Case Teaching Notes
for
“Emily and Dr. Haskins:
Classroom Expectations, Pragmatics, and Clinical Acumen”

by
Susan Behrens and Linda Carozza
Department of Communication Sciences and Disorders
Marymount Manhattan College

Introduction / Background

Most students who would work with this case study would be majoring in the allied health field or education. In other words, they would be in a field of study that required a late-stage internship or practicum. While our case study is placed in a Clinical Psychology department, the issues raised are likely to arise in speech therapy clinical work, education student teaching, social work internships, nursing, etc.

The case study would be beneficial to students about to start their fieldwork. Another application of this case study would be to introduce the issues of Emily and Dr. Haskins in an introductory course for students to think about the clinical/pragmatic skills, not just scholarship and study skills, needed to enter their chosen field. Students finishing their graduate work in these fields and about to become supervisors of undergraduate or first-term graduate students themselves would comprise yet another audience for our case study.

Finally, those studying and working with autism would benefit from this case, although the main focus is less on autism and more on the identification of clinical acumen and the traits required to be successful in the allied health field. We use an example of an individual with Asperger’s Syndrome for several reasons: (1) there has been a tremendous rise in the diagnosis of Asperger’s Syndrome in the last decade; (2) people with this syndrome are highly verbal, intelligent, diligent workers and thus very likely to be accepted to college programs; (3) the syndrome presents a vast disconnect between the ability to do college work and the skills needed to fit in socially and develop “people skills,” and (4) many people with a particular diagnosis often gravitate towards that field in order to “give back”—thus it is a bit more realistic that a pragmatically odd student in one’s classroom may have Asperger’s Syndrome.

Objectives

In completing this case, students should be able to:

Classroom Management

Students might encounter this case study as they are about to enter their own fieldwork placement. Conversely, they may be in an introductory survey course, where the case could be used to raise the question, “What makes a good clinician?”

The case study is divided into three parts. It can be taught in a three-hour class period. Alternatively, Parts I and II could be dealt with in class and Part III assigned for homework. Indeed, the last question in Part III cannot be answered without consulting outside sources and thus could be omitted for an in-class only lesson.

As the case study proceeds and the students encounter more data, Emily’s situation becomes more complex. The sympathies the reader might have for Emily in Parts I and II may be mitigated by a shift in Part III to the viewpoint of Dr. Haskins. Students should work on these parts in order. For each part, the scenario is first read aloud. Then, in small groups, students work on the questions posed at the end of each part. A reporter in each group presents the group’s findings to the class at large, while a designated scribe records the answers from each group for each question on the board or on large display paper.

When the class gets to Part III, they should revisit their answers to prior questions and reflect on any change in their thinking before answering the questions in Part III. This can also be done as a homework assignment.

At the end of the case, the student groups should present their decisions about appropriate next steps that Emily might take. In addition, they should make recommendations to the department chair as to improvements in the training, tracking, and evaluation of students in this major. Role-play is possible here, with a student taking the part of Emily, another student taking the part of Dr. Haskins, another the part of the department head, and one the part of a graduate school admissions officer. Further research could involve current thinking on autism and treatment models being used with those on the autistic spectrum across the life span. One promising method involves the analysis of conversational style and speaker awareness of rapport markers that establish common ground with a conversational partner.

Major Issues

There are several important issues that are raised by this case study. One is the responsibility of a supervisor to honestly evaluate a clinical trainee and to decide who will and will not be fit to enter the field.

Another issue is the identification of traits and diagnostic tools to determine before a student’s fieldwork experience whether that individual should be placed with real clients. What responsibility does the academic department have for maintaining the integrity of therapy being offered while training students?

A third issue is the real-world consequences of living with the pragmatic impairments of autism and Asperger’s Syndrome. How do individuals on the continuum, who are intelligent and perhaps quite adept in the classroom, make the transition to work in the real world?

Answer Key

Answers to the questions posed in the case study are provided in a separate answer key to the case. Those answers are password-protected. To access the answers for this case, go to the key. You will be prompted for a username and password. If you have not yet registered with us, you can see whether you are eligible for an account by reviewing our password policy and then apply online or write to answerkey@sciencecases.org.

Closure and Summary

The case study profiles a hard-working student of clinical psychology with good grades who, nonetheless, does not possess the clinical skills necessary to work in the field. In addition, the student’s placement on the autistic spectrum is never fully revealed by the student. Thus, professors are ill informed and not prepared to deal with the student. They may eventually become more informed through such methods as discourse and conversational analysis (see References); discussions with senior supervisors; and assignment of more than one supervisor to a student. In other words, supervision should be elevated as a science. In addition, educators could be better trained to identify and work with students on the autistic spectrum. The department suffers from a “disconnect” between the expectations of the students in the classroom and their required duties in their clinical year. Department restructuring needs to take place and intermittent checks are necessary for students as they make their way to their clinical year. Perhaps an alternative track could be presented to students who do not pass a mid-program assessment or clinical fitness test. Students in the allied health fields need to be aware of the full array of skills necessary for successful entrance into their chosen field.

References

Note: An asterisk * designates readings that are especially relevant for students.

Acknowledgements: This case was developed with support from the National Science Foundation under CCLI Award #0341279. Any opinions, findings and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

Date Posted: 02/06/07 nas

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