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the Pullman Family

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family Assessment Visual Report California state University, San Marcos Nurs 480


Meet the Pullmans

The Condition: Auggie Pullman was born with a genetic condition which affects facial

formation. Auggie has always been self conscious about his appearance and wears an astronaut helmet in public to hide his face. Isabel encourages and demands for Auggie to start attending a formal school now when all students will be new to the 6th grade middle school.. The transition was difficult but Auggie befriended a boy named Jack. On Halloween, Auggie overheard Jack state that he would rather die than look the way Auggie does. This caused Auggie to have a crisis due to the betrayal of his friend and the lack of acceptance throughout the school mates. Auggie had been ostracized by his peers and received threatening notes and drawings calling him a “freak.”

Auggie is a ten year-old boy with mandibulofacial dysostosis, a facial deformity disorder. Auggie is apprehensive about attending a private school and is concerned about what people will think of him. He desires to be accepted as he is and wants to make friends. Auggie is in the adolescent developmental stage with the role of identity vs. role confusion. Auggie is challenged with role confusion because he is unfamiliar with the social norms of school, he is trying to find where he belongs and how to fit in.

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Via is Auggie’s teenager older sister. They have a very loving and caring relationship. Via is very protective of her brother but also faces moments of embarrassment and resorts to lying about being an only child. Via would also be in the adolescent developmental stage with the role of identity vs. role confusion. She is experiencing some role confusion as she had a falling out with her best friend, she is not true to her identity when she lies about being an only child, and she struggles in school to participate in a production. Nate is Auggie and Via’s father. He and his family live in upper Manhattan. Nate is very concerned about Auggie attending a formal school because he foresees other kids bullying Auggie for his different appearance. Nate is the head of the household. Nate is in middle adulthood age, he would belong to the developmental stage of generativity vs self-absorption or stagnation. Nate is succeeding in this stage and has generativity as he has formed a family, he provides for them and contributes to the community through his work, and is happy with his life even through the challenges.

http://rj-palacios-wonder.wi kia.com/wiki/File:Nate.png

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Isabel is Auggie and Via’s mother, she has homeschooled Auggie up until this point. She is determined to have Auggie start attending Beecher Prep because all kids would be starting at this new school and come from various schools, therefore Auggie would not face that disadvantage. She believes that it would be easier on Auggie to start now rather than later. Isabel takes care of the family and home. Isabel would also be succeeding in the generativity vs self-absorption or stagnation stage. She has successfully educated her children, she takes care of her family, and she is giving back to her community through being a good citizen. Isabel is the glue that holds the family together and everyone is very supportive of one another. The family dynamic is very http://www.thenational.scot/culture/1 5695210.Film_Review__Wonder_ea loving and caring, they have open discussions and do not let rns_the_right_to_pluck_your_heartst problems pass without communicating about the situation. rings/


Culture/Religious Views: The Pullman family mentions God but does not specify any particular religion. They are people who believe in good and celebrate occasions such as Christmas and birthdays. One small tradition that the family has is being walked to and from school every day as a family and often the astronaut helmet is brought incase Auggie wants it. Another tradition observed within the family was the gift exchange during Christmas. The family is caucasian, lives in upper manhattan, and is well taken care of. The caucasian culture values eye contact, hand shakes, and mutual respect.

Communication: -Verbal: Verbal communication among the family is good. Feelings are always expressed, not specifically to the entire family but at least one-to-one. The family does not seem to have serious conversations as a whole, rather they have spoken one-on-one and then shared the information -Non-verbal: The family’s non-verbal cues are dramatic. Via became upset and slammed her door shut to make a point and demonstrate her frustration. Auggie does similar actions, his trademark to let others know is when he puts on his astronaut helmet and is acting serious.

Strengths: ●

● ●

Isabel is a stay at home mother who has time to devote to her children and have quality time with them after school The family as a whole is very nurturing, caring, and loving in nature The family lives comfortably with enough resources. Good communication foundation has been established among all members of the family.

Weaknesses: ● ●

Via feels embarrassment due to her brother’s condition. Auggie lacks motivation and experience to try to socialize and make friends. The family has sheltered Auggie for many years allowing him to hide behind an astronaut helmet and he is now he copes by trying to be invisible or hide himself rather than dealing with the problem. Auggie is very self-conscious and lacks motivation, courage, and a positive self-image.


Systems Theory The Systems theory is based on the belief that the family unit as a whole is greater than the sum of each individual member. Value is highly emphasized on unity rather than individuality. This theory reflects the fundamental values of the family because they are very open, honest, and rely on each other. The relationships between the members are interrelated and dependent on each other even though each member faces their own unique challenges. When Auggie was faced with the challenge of attending a formal school, the family as a whole walked Auggie to the gates of his new school. When faced with the conflict of Auggie being targeted due to his different appearance, the whole family unit was affected. Via felt embarrassed about her brother’s facial deformation, she avoided talking about him and lied about being an only child. Via also tried to avoid having people over to her house. Isabel’s role changed from homeschooling Auggie to taking a step back and letting him try to grow. When he was being attacked she was deeply hurt along with Nate who had been afraid a conflict like such would happen.

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Interventions 1.Auggie has facial deformities despite multiple corrective surgeries. Per Lorot-marchand, Guerreschi, Pellerin, Martinot, Gbaguid, Neiva, Devauchelle, Frochisse, Poli-Merol & Francois-Fiquet (2015), assessing and evaluating children with cleft lip-palate for the effects of teasing and taunting is important because school is where children learn to socialize and often where they are confronted with these challenges. Their study found that the majority of the participants reported feeling sadness, about a third experienced depression, less than a third did not want to go back to school and these numbers serve to highlight the psychological consequences. Children who are teased due to these deformities will not want to attend school, they have higher retention rates, and can even lead to suicide. Although it is unclear if Auggie was affected by a cleft palate, it is common for children with mandibulofacial dysostosis to have cleft palates. With this knowledge, we know the family should speak openly and honestly with Auggie regarding his school experience and if he is having any suicidal thoughts. The family is an important factor because they bring the strongest support. This is especially important because Auggie had been receiving many comments and many notes on how to prevent suicidal ideation and treatment. 2. Counseling will be proposed to work with a psychologist to develop better defense attitudes and learn how to handle different situations though exercises or role play, along with referrals to peer programs similar to big brother or big sister (Lorot-marchand, Guerreschi, Pellerin, et al., 2015). 3. Greeff & Van den Berg (2013), conducted a study to reveal the characteristics of those residing in this house to reduce stress and vulnerability, finding that those with intra-familial resilience factors better adapted to conflicts by viewing the problem as an opportunity to grow. Such strengths include mutual support, cooperation, and commitment to working through the conflicts.

Outcomes 1.The Pullman family will have open discussions to assess for any potential signs of harm or suicidal ideations. Patient will report not feeling alone through the process.

2. The Pullman family will seek psychological professional help and verbalize knowledge and preparedness to deal with a bullying situation and improved self esteem. .

3. The family will be assessed for what their traits are and compared to those of healthy, open families and be educated on how to develop those traits to be better equipt to deal with conflicts by working as a whole unit.


References: Greeff, A. P., & Van den Berg, E. (2013). Resilience in families in which a child is bullied. British Journal of Guidance & Counselling, 41(5), 504-517. Lorot-Marchand, A., Guerreschi, P., Pellerin, P., Martinot, V., Gbaguidi, C. C., Neiva, C., ... & Francois-Fiquet, C. (2015). Frequency and socio-psychological impact of taunting in school-age patients with cleft lip-palate surgical repair. International journal of pediatric otorhinolaryngology, 79(7), 1041-1048

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