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Commentary: Conceptualising demand avoidance in an ASD context – a response to Osman Malik & Gillian Baird (2018)
No full textMalik and Baird have raised a number of important points drawing on our study of parent‐reported dimensions of difficulty in children with features of extreme/’pathological’ demand avoidance. In particular, they highlight the pressing need to understand why some children exhibit problematic demand avoidance, and identify factors that promote and maintain these behaviours. As Green et al. (2018) note, children with ASD often show a strong reactivity to the environment. As such, stimuli, activities or interactions that present no problems for typically developing children may unexpectedly provoke extremes of affect. Both Green and colleagues (2018) and Malik & Baird highlight a number of possible contributory factors, including sensory sensitivities, difficulty in predicting outcomes, need for sameness, poor tolerance of uncertainty, and fluctuations in autonomic arousal
An exploration into the parental experience of Emotionally Based School Non Attendance in young people
Get PDFSchool refusal, school phobia, school anxiety and emotionally based school non-attendance are all interchangeable terms used to describe children who experience high levels of distress and anxiety that prevents them from going to school. Emotionally Based School Non Attendance (EBSNA) in young people is a complex and multifactorial condition which can be a symptom of an underlying mental health disorder (McShane & Rey, 2001). This study explored the experiences of parents of young people aged 13-15 years old who present with EBSNA, who no longer attend mainstream school and who attend an alternative educational provision. Interviews were conducted with five parents and transcripts were analysed using Interpretative Phenomenological Analysis (IPA), leading to four superordinate themes: ‘It turns your life upside down’; Power and the battle to be heard; Loss and fear and Retrospective clarity. These themes captured the far-reaching effects on parents which impacted on relationships within the family, their own mental health and poor relationships between home and school. Parents shared their concern for their child’s future and described the need to understand the origins of their child’s condition. Implications for Educational Psychologists (EPs) and other professional agencies suggest that it is important to increase our understanding and awareness of the parental experience and consider ways of improving the quality of parental and professional relationships
The pros and cons of online symptom checkers
No full textThere are various models of triage for general practice that aim to improve access to care, including 'online symptom checkers' hosted on the practice's website. Dr Gabrielle Pendlebury from Medical Protection looks at the pros and cons of using these systems
When should you break a patient's confidentiality?
No full textPractice managers are often the first to become aware of issues through discussion with the various clinicians. Gabrielle Pendlebury, Medicolegal Adviser at Medical Protection, discusses when it is appropriate to break a patient's confidentiality in the public interest
Professionals’ understanding of sexualised behaviour in children who have experienced sexual abuse: An analysis
No full textThis paper examines professionals’ construction of their understanding of challenging sexualised behaviour in children who have themselves experienced sexual abuse. Seven experienced professionals, working directly with children under 16 who had been sexually abused, were interviewed using a semi-structured interview schedule that was based on four key themes identified from a review of literature (gender; labelling; choice, responsibility and agency, and, training). Complementing the use of the semi-structured interview, a vignette was used to apply the questions to a fictional case study where the gender of the central figure was altered between female and male. Following a feminist socialconstructionist perspective the transcripts were analysed using Foucauldian discourse analysis and discursive psychology. Analysis showed
gendered discourse ran throughout the transcripts and intercepted with therapy discourse. The implications of these findings are to alert practitioners to the limitations of their own discourses and to highlight the
shortcut in thinking that therapy discourse can create. The research illustrates the need to avoid identities and labels being given or assumed about a child which could then become increasingly entrenched as the child becomes older
