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Case Study: Autism, developmental delays, attachment challenges

🕑 4 minutes read
Posted May 3, 2017

Associate Name: Doreen Hunt

Name of Organization: Children’s Therapy of Woodinville, P.L.L.C.

Age/Gender of Client: 5-year-old male with autism, developmental delays, attachment challenges

Background: Thomas is a five-year old who was adopted at the age of 9 months, from a developing country where he spent time in an orphanage and foster care. He suffers from attachment challenges, Autism, and global developmental delays, and was a very angry, inflexible, detached and neurologically disorganized boy when we met a year ago. He has done several iLs Focus programs intensely in clinic-combined with home program and has made beautiful changes from them.

Presenting Problem: Thomas displays behavioral dysregulation, auditory processing difficulties, anxiety with change or unexpected transitions.  He has poor social engagement with his brother or peers, obtains brief eye contact, and no two-way communication.

Therapeutic Goals:

Improve self-regulation and ability to engage in purposeful activity (play, learning/pre-academic); Increase happiness and positive interaction with others.

Improve Social engagement and Communication

Improve Fine Motor and Visual Motor development

Improve Visual Perceptual skills

Improve Visual tracking, eye-hand coordination

iLs Program Used:  Safe and Sound Protocol (SSP).

Thomas has completed the Sensory Motor, Concentration & Attention, Reading & Auditory Processing in the past.

He seemed an ideal candidate for the SSP, so he completed the program during a break between iLs programs.

Summary of Changes:

BBC Sensory Scales: Auditory Processing – Primary Caregiver Version

This tool assesses behaviors related to auditory processing.  Responses are on a 4-point Likert scale (4=Almost Always; 1= Almost Never)

Q: How often does your child hold his/her hands over or plug his/her ears?

A: Pre: 2; Post:1.

Q: How often does your child seem overly aware, distracted, or disturbed by continuous noise in the environment (for example, TV, stereo)?

A: Pre: 4; Post: 1

Q: How often does your child take a long time to respond when spoken to, even to familiar voices?

A: Pre: 4; Post: 2

Q: How concerned are you about the above behaviors?

A: Pre: Very concerned: Post: Moderately concerned

Parents’ Comments:

Thomas’ mother wrote a grateful letter describing her observations since he completed the SSP.

A few highlights are:

  • Thomas is now communicating on a deeper and more emotional level
  • His language, intonation and eye contact have all improved
  • He can think more clearly and connections are made more quickly

Below are segments from the three-page letter:

At times, over the last month and a half, I have asked myself if I am making this up.  If somehow the changes I’ve observed are the result of wishful thinking.  They are not.  Something is changing in the connections he is making.  The awareness of the world around him.  The stress level of interactions with people and his environment….

The biggest change I see is that he wants to communicate.  Not just ask for things, but communicate.  He has always been an affectionate child.  But now he seems aware that we want love from him as much as he wants it from us.  It’s like bits of his brain can make connections now where before there was only static…

I believe this program allowed him to rapidly make connections that were laying dormant in his brain.  That information that was stored can now be accessed easier, or simply accessed at all.  Something changed.  Things we had been working and working on are suddenly there at a greater rate.  That I am sure is real.

Therapist’s Comments:

Thomas is more ‘connected to others and teachable’.  He greets familiar people unprompted; he is quiet instead of constantly talking about the information racing through his “noisy brain”.  He will now sing along, count along to 20 (mostly accurate) and can name most colors correctly.  His attention span has increased and he’ll engage positively in activities requiring visual motor, fine motor skills and puzzles (instead of screaming “NO!”). He is happy, smiles frequently and is able to transition easily between activities. 

Conclusions and Recommendations:

Thomas’ response to the SSP was very positive.  And the progress he has shown in the areas of physiological state, behavioral regulation and social communication have affected his engagement in the world around him, his family and his classroom community.

Thomas will continue with Occupational Therapy and iLs Focus Programs.  He is currently doing the Reading and Auditory Processing Program for the 2nd time.  He has very good “body organization” skills (balance,  motor planning).  He loves to skip, throw and catch balls (except for delayed visual fixation and tracking skills); He rides a 2 wheel bike with training wheels.

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