“Of course I don’t have my underwear. I’m undoubtedly not wearing my underwear…. These are not boxer shorts. Mine are boxer shorts. These are Hanes 32… My boxer shorts have my name and it says Raymond…I get my boxer shorts at K-Mart in Cincinnati”. (Rain Man, 1988) This quote from the favored film Rain Man perfectly captures the dysfunction that plagues Raymond Bobbitt, one of many primary characters. He is a very explicit man who should at all times do every thing on a schedule; any disruption in this schedule utterly turns his world the incorrect method up.
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He exhibits little or no emotion, unless something occurs to upset him, during which case he fully melts down. His conduct is kind of that of a younger youngster. However, he additionally has a very unique present. He has an absolutely astounding memory and may recall the smallest particulars from events that occurred when he was only a younger youngster. At one level in the movie, a girl drops a box of toothpicks and Raymond is ready to immediately determine how most of the toothpicks spilled out of the field.
The behaviors of Raymond Bobbitt, while very interesting, are nowhere close to normal and so they prevent him from functioning in any kind of normal society. It is due to this that I have decided he has a psychological dysfunction and may benefit significantly from treatment. In order to diagnose Raymond, you will need to look at all the elements which will contribute to his behavior. The DSM-IV multiaxial system is a nice way to break every thing down and do that.
It has 5 sections that take a deeper look in to all the elements that contribute to the attainable mental dysfunction of a patient and provides a regular for classifying psychological disorders. Because of this, it’s closely relied on when making an correct diagnosis and shall be used to diagnose Raymond.
Axis one of many DSM-IV system is reserved for the scientific signs of the dysfunction. Raymond showed lots of the typical scientific symptoms of an individual with autism. The first symptom that they often show is developmental regression. Most sufferers of autism do not show any signs of developmental problems until round 15-30 months. Since Raymond was a younger child and never an toddler when he was despatched away to stay at the care house, it can be assumed that he did not begin to show issues until he was a younger toddler, which is consistent with the autism analysis. Another clinical symptom of autism is abnormal reactions for environmental stimuli. This is clearly seen by Raymond once we see him utterly soften down when the fireplace alarm goes off. The loud noise, which is not one thing that might bother regular individuals, is an extreme quantity of for him to deal with. Abnormal social interactions are another factor that Raymond shows that can be characterised by autism. He cannot maintain a normal conversation and has big problems understanding the social intentions of his brother as he takes him on their trip. It can also be clear whenever you take heed to the best way that Raymond talks that he would possibly endure from autism; he refers to himself as “Raymond” instead of “I” and he often rambles on to nobody particularly about his schedule or whatever else he’s thinking on the time. The final characteristic of autism that is seen in Raymond is the stress that he feels every time his routine is broken. (Brasic, 2013) When his brother takes him away from the care house and changes every thing, Raymond shows significant anxiety. He insists that they watch Jeopardy at 5:00 and is constantly speaking about what he ought to be doing at any given time. He begins to melt down when he is not doing what he normally does and continues on till his brother lastly lets him get his method.
Under axis II, the persona problems and mental disabilities are assessed. There are a number of of those which would possibly be related to each Raymond and Autism, particularly and autistic Savant. The biggest personality disorder that’s shown by Raymond and that’s also exhibited by autistics is that he has excessive anxiety. (Mayo Clinic, 2013) It is clear by the way that he will not get on an airplane as a outcome of there aren’t any out there airlines that have by no means experienced a airplane crash. A regular particular person wouldn’t suppose that much in to getting on a plane, they usually definitely wouldn’t know the statistics of every airline that there’s. Even after they start driving, Raymond starts rambling off statistics about driving and car accidents, making it clear that he is not even snug riding in a automobile. You can even look back at some of the other examples that we now have already checked out to indicate his elevated anxiousness levels. When the fire alarm goes off, and he begins breaking down, he is reacting abnormally (the symptom from axis I); it’s because of his excessive anxiousness that he starts to display this conduct. The similar goes for why he is continually rambling and is so distressed about missing his exhibits, not having dinner at the proper time and every little thing else that has modified in his schedule; he does all of this as a result of he is affected by constant nervousness as a result of his autism and his change in routine. Another thing to take a look at underneath axis II is his mental skills. While he isn’t capable of perform as a traditional particular person intellectually (another symptom of autism), he reveals extraordinary abilities intellectually in other areas. He remembers particular occasions from his childhood beginning at a very younger age, and he remembers them with extreme accuracy and element. He can be capable of retailer things in his reminiscence that no regular individual would be succesful of, such as when he knew the one and only airline that had by no means had a plane crash (it was a really small and unknown airline at that) or when he knew the entire highway statistics regarding automobile accidents. It can additionally be made clear that he’s sensible at math, counting and patterns when he’s in Vegas and is counting the playing cards with ease. All of these superb mental skills that he exhibits are characteristics of a savant as well. (Hiles, 2002)
Axis III is reserved for and bodily problems that may be related in diagnosing or treating the mental dysfunction. For instance, if a person is suffering from a temper dysfunction and they even have a disease which causes them pain or discomfort, then that could be something that contributed to their depression. (Edelson, 2013) Raymond doesn’t show any of those nevertheless, so there can be no diagnosis for him underneath this axis.
Axis IV is used to assess any environmental stressors that may have an result on the prognosis or treatment or the mental dysfunction. This was a big consider Raymond’s diagnosis and his show of signs. He was doing pretty nicely at the care home and, although he was nonetheless displaying some symptoms of an autistic savant, he was capable of reside fortunately and relatively stress free.
However, when his brother took him from his place of consolation, his signs received considerably worse. His anxiety ranges went by way of the roof and it was clear that he was not handling the change properly. He had lost his major help group, which included all of the nurses on the hospital and he was left only with his brother who he had not seen since they have been younger youngsters. This caused him nervousness as a end result of he was not acquainted with him and his brother was not ready to take care of all the behaviors that Raymond displays. He was additionally showing elevated levels of tension because of his surroundings. When they left the care house, it was clear that Raymond didn’t want to go as a outcome of he mentioned it and started appearing out. But his brother made him, and his actions just obtained worse from there. Every night time Raymond would insist that they no less than follow his schedule and he would start throwing a tantrum in the event that they didn’t. Also, once they were within the casino, he could not deal with the entire flashing lights and the ringing of the bells. This eventually led to another melt down. After being with his brother for almost their complete journey, it seemed like Raymond began to warm up to him a bit. Since his brother was the one constant throughout their trip, this once more reveals how much Raymond wants something consistent and some sort of routine, a necessity that is quite common in autistic. (Bellini, 2013)
Axis V is used for the Global Assessment of Funtioning (GAF). It is an analysis of the patient’s capacity to operate in day by day life and is predicated off of a 100 point scale (100 being probably the most functioning and zero being the least). When looking at Raymond, I would assign him two separate GAF scores. When he is in an comfy environment, similar to when he is residing in the care home, I would give him a GAF of 40 because he nonetheless shows signs and would not have the flexibility to hold a job and performance in society, but he’s not extreme. However, when taken out of his environment and put out on the planet, I would give him a GAF of 20 as a end result of he begins to show excessive behavior and even becomes a menace to himself or others. (PsyWeb, 2013) There was a degree when considered one of his soften downs became so unhealthy that he started banging his head and hurting himself. He is in need of constant supervision when he is not in a comfortable acquainted place.
After taking a look at the signs that Raymond displayed (which embrace things like not making eye contact and continually fidgeting, not seeming to pay attention to when individuals talk to him and never having the ability to hold a conversation, and resting touch and changes in routine) and breaking them down with regard to the DSM-IV multiaxial system, I even have determined that he suffers from Autism, and extra specifically, he is an Autistic Savant. He would be categorized as a Savant because he, while missing in lots of areas, does have extraordinary expertise in different areas. There was a time in the film when his brother takes him to Vegas and tells him to count cards in blackjack and Raymond (having to prior training) is prepared to do it with ease. His symptoms underneath the DSM-IV model are extremely in maintaining with these of an autistic savant. He shows all of the clinical signs (axis I) that an autistic would show, including abnormal social conduct, the lack to hold a normal dialog and the constant fidgeting. These behaviors are also in keeping with the autistic and savant personality problems and psychological skills (axis II), including the acute nervousness and the extraordinary skills in particular areas. There usually are not essentially any bodily issues (axis III) that contribute to being an autistic savant, and Raymond didn’t present any of those both. His environment (axis IV) nonetheless, did play a significant role his conduct and that is fairly common with autistics as nicely. (First Signs, 2012)
After diagnosing Raymond as an autistic savant, the most important remedy that I would suggest for him would be to return to the care house and live the rest of his life there. When treating autism, there isn’t a one set treatment as a result of every particular person with autism is exclusive. (Autism Speaks, 2013) Since we had been in a position to see how Raymond responded to living in the care house and sticking to a strict routine, we have been in a position to see that it labored for him. This plan, and the routine that was tailor-made for him, labored to reduce his signs and reduce his behavioral issues. As far as him being a savant as properly, there actually is no remedy wanted for that as a result of it doesn’t pose an issue in his life. It is a expertise that he lives with and not something that needs to be mounted. If Raymond is returned to the care residence and his acquainted schedule, there is not a reason that he can not reside out the rest of his life as happily and comfortably as attainable.
- Autism Speaks. (2013). How is Autism Treated? Retrieved from: http://www.autismspeaks.org/what-autism/treatment
- Bellini, Scott. (2013). The Development of Social Anxiety in Adolescents With Autism Spectrum Disorders. Retrieved from: http://foa.sagepub.com/content/21/3/138.short
- Brasic, James. (2013). Autism Clinical Presentation. Retrieved from: http://emedicine.medscape.com/article/912781-clinical
- Edelson, Steven. (2013). Research: Autistic Savants. Retrieved from: http://www.autism.com/index.php/understanding_savants
- First Signs. (2012). DSM-IV Criteria Pervasive Developmental Disorders. Retrieved from: http://www.firstsigns.org/screening/DSM4.htm
- Hiles, David. (2002). Savant Syndrome. Retrieved from: http://www.psy.dmu.ac.uk/drhiles/Savant%20Syndrome.htm
- Mayo Clinic. (2013). Autism. Retrieved from: http://www.mayoclinic.com/health/autism/DS00348/DSECTION=symptoms
- PsyWeb. (2013). Axis V- Global Assessment of Functioning Scale. Retrieved from: http://www.psyweb.com/DSM_IV/jsp/Axis_V.jsp