Final Week

Hunter died as he had lived - without much connection to others around him. He spent much of his time with computers in his last years, and his moods and behaviors were mostly associated with how he experienced himself in "Second Life." He was 61 when he died.

Week 9

At age 48, Hunter Arias has had anything but a "normal" life. Now that he is out of prison, he doesn't know what to do with himself. It seems that around Hunter's 30th birthday, all of the medications he was taking stopped working - if only for what seemed like a few minutes - but it was enough time for him to fly into a rage and assault a grocery store clerk. The injuries were serious enough that the individual spent several weeks in intensive care, and Hunter was charged with a felony. In spite of his difficulties, he spent several years behind bars.

Life in prison was hell for Hunter. His parents came to visit him often, but that fact did little to challenge the agony of being locked up. Hunter couldn't stand it. He had several bouts of depression while in prison and attempted suicide twice.

Hunter was released to his parents, and they still care for him as they continue to grow older. It is becoming more and more difficult for them as they have developed health difficulties. Hunter spends most of his time alone in the house surfing the Internet and has developed a fondness for the Civil War.

* What percentage of people in prison also meet criteria for some kind of mental illness?

* What resources are there in Harrisonburg for individuals trying to transition from being incarcerated to living a "normal" life?

* What happens when someone is convicted of a felony once they are finished serving their time? Are they able to get a job anywhere?

* Describe the typical developmental milestones for middle adulthood.

Week 8

Hunter is now 25 years of age. He has had a number of short and long term hospitalizations owing to his complex set of behaviors. He has been relatively stable for a period of 2 years, and he is currently living with Rick and Sandy. They do all that they can to assist him, but they worry about who will care for him after they are gone. He just doesn't seem to be able to manage outside of either their care or a very structured facility.

Hunter is able to communicate his basic needs. He has a look in his eyes, however, that is just a bit strange - it's like he never quite looks at people, and he is quick to follow whatever small impulse might come into his mind at any given time. He is severely distractible and impulsive all of the time, and it can be exhausting just being around him. Hunter spends much of his time playing video games, a welcome activity when you ask Rick and Sandy. It seems to calm him, and it keeps him out of trouble. 

* What is the time period for early adulthood? What are the physical, cognitive, and socio-emotional changes that typically take place during this period?

* Assuming that Hunter's parents did not have their own health insurance policy on which to place him after he turned 18, how would all of Hunter's hospitalizations be paid for? What kind of insurance is he likely to have as a 25 year-old autistic man? Does he receive any compensation for not being able to work owing to his disability? If so, who keeps track of his money for him?

* What are the prospects for Hunter in the longer term? What kinds of community resources exist in a) rural communities (take Southwest VA, for example), b) towns (perhaps Charlottesville and Harrisonburg as examples), and c) large cities (Richmond, Tidewater) for people like Hunter?

 

Week 7

Hunter's behavior has steadily declined, and Rick and Sandy continued to be at their wit's end regarding what to do. At age 16, Hunter is physically pretty large, and Sandy is scared of him. Rick is to the point that he can't control him physically any longer, and Hunter knows it. The psychiatrist has prescribed high doses of medication for Hunter, and those often have an effect, but it seems like there is something happening at home in particular that can set Hunter off like no other place can. The school is able to keep Hunter mostly out of trouble, but he is almost self-contained all day with a 1 to 1 aide.  

It was the constant threat of violence that had Sandy and Rick looking for help anywhere they could get it. Finally, on the day that Hunter ran at Rick and pushed him through the sliding glass door, Sandy called the police. Rick and Hunter were a mess of glass and blood when the police arrived. Both were taken to the ER for lacerations, and, remarkably, neither suffered lasting injury. Hunter was taken to the one place in the state that dealt with acute care for children in psychiatric distress.

* In Virginia, where would a child like Hunter go for short-term psychiatric stabilization? What is the process for transitioning from that facility to a longer-term residential facility?  

* What residential treatment options are available in Virginia for children like Hunter? Would Hunter meet admission criteria for these programs? Who would pay for a stay in a treatment center?

* What are the decision processes that might ensue regarding whether or not Hunter returns home after treatment? What should be considered when making such a decision?

* If Hunter does not return home, where would he go after he finishes treatment?

* If Hunter were 18 years of age and the above scenario occurred, where would he likely go? For how long?

DECISION POINT:

Does Hunter return home after his stay at the residential facility?

Week 6

5 years have passed and Hunter is now 13 years old.  Hunter continues to have difficulties communicating and expressing his emotions.  Jake is rarely home except to eat and sleep and always keeps to himself. Hunter knows that he is not the same as the other kids at school and seems to resent having to go to a special period every day.  Middle school has been rough experience for Hunter and makes getting him up in the morning a nightmare for Rick and Sandy.  His medication seems to take the edge off his tantrums, but his parents are starting to get worried.  A few days ago, one of Hunter’s outbursts spun out of control and resulted in him throwing a mug across the room and smashing a cherished family heirloom.   

* Describe typical developmental milestones for a 13 year old. As best you can given the information you have, evaluate the extent to which Hunter's development so far has deviated from those milestones throughout his lifespan. 

* What can Rick and Sandy do regarding Hunter’s aggression?

* Should Hunter’s parents take him back the psychiatrist for more medication?

* What kind of transition planning is likely to be in place for Hunter? Indicate 3 specific transition goals that one might find in Hunter's current IEP. 

Week 5

Hunter is now 9 years of age. His parents, with the assistance of a local child psychiatrist, placed him on medications two years ago.

* What medications was Hunter likely prescribed given his diagnosis of Autism Spectrum Disorder? Have the medications you indicate been approved for use in children by the FDA?

* Write a narrative “interview” in which you communicate with Hunter in an effort to get to know him.

* Write a narrative “interview” in which you talk with Hunter’s parents about him.

* Who is Hunter? What kind of child is he? What might someone expect upon meeting Hunter for the first time? Base Hunter’s imagined personality on what you know about he and his family so far.

Week 4

Hunter Arias – Week Four

Sandy and Rick are exhausted. At 5, Hunter has continued to be a handful. He is now in Kindergarten at the local public school, and the start of the year has already been filled with challenge. Hunter just isn’t like other kids – no one quite knows how to handle him. Sometimes, he seems to look askance when asked a question; he seems to have trouble making eye contact. At other times, he is completely engaged in an activity and can interact somewhat, if only through the activity. Through it all, Hunter’s presentation is consistent for a child with Autism, the condition with which Hunter was diagnosed at age 4. That’s about when Sandy and Rick could find the money to get him all of the tests he needed. At least they know, but it’s been hard.  

Rick continues to be on disability for the injury he sustained on a construction site where he was working at the time. Sandy’s job as an administrative assistant for a local advertising company is stable, but she has few benefits.  Jake acted up so much in school that the team suggested in-home counseling for the family. Rick and Sandy said no. They also suggested that Hunter go to a counselor in the community for help with his tantrums.

The strain of all of the behavior of the kids is starting to take its toll on Sandy and Rick. They are less able to tolerate one another’s moods, and there is much more tension in the home than there used to be.  

* What are typical developmental milestones for a 5 year-old (cognitive, affective, gross & fine motor)?

* What services are available for a child with Autism in Virginia? Assume that the Arias family lives in Harrisonburg. What is an ED/CD waiver (this is through Medicaid; you may contact VAIL [Valley Associates for Independent Living] to find out more.) What is a DD waiver? Assume Sandy and Rick make $42,000 per year. Is Hunter eligible for Medicaid?

* Since Rick and Sandy adopted, do they receive a monetary amount each month? If so, from where does the money come?

* Describe the process of Special Education that took place when Hunter was 4. Assuming that Hunter has minimal verbal communication, what are some goals you would have in his IEP for Kindergarten? What placement would you recommend for him (self-contained, mainstream with resource, etc.)?

* What is in-home counseling? Who provides it in the area?

Week 3

Hunter Arias – Week Three

Hunter, now just over two years of age, has proven to be a much different child than Jake. Hunter struggled to meet some developmental milestones and always seemed to be, in Rick and Sandy’s estimation “difficult.” It seemed to them like many things were a struggle – transitioning from breast-feeding to bottle-feeding, getting dressed, learning to use the potty, and being around other kids. In his day care, Hunter is a “handful” and has to have close supervision.  There were, of course, the tantrums at home. Rick’s mother says they are normal, and that Hunter just needs old-fashioned discipline. On top of that, Hunter still hasn’t started to speak. He makes slight grunts but otherwise does not communicate verbally. Jake, now 6 years old, has started to “act out” at home and at school. In fact, the school has requested a parent conference to talk about the behavioral difficulties Jake has had in the 1^st grade.

* What should Sandy and Rick expect at this point in terms of Hunter’s major developmental milestones? What should a 24-month old be doing?

* What should Rick and Sandy do, if anything, to figure out what is happening with Hunter? Develop a step-by-step plan for assessments that they might complete as well as the associated professionals who might conduct such assessments. Assuming Rick and Sandy lived in Harrisonburg, who would carry out the assessments you recommend?

* What is PACE? Is Hunter eligible? Why or why not? (Hint: Contact the McNulty Center, the children’s part of the Community Services Board)

* What else is important for you to know about Hunter’s family at this point? (Hint: Think about all that you don’t currently know about the family that could be helpful for you with regard to demographic information.)

Week 2

Hunter Arias – Week Two

Just after birth, the child now named Hunter has found his new home. He will be a part of the Arias family. After Rick’s accident, Sandy and Rick Arias are thrilled to have a chance to have another child, and the transition is going fairly well with their 4 year old, Hunter’s older step-brother Jake. Hunter has proven to be a much different baby than Jake, and he cries much more than Sandy remembers Jake crying. Sometimes, he wakes up at night crying and seemingly cannot be consoled. Sandy and Rick bring him to sleep in their bed many a night, and this seems to help somewhat. The pediatrician has told them that Hunter has “colic” and that they shouldn’t be worried. Hunter has had all of his immunizations, and Rick and Sandy have heard that this can cause problems for kids. In fact, they’ve heard it causes Autism, and they are not sure they are going to have him continue his immunization schedule – particularly if he keeps on like this at night.    

* Write a developmentally appropriate narrative of the conversation you would have with Jake about his new brother.

* If he continues to have trouble at night, would you advise Sandy and Rick to continue to bring Hunter into their bed? Why or why not?

* What should Sandy and Rick expect at this point in terms of Hunter’s major developmental milestones? What should a 3-month old be doing? Is his “colic” something that Sandy and Rick should be concerned about? Why or why not?

* Are vaccines safe for children? Is there any evidence that they cause Autism as Sandy and Rick have heard? Would you recommend that Hunter continue to receive his immunizations? Why or why not? What are the risks if he does not receive them?

DECISION POINT

* Will Hunter continue to receive his immunizations?

For the first post, each group will learn some information about each person’s family of origin. This should aid each group in beginning to imagine their respective adoptee. While some of the information may at first appear to be unrelated to our subject of study, life-span issues for individuals with disabilities, fear not. It will all make sense as we move through the semester.

Hunter Arias – Week One

In a small, secluded corner of a downtown block, a 15 year-old girl wonders what she should do next. The pregnancy test came back positive, and she knows her father will yell and scream and curse if he finds out. Worse than that, she thinks he might try to hurt Pedro again. After the last time her father came after her boyfriend with a knife, she’s not sure what would happen if her father knew this. She long ago decided to keep the baby – now that she had her Quinceañera, she had a whole new set of expectations for herself. Still, it wouldn’t be easy. She would have to hide the baby from everyone and find a way to give it up for adoption. She couldn’t imagine giving away her baby to someone she didn’t know. Would they be good parents? Would they love the baby like she would? Would her baby be OK? As she sat there on the corner, all of these thoughts were racing through her mind. 

Questions:
  
What is a quinceañera? Why was it important to this girl? 

     Explore the system of adoption in Virginia. What is the relationship between the foster care system and the adoption system? Provide demographic information regarding how many children each year are up for adoption, their ages, how they come into the foster care/adoption system, and the challenges inherent in adopting. What resources exist to assist parents interested in adopting? Make a graph that shows the numbers of children in the system according to their ages and ethnicity. Which children are most difficult to place in adoptive and/or foster homes?

Discuss the reasons someone would adopt a child. What mechanisms are in place for agencies to determine who is allowed to adopt? What are the psychological challenges of adoption for the adoptive parents?

Welcome!