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Case study: social engagement difficulties

🕑 3 minutes read
Posted June 26, 2018

CLIENT BACKGROUND: Client is a ten-year-old girl that presents as very interested and curious about the experiment as her younger brother is participating.   She has always been curious and interested in science.

PRESENTING PROBLEM: Looking at her facial features one notices that her eyes do not connect very much, and she does not look directly eye to eye very often.  She reports that she has had trouble making friends in school, but this past year has been much better. She has always been very engaged in learning, loves to learn.  She has been tested by school and is in the gifted program.

A video was taken before the first session.  She states some very remarkable awarenesses that surprised her family to know.

INTERVENTIONS USED: The Safe and Sound Protocol was implemented for consecutive 5 days.

Session 1:

Client has asked to be in the experiment as her younger brother was doing it and she says she is a little jealous that she is not doing it.  Coloring books, water colors, paper, stuffed animals, etc. along with pillows and a blanket have been provided for comfort and to keep her entertained while listening. It is explained that she will be listening to music, that the sound may go up and down and may even sound a little different than she is used to but all of that is part of the experiment. She is to just paint, draw, color and listen to the music.  She is instructed to just listen to the music, not try to sing along or dance. Headphones are put on. She seems very happy, paints colors. The only objection and emotional response is when music from the soundtrack of Frozen comes on. Client reports that she does not like all of the “Frozen stuff” as it has been overdone / over used. She liked this music when she was young, but she is older now and no longer likes it. She is encouraged to just keep listening to it for the sake of the experiment.  She says OK.

Session 2:

Client comes to session happy and ready to do the experiment. Environment is same as before with art supplies and comfy pillows, blankets, etc.  Therapist repeats instructions about singing and dancing and client smiles and says, “OK”.

Note: Her brother just completed the hour before her.

Session 3:

Client comes and says she is ready. Normal set up. Client has always liked to do art on her own. She paints, and the therapist sometimes observes her thinking as she is listening. All goes well.

Session 4:

Client comes in with brother who is doing the intervention, as well, and asks if they can do it together. They make the request together. Therapist does have an audio splitter and two headphones, so it is coordinated so that they both can do Day 4 Part B together by starting her out first with Part A as brother started out earlier but has had a half day delay.   When Part B is done together, separate “work areas” are established within the same room but separated with different blankets, art supplies, etc. Therapist tells them it is important that they stay tuned to the music and not be engaged with each other or it may disrupt the experiment. They say they understand. They do a good job of being focused on their projects but there is a nice smiling at each other every once in a while.  Brother goes on to Day 5 Part A without sister.

Session 5:

Client comes in happy to do experiment. Therapist notes that she is really enjoying doing the intervention.

CONCLUSIONS AND SUMMARY OF CHANGES: Client seems happy.  Therapist tells her to pay attention to see if there are any differences in the coming week and that a check in will be done a week later.

One week later:

A new video of client is recorded.  She reports she feels more relaxed and that her hearing has improved. She says she has noticed changes in her brother, also. He is not as angry, talks with her and listens to her differently.

Mother reports that her two children are getting along better and that especially her son has less anger and tantrums now. She says she feels daughter is listening more.

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