Case Study

Story Background: (Initial Stage)

Mia was a 5 year old girl when her family contacted me. Parents had few experiences about Mia, where she had trouble making eye – contact with listeners. She would not have any social interaction with her peers. Her expressive language was vague – her sentences were long but the words she chose didn’t quite communicate her meaning and the listener had to work extra hard at decoding the message. It was hard to have a conversation with Mia: she tended to monopolize the taking, worked hard to steer it toward one of her favourite task and did not appear to be listening when it was the other person’s turn to talk. She had trouble with focus and attention – she was quite distractible. Mia periodically had bouts of anxiety and it was much harder for her to focus when that was happening. Talking in regards to her speech – we practiced looking at the listener and using exactly the right word to answer and lots of visuals to help her with the right words.

Children on the autism spectrum vary widely. However, we usually see some difficulty with language pragmatics, the social rules of conversation, including making eye contact, taking turns talking and listening, responding appropriately to questions, knowing how to insert into a group, knowing what to talk about, and when older, knowing how to lead a conversation.

There may be an intense desire to talk about one specific subject over and over. Often with children on the spectrum, we also see difficulty being specific with word use and difficulty organising one’s thoughts into clear, concise sentences. The goal was Mia fell in these two areas. Mia was also receiving speech therapy.

Step 1: Determine the needs of Family:

During the first week of intervention, I learned parents a great deal about Mia’s strength, learning styles and specific needs. I further decided to learn more about the needs of Mia’s family. I understood that needs in the home may differ from other environment, so wanted to take some time out and was willing to know more about Mia’s home situation before going any further. It was very important to understand the parents concerns and priorities. I gathered information regarding Mia’s strength, parent- child interaction pattern and primary areas of concern. Additionally, I took more information about daily routines and family activities.

Step 2: Selecting Goals

Here it was important to communicate Mia’s ability to communicate her wants and needs consistently at her home. I would like to see her reduce her occurrence of interfering behaviour including screaming, crying and dropping on to the floor. Once goals are identified, they write the goals in the observable and measurable terms so everyone has a clear understanding and can monitor the target skill accurately.

Intervention with parents was taken forward and the progress was monitored.

Step 3: Monitor Progress

I made sure that Mia’s parents are implementing the intervention with fidelity. (Evaluate and document the progress). Each time Mia’s scores the checklist, results were reviewed and were provided with positive comments and suggestions were made for areas of improvement. I helped the parents generalize the strategy and intervention plan to other behaviours.

Therefore, during the monthly training sessions, she discusses additional needs and concerns, outlines new goals, and provides additional training to help them implement the intervention effectively.

Now, after 8 weeks Mia is consistently verbally requesting “up”, “swing” and “cookie”. She will sometimes request “chip,” but often requires her parents to provide a verbal prompt.

During this time, her parents have seen a significant decrease in the occurrence of interfering behaviour, as she now demonstrates this behaviour on average less than two times per week. Her parents are thrilled with her progress.