spends all of his time watching TV or listening to CDs alone in his room.
Hes putting on so much weight, and doesnt want to work at his speech
therapy. His biggest goal right now is finding a girlfriend, but his dad and
I want him to spend more time on his schoolwork!"
Working in a home health
agency that provides case management and respite care to individuals with disabilities,
youve heard these complaints before from parents of teens with developmental
disabilities. Although Mark has Down syndrome and a history of congenital heart
disease, hes pretty much a typical adolescent when it comes to puberty
issues and family relationships. At the time of life when his typically-developing
peers are physically and cognitively able to separate from their parents, Mark
still faces developmental delays and physical challenges that tie him to his
mother and father.
Since this is your first
meeting with Mark and his parents, youve arranged to interview them together
and then separately. As you talk with Mark alone in the family room, he confides,
"My mom and dad love me but they treat me like a little kid." In response
to your gentle probing, Mark replies, "I want to drive a car and take a
girl to the prom." When asked what hed like to do when he turns 22,
Mark promptly blurts, "Go to college and live in a dorm."
Back in the living room, you gather information from Mark and his parents to complete a nursing assessment. By the end of the session, youve listed a few health concerns:
Mark and his parents agree that they need to make some decisions about social activities, and have asked you to participate in the transition meeting scheduled at his school next month. Before you leave, you outline some recommendations, and promise to make some referrals for the issues that the family is ready to address.