Case Study of a Child with Autism


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Case Study of a Child with Autism


John, An only child, was born after normal pregnancy and delivery. As
an infant, he was easy to breast-feed, the transition to solid foods
posed no difficulties, and he also slept well. At first, his mother
and farther were delighted at how easy he was: he seemed happy and
content to lie in his cot for hours. He sat unsupported at six months
(this is with in the normal range), and soon after he crawled
energetically.

His parents considered him to be independent and wilful. However, his
grandmother was puzzled by his independence. To her mind, he showed an
undue preference for his won company: it was as if he lacked interest
in people.

John walked on his first birthday, much to the delight of his parents;
yet during his second year he did not progress as well as expected.

Although he made sounds, he did not use words indeed, his ability to
communicate was so limited that even when he was three years old his
mother still found her self trying to guess what he wanted. Often she
tried giving him a drink or some food in the hope that she had guessed
his needs correctly.

Occasionally he would grab hold of her wrist and drag her to the sink,
yet he never said anything like drink, or he would just point to the
tap.[IMAGE]

This was obviously a source of concern in itself: but at about this
time his parents became concerned about the extreme of his
independence. For example, even if he fell down, he would not come to
his parents to show them he had hurt him self. At times they even felt
he was uninterested in them, because he never became upset when his
mother had to go out and leave him with a friend or relative. In fact,
he seemed to be more interested in playing with his bricks than
spending time with people. He made long straight lines of bricks over
and over again.

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[IMAGE]He spends an extraordinary number of hours lining them up in
exactly the same way and in precisely the same sequence of colours.

From time to time, his parents also worried about his hearing and
wondered if he were deaf, particularly as he often showed no response
when they called his name.

At other times, however, his hearing seemed to be very acute, he would
turn his head to the slightest sound of a plane or a fire engine in
the distance. In the weeks following his birthday they became
increasingly concerned, despite reassurances from health
professionals.

He was not using any words to express him self, and he showed no
interest in playing with other children. For example, he did not wave
bye bye or show any real joy when they tried to play peek-a-boo. His
mother agonized about her relationship with john, because he always
wriggled away from her cuddles, and only seemed to like rough and
tumble play with his father. She worried that she had done something
wrong as a mother, and felt depressed, rejected and guilty.

When he was three and a half years old the family Gp referred john to
a specialist. The specialist, a child psychiatrist, told the parents
that john had autism, but added that his psychological abilities in
spatial tasks (such as jigsaws) suggested that his intellectual
abilities were normal in these areas. The specialist thought it was
too early to give an accurate picture of the way he would progress,
but said there were some indications to suggest he would do better
than most children with autism. John was sent to a special playgroup,
and received speech therapy. A psychologist visited the family at home
and helped the parents plan ways of encouraging the development of
communication and reducing the frequency of his temper tantrums.[IMAGE]

In his fourth year, john suddenly began to speck in complete
sentences. His parents were greatly relived, and for a time actually
believed he had finally grown out of the problems. However, his speech
was quite unusual. For example, he often repeated back word for word
whatever his parents said, so if they asked him ' do you want a
drink?' he would say ' you want a drink' in reply. At other times john
made rather supervising remarks. For instance, he would say ' you
really tickle me' in a tone of voice similar to that of a family
friend who had used the same expression a day ago. However, his use of
this phrase, and most of his speech, was usually inappropriate to the
setting, and it lacked any clear meaning.

The years from four to six were very difficult for the family. Despite
speech therapy and special hep at school, john only made slow
progress. He developed a fascination with vacuum cleaners and
lampposts and started to draw them over and over again. He became
exceptionally excited whenever his mother took the vacuum out, jumping
up and down and vigorously waving his arms and flicking his fingers
near to his eyes (this is also known as flapping. [IMAGE]

He also became preoccupied by lights, rushing around the house
switching them off and on. Even family outings became ion ordeal, John
threw wild tantrums unless the family took exactly the same route and
let him count the lampposts. He never seemed to tire of doing the same
thing over and over again.

[IMAGE] His behaviour was also unusual in other ways in that he never
really seemed to look at any one directly. Rather, he would look at
them only fleetingly or not at all. Despite this John seemed to notice
everything in minute detail. He could ride his bike along the most
crowed pavements without knocking anyone over, and he spotted car
number plates with a figure four in them long before anyone else had
noticed. He would also do thing s that his parents would find
embarrassing, like grabbing and eating sandwiches from strangers
plates in restaurants.

When John started school, he found it difficult to learn to read and
write, although in other areas of work he was very quick, for example,
he was very good with his number work, and took a great delight in
learning multiplication tables. He was also still quick at jigsaws,
and could mange even difficult puzzles with ease, at six years old he
did a 200-piece jigsaw on his own, and a100- piece one upside-down!

Socially however he was unable to make any friends what so ever. He
would attempt to join a game that he liked, but his approaches were so
odd that other childr3en tended to ignore him. Most of the time, John
was to be found on his own, busying him self with one of his special
interests, more absorbed in counting lampposts than playing with then
other children.

[IMAGE] From the age of seven, John was sent to a special school for
children with autism. At about this age his parents also noticed he
seemed more interested in their company. He would show his mother that
he hurt him self when he feel down, and he even seemed to derive some
comfort and pleasure from cuddles. Also he began to wait for his
father to come home from work, and even started to look out for him.
However his parents where never sure whether John truly enjoyed seeing
his father return, or whether he was simply waiting to see if his
father came home at exactly six o'clock.

Fortunately, while at school he development more and more. He is now
nineteen years old and no longer simply repeats things that he has
been told, but is able to make appropriate responses and hold a simple
conversation. He is able to read simple books, although he has
difficulty in grasping the story line, although he has little interest
in speaking or reading. Instead he prefers to pursue his current
interest in collecting bottle tops and listing to music. He watches
programmes on pop music, and seems to derive [IMAGE]enormous pleasure
from writing out or reciting a list of all the current hit records and
their order in the charts. He has learnt this entire list by heart,
and can tell you what the top twenty records where on any particular
date.

Although he has mastered simple social pleasantries, he still finds
social gatherings very difficult, and always ends up on the periphery
of any group. He has not established any close friendships, despite
his desire to do so. Sadly this troubles him, recently he asked his
parents how he could make friends and they find this hard to explain
as to them it just come naturally.

Currently John has a place in sheltered employment, fitting components
into radios, he is considered to be a reliable and careful worker but
his employers feel unable to give him any more responsibly because he
is unable to master social skills required for dealing with colleagues
and costumers. He has some awareness of these problems and talks about
how difficult he finds it understanding people, ' I never know what to
do next' he says. Despite this he had expectations of the future the
wants to marry and have a family, but seems to have no firm grasp of
what this might entail.

[IMAGE] (S, Baron, 1995)

John Shows the characteristic problems of autism he failed to develop
normal social relationships and communication in the first three years
of life, he showed unusual interests and repetitive behaviours.

John is typically of one group of children with autism he is outgoing
socially, he can approach children but his attempts are repetitive and
stilled.

Johns communication problems are rather subtle and consists of
speaking in a one sided repetitive way.

[IMAGE]John shows classic ritualistic behaviour, doing the same
activity over and over again in an identical fashion, he will insist
on taking exactly the same route to school very day.

John likes nothing more than counting lampposts, he will spend hours a
day immersed in nothing else.

This will cause problems as a child he would scream if apiece was
missing from a jigsaw now he admits he finds change difficult to deal
with.


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