Braverman Family Assessment
Breanna Chappell California State University
Asperger Syndrome is a “high functioning”
Max Braverman is the 8-year-old son of Adam and Kristina Braverman. He is artistic and a bit eccentric. He insists on wearing a pirate costume to school and has an extreme fear of fire that limits him from going near anything with a flame. He shows little interest in sports because he believes he is not very good at them and he would rather spend hours putting together his legos. He has an obsession with bugs and a wealth of knowledge about them. He displays repetitive behaviors like uncapping and recapping a marker over and over. He makes little eye contact when communicating, refuses to say hello back to a peer at school, and does not say “I love you” back to his dad. At school he has an anger outburst when a peer calls him a “freak”. The school suggests Max get a behavioral assessment and he is diagnosed with Asperger syndrome (AS).
autism spectrum disorder (ASD) characterized by repetitive behavior patterns and restricted interests in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is typically diagnosed in children older than 3 and most often in males. The child is likely to exhibit social problems, communication abnormalities, speech and hearing abnormalities, and sensory sensitivity. Each individual presents in their own way but some of the common behaviors associated with Asperger syndrome are “robotic” speech, challenges with nonverbal communication, tendency to discuss self rather than others, lack of eye contact or reciprocal conversations, obsession with specific, often unusual topics, repetitive behaviors, and limited or inappropriate social interactions. Those with Asperger syndrome have normal often superior intelligence but often lack in their motor skills. Physical symptoms can include early childhood motor delays, clumsiness, fine motor difficulty, gait abnormalities, and impaired ball-playing skills. The social impairment of Asperger syndrome is life-long but those with supportive family with knowledge of the disorder tend to have a better prognosis (Autism Speaks, 2018; Brasic, 2018).
Meet the Rest of the Braverman Family Adam Braverman is the 40-years-old, husband to Kristina and father
to Haddie and Max. He is the oldest of four siblings, son of Zeek and Camille Braverman. He is often consulted when his family is having issues, for example, he helps his father with his plumbing and his sister with advice on her teenage daughter. He works as a business manager at a shoe company. He is the coach of his son’s baseball team, but gets fired after a disagreement with the umpire over whether or not Max was safe at first base.
Zeek & Camille Braverman are Max’s paternal grandparents, they have been married 46 years. They have four children: Adam, Sarah, Crosby, and Julia, each with their own different family dynamics. They are both very supportive and involved in their children’s lives.
Kristina Braverman is the 38-year-old, wife to Adam and mother to Haddie and Max. She is a stay at home mother who shuttles the kids back and forth from school and soccer. She is described as a "wise and quietly forceful woman who loves her husband and children deeply and with incredible strength.” Figure 5
Haddie Braverman is the 15-year-old, daughter of Adam and Kristina. She is a “good girl”, straight A student, and supportive older sister to Max. She has a close group of friends at school and is subject to peer pressure when she buys a bag of marijuana with them. When her parents find the bag she feels guilty enough to later confess that it was hers. Figure 6
The Braverman Family Structure Family Structure & Dynamics Adam Braverman’s family is a traditional nuclear family with a husband, a wife, and two children. Adam’s younger brother, Crosby, calls them the “perfect couple.” They live in Berkeley, CA in a house. Adam works and is the sole provider for the family, while Kristina stays at home as a homemaker. They seem to be a very close, supportive family and communicate well with each other. They have nightly family dinners and often have family get-togethers with Adam’s parents, siblings, and their children.
Duvall’s Stages of Development According to Duvall’s family stages of development, The Braverman family is in the ‘families with school-age children and adolescents’ stage. Adam and Kristina haven been married for awhile and their children are 15 and 8. Although with their oldest Haddie they already went through the school-age child stage, they are having to figure out what works best for Max’s differences. Their tasks are to support Max’s interests and needs and determine disciplinary actions and family rules and roles that work for Max’s uniqueness. With Haddie they are trying to figure out how to allow her to establish her own identity but still be a part of the family, thinking about her future, and increasing her role in the family to help where needed (Kaakinen, Coehlo, Steele, Tabacco, & Hanson, 2015).
Culture/Religious Traditions The Braverman family has no clear religious identification or traditions, however they do have baseball. Playing baseball , or sports for that matter, seem to be a family tradition. Zeek has and expectation that Max will be a “tough” kid and coaches him on how to handle a basketball, but then accidently elbows him in the face during a game. Family meal time seems to be an important aspect and tends to be a time of a lot of discussions for Adam’s family and the Braverman family as a whole. They are all supportive of each other’s successes and failures. The whole Braverman family goes to support Max at his baseball game.
Strengths and Challenges Braverman Family Strengths ● ● ● ● ● ●
They are a very tight-knit, close, and supportive family and tend to encourage each other. They understand their roles within the family. They listen to and respect each other. They trust each other. They spend an appropriate amount of time together as a family unit. Adam and Kristina make the kids a priority.
Family Communication Verbal Communication
Braverman Family Challenges ● ● ● ●
A lack of understanding of Max’s recent diagnosis of Asperger syndrome. Adam’s denial of Max’s diagnosis, as well as Kristina feeling overwhelmed. Zeek’s thoughts that Adam should parent like he did. Haddie trying to balance growing as an adolescent and becoming more independent yet still being apart of the family. Max receives more attention due to his diagnosis at times, leaving Haddie out.
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They openly communicate with each other. They sometimes talk over each other. Adam can be very direct and firm at times, like his father Zeek. Adam and Kristina listen to their kids when they talk.
Non-verbal Communication ● ●
They use gestures and make eye contact when they talk. They hug each other for support.
Max’s Communication Challenges ● ● ● ●
Max doesn’t communicate well with his peers. He has trouble making eye contact when talking. He often has a flat affect and rarely smiles. Instead of discussing his feelings, he often acts out with aggression and by yelling.
Family Theory - Chronic Illness Framework Type of Illness Onset Although Max’s diagnosis of Asperger syndrome was sudden and unexpected, the onset is gradual and the Braverman family will adapted over a period of time.
Course of Illness Max’s course of illness is constant and will evolve into a somewhat stable and predictable illness after the initial diagnosis of Asperger syndrome (Kaakinen et al., 2015).
Outcome Asperger syndrome is lifelong, however people can be taught how to cope with it. Individuals with Asperger syndrome have a normal lifespan but they are, however, at an increased risk for depression, mood disorders, obsessive-compulsive disorder, and Tourette disorder (Brasic, 2018). Although Max’s diagnosis has increased stress to the family and caused a shift in their equilibrium, because Asperger syndrome does not shorten the individual’s life span, it does not generate the same amount of family adjustment as other outcomes (Kaakinen et al., 2015).
Time Phase of the Illness: The Initial/Crisis Adam and Kristina have just received the diagnosis that the therapist believes Max has Asperger syndrome. Initially Adam is in disbelief and Kristina is overwhelmed and upset that something is wrong with her son. They have little knowledge of Asperger syndrome and how to help Max at this point. It is important that the family establish a good working relationship with healthcare providers, gather information about Asperger syndrome, and accept the diagnosis (Kaakinen et al., 2015).
Family Functioning: Stress Response of the Family When a family member becomes ill it triggers a stress response in the family to adapt to the needs of the family member (Kaakinen et al., 2015). When Adam and Kristina find out that something might be wrong with Max, they immediately want to take him to the best doctor to get him evaluated. They also get together with the parents of a child with Asperger syndrome to try and get a better understanding of it, which cause them to feel more overwhelmed.
Interventions 1. Educate the family on Asperger syndrome and provide them with the knowledge to help Max. Rationale: “People with Asperger syndrome tend to have a better prognosis when the receive support from family members who are knowledgeable about the disorder” (Brasic, 2018).
2. Refer the family to a therapist and/or support group like the Asperger Syndrome and the High Functioning Autism Association (AHA). Rationale: Families’ live are impacted in many ways when handling chronic illness. Often families feel that they don’t know how to emotionally support each other and that the stress can have a negative impact on relationships (Golics, Basra, Salek, & Finlay, 2013).
3. Refer the family to a registered dietitian for Max’s nutrition. Rationale: “For children with ASD, a nutritious, balanced diet can make a world of difference in their ability to learn, how they manage their emotions and how they process information. Because children with ASD often have restricted diets as well as difficulty sitting through meal times, they may not be getting all the nutrients they need, particularly calcium and protein” (Ansel, 2018).
Outcomes: 1. Adam, Kristina, and Haddie will have a well rounded education on Asperger syndrome and ASD and will be better prepared for how to handle Max’s recent diagnosis. 2. Adam and Kristina will began seeing a therapist to discuss any concerns on how Max’s diagnosis is affecting their relationship and any concern they have. As a family they will attend support group geared towards families with children with ASD to share experiences and support one another. 3. The Braverman family will understand the importance of nutrition in Max’s care and will know what kind of meals and snacks to fix him to support his diet and ensure he is getting the proper nutrients.
References Ansel, K. (2018). Autism spectrum disorder (ASD) and diet. Retrieved from https://www.eatright.org/health/diseases-and-conditions/autism/nutrition-for-your-child-with-autism-spectrum-disorder-asd Autism Speaks. (2018). Asperger syndrome. Retrieved from: http://www.autsimspeaks.org/what-autism/asperger-syndrom Brasic, J. R. (2018). Asperger syndrome. Retrieved from https://emedicine.medscape.com/article/912296-overview Golics, C. J., Basra, M. K. A., Salek, M. S. & Finlay, A. Y. (2013). The impact of patientsâ€™ chronic disease on family quality of life: An experience from 26 specialties. International journal of general medicine, 6, 787-798. doi: 10.2147/IJGM.S45156 Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A. & Hanson, S. M. H. (2015). Family health care nursing: Theory, practice, and research (5th ed.). Philadelphia, PA: F. A. Davis Company. Katims, J. (Writer), & Schlamme, T.. (Director). (2010). Pilot [Television series episode]. In J. Katims (Producer), Parenthood. Berkeley, CA: NBC Universal.
Images Figure 1: NBC. (2010). Braverman family. Retrieved from https://www.amazon.com/Parenthood-Season-1/dp/B0038L1XPO Figure 2: NBC. (2010). Maxâ€™s pirate outfit. Retrieved from https://www.bustle.com/articles/60881-14-crazy-things-about-the-parenthood-pilot-you-probably-forgot-crosby-lived-on-a-boat Figure 3: NBC. (2010). Max Braverman. Retrieved from http://parenthood.wikia.com/wiki/Max_Braverman Figure 4: NBC. (2010). Adam Braverman. Retrieved from http://parenthood.wikia.com/wiki/Adam_Braverman Figure 5: NBC. (2010). Kristina Braverman. Retrieved from http://parenthood.wikia.com/wiki/Kristina_Braverman Figure 6: NBC. (2010). Haddie Braverman. Retrieved from http://parenthood.wikia.com/wiki/Haddie_Braverman Figure 7: NBC. (2010). Braverman family tree. Retrieved from http://koolthingzzz.blogspot.com/2010/10/modern-family-vs-parenthood-debate.html Figure 8: NBC. (2010). Braverman family dinner. Retrieved from http://www.tv.com/news/8-turkey-day-themed-tv-episodes-worth-revisiting-this-thanksgiving-138550130328/ Figure 9: NBC. (2010). Max playing baseball. Retrieved from https://www.bustle.com/articles/60881-14-crazy-things-about-the-parenthood-pilot-you-probably-forgot-crosby-lived-on-a-boat Figure 10: NBC. (2010). Discussing Max. Retrieved from https://www.bustle.com/articles/60881-14-crazy-things-about-the-parenthood-pilot-you-probably-forgot-crosby-lived-on-a-boat Figure 11: NBC. (2010). Adam and Kristina hugging. Retrieved from http://ew.com/article/2012/09/19/parenthood-creator-on-kristinas-tragic-reveal-its-something-thats-very-personal-to-me/