorder (ASD), how might different members of the interprofessio