Rain Man, released in 1988, is a story of two brothers with a brief history in their childhood and how one’s mental illness changes the other’s outlook on life. The main character, Charlie Babbitt, believes he is an only child and is living life on the fast track. This is until he is notified of his estranged father’s unexpected death. Charlie learns that his inheritance was placed in a trust, to an unknown trustee. Charlie seeks out this beneficiary bringing him to Wallbrook, a mental health facility. He is introduced to his brother, Raymond.
As an autistic savant, Raymond has been living at Wallbrook for most of his life. Charlie, unfamiliar with the disorder, takes Raymond across the country in an attempt to get his inheritance. Charlie does not know how to handle his brother’s needs, so he often has frustration with Raymond. As time proceeds, the brothers begin to build a relationship unbeknownst to Raymond. Charlie begins to cope with Raymond’s needs. He now wishes to keep Raymond with him on a long term basis. However, the court and psychiatrist do not agree with this.
Raymond is in the end taken back to Wallbrook to live safely with the structure he needs in life. Autism is a neurodevelopment disorder that causes impairment in social interactions, language development, and communication skills (NINDS, 2014). There are various forms of autism, ranging from mild to severe. Asperger’s is a type in which behavior is consistent with autism, but there are little if any communication deficits present. Typically one with autism is cognitively impaired, however, this may reflect in only certain areas.
The same individual may excel in other areas such as math, memorization or creating art or music. In ten percent of cases significant enhancement of these skills occur, known as savant syndrome. There a wide range of symptoms including rigid repetitive behaviors, avoiding eye contact, and hyper-or hypo-reactivity to sensory input (Halter, 2014, p. 192). Another common occurrence is up to 80% of children with high functioning autism have an anxiety disorder (Center for Disease Control, 2015).
They often have a tendency to stick to routines or rituals, resistance to change and have fixations with particular objects. An individual with moderate to severe autism may be unable to live or work independently. They often have no reasoning skills and are a risk to themselves. Diagnosis may be delayed due to the wide range of symptoms and various degrees of severity (NINDS, 2014). Diagnosis can typically occurs in the first three years of life, but can occur late into childhood as well.
There are no ethnic or lifestyle factors that cause or prevent the disorder. It is thought that genetics play a significant role in the cause of Autism. Studies show that in twins if one child presents with autism the other twin has a 90% chance of occurrence as well (NINDS, 2014). It is known that boys are four times more likely to develop autism than girls (Halter, 2014, p. 192). Each case of autism is unique and requires its own individualized plan of interventions. What aids one child may show no effect on another.
With autism providing early interventions at a young age, birth to three years, gives the best chances for someone with this lifelong disorder. A behavior and communication approach in therapy helps with providing structure, direction, and organization in their life (Center for Disease Control, 2015). This is the kind of approach that Raymond received at Wallbrook. During Raymond’s time away from the mental health facility he experienced anxiety and emotional outburst in which he inflicted harm to himself.
Raymond clearly displayed his need to keep to his daily schedule and was unwilling to accept change. Applied Behavior Analysis, known as ABA, has been accepted in many health care communities and is used in schools. There are numerous types of ABA, but the overall goal is to promote positive behavior and discourage negative behavior in an attempt to improve the child’s skills (Center for Disease Control, 2015). Other forms of therapy such as occupation, speech, and sensory integration are also utilized. There is no pharmacologic therapy that can treat or cure autism.
However symptom management can be obtain through medication. Medications such as antianxiety, antidepressants, anticonvulsants are commonly prescribed in association with autism (Center for Disease Control, 2015). In the film, Raymond appears unaffected by his disorder. This could be, due to his inability to reason or to communicate his feelings. Charlie is extremely frustrated throughout the movie. He does not understand why Raymond does not communicate, or why he is unable to accept change. Raymond never senses the distress Charlie is experiencing.
Charlie begins to cope with Raymond’s needs; however, he struggles to build a relationship with his brother. Autism is a challenging disorder. The outburst while inflicting physical harm expressed by Raymond made me nervous. The unknown of how one may react to a situation may result in a constant anxiety for the caregiver. Living with or caring for someone with Autism changes the way you live your daily life. You must think of their safety at all times. To provide someone with the routine and structure needed to keep them at peace, the provider must live by this routine as well.
It must be extremely challenging and exhausting in different ways to everyone involved. I gained a significant amount of knowledge about autism after the movie and research. I learned that anxiety is present in many cases. I also have a better understanding of how if effects their daily lives and the need and outcomes of interventions. Given the safety concerns and emotional reactions one may have, I am glad to have a better understanding of how to work with an Autistic individual. The nursing care provided is important because this is a lifelong but manageable disorder.