Autism Spectrum Disorder: A Case Study of Callin

Autism Spectrum Disorder: A Case Study of Callin

Introduction

Autism Spectrum Disorder (ASD), which is a neurological disorder characterized by the presence of persistent communication and social issues, starts in early childhood. The term persistent means that it keeps on growing throughout an individual’s lifetime. It has more significant impacts on children, such that it reduces their social and cognitive skills. However, it doesn’t affect their motor skills. Children must have symptoms of ASD before diagnosis. The severity of ASD varies from one individual to the other, despite showing similar communication impairments. Children with suffering from ASD experience some difficulties when interacting with their fellow children, parents, teachers, and other people that are very close to them. Still, on the interaction issues, a child with ASD cannot be able to process facial expressions and other non-verbal cues; for instance, typical infants smile when someone smiles at them.

On the contrary, infants with ASD lack that aspect of responsiveness due to the failure of identifying and processing various forms of non-verbal communication. Also, the development of their conversational skills may take longer as compared to typical infants. People with ASD tend to show unacceptable social behaviors, such that they isolate themselves and obsessed with interesting topics; therefore, there are higher chances of throwing a tantrum in case their needs are not met basing on their expectations. In most cases, the ASD symptoms appear when a child is one and a half months rather than from birth. The purpose of this case study is to describe criteria for diagnosing ASD, causes, and effects of ASD and end with a case study about an infant who has ASD.

Criteria for Diagnosing ASD

The standard rules for diagnosing ASD is provided by the American Psychiatric Association’s Diagnostic and Statistical Manual. The manual must be followed strictly by healthcare professionals. As discussed in the introduction part, infants who have ASD demonstrate problems in both verbal and non-verbal communication; therefore, these problems should be persistent before diagnosis; for instance, the deficit in sharing interests, understanding relationships, and non-verbal communication. Regarding issues related to sharing of interests, infants fail to start an interaction with others and isolate themselves for a long period.

On the other hand, an infant fails to understand and respond to non-verbal cues such as smiles as far as non-verbal communication is concerned. In relationships, an infant is not interested in relating to others; therefore, it becomes a problem to make friends as well as maintaining relationships. Other deficits are related to emotions, verbal communication, and behavior adjustment. The manual has stated that history plays a pivotal role when measuring ASD severity in children; for instance, an infant with ASD has the following characteristics, namely; fixated interests, inflexible non-verbal behavior, rigid thinking, and hyperactivity to various environmental factors. The severity is determined basing on how these unusual behaviors are repeated day in day out. The severity can be categorized into three levels level 1, level 2, and level 3. Children exhibit distinct characteristics basing on the severity level; for instance, level 1 infants tend to give minimal responses, while those in level 2 interact with only those people whom they are interested in; however, they also have some problems relating to interaction initiation.    

Background Study to ASD

Suspected Causes of Autism Spectrum Disorder

The health care professionals have not found or determine specific causes of ASD. This disorder is sophisticated; therefore, the research has indicated that it is caused by various factors ranging from genetics to environmental. Varying in severity level is one of the factors that have contributed vastly to its unknown causes.

Several studies show that there exists a link between ASD and different genes. ASD is said to be related to genetic disorders, not limited to Rett and fragile S syndromes. Other than genetic disorders, genetic mutations pose a high risk to some infants. Also, other researches reveal that other genes impact on communication between brain cells, therefore limiting the development of the brain. Furthermore, other genes play some pivotal roles in determining the severity level of ASD in children. These genetic mutations may be inherited or self-generated.

• Environmental Factors.

Environmental factors have been an area of interest to researchers over recent years. Environmental factors consist of external factors that may pose a risk to infants other than genes. These factors include prematurity and prenatal factors, among others. To begin with, prenatal risk factors, the state of health of a mother, is directly proportional to the health of the neonate; for instance, there is a high chance of unhealthy mother to have unhealthy neonate. Apart from environmental factors, parental age is equally important. If parents are older than 34years old, there are high chances of their child having ASD. However, ASD is not related to parental age.

Additionally, maternal physical health is also a factor that increases the risks of ASD in infants. Metabolic syndrome is one of the examples of physical fitness. The risk associated with maternal bleeding is approximately 81%. These physical health conditions may result in ehypoxia, therefore limiting brain development. Other than brain development, they are also responsible for membrane adhesion, which is related to ASD.

Impact of ASD

The ASD is a sophisticated disorder; its effects on client factors vary from one person to the other.

• Sensory System

The role of the sensory system is to detect a physical stimulus and communicate this information to the sensory nervous system primarily for analysis and extraction of valuable information. The ASD interrupts activities that are related to information processing, therefore resulting in abnormal responses. Following these developments, there is a need to develop children’s visual processing skills to counter the effects of ASD. Children with ASD tend to show mixed reactions to inappropriate smelling and common noises. They often throw a tantrum to certain smells. ASD also impact negatively functioning of olfactory processing.

• Mental Function.

One of the common mental functioning issues associated with ASD is attention deficit. The research shows that task complexity affects an individual’s memory directly. Although there are few ASD individuals with cognitive impairments, a larger population is characterized by a low Intelligent Quotient (IQ) rate. The impact of ASD on attention and memory affects children’s learning capabilities.

• Urinary function

Although in most cases, ASD does not have any negative impact on urinary functions of children, those with high ASD severity levels may be affected in one way of the other.

• Motor skills

ASD causes some motor impairments in children, such as clumsiness, apraxia, and balance. These impairments become evident when children carry out activities such as hand-clapping and spinning.

Other than client factors, the ASD has also impacted families.

• Maternal and Paternal Stress

ASD may lead to the stigmatization that results in stress as a result. The mothers having children with ASD have many tasks that they carry out in a household, therefore leading to stress. Some studies have revealed that mothers face a lot of challenges when dealing with their ASD children as compared to fathers. However, other studies show that ASD increases the relationship between parents and their children, especially when the infant’s condition has improved significantly. Other than stressful life, there are also more chances for parents with ASD children to divorce or separate.

• Sibling Impact

ASD also has some positive and negative impacts on brothers and sisters of the victim. The brothers and sisters of an ASD child feel embarrassed with their affected child. This embarrassment becomes a reality, especially when playing, therefore contributing vastly to loneliness and issues related to maintaining relationships with other peers.

• Financial Impacts

The ASD leads to economic instability in families. There is a lot of money that is spent by families with an ASD child; therefore, increasing the daily and monthly expenses of families, which results in an economic burden.

Case Study

History

Callin is a seven years old male diagnosed with ASD. His ASD is level three; there is a need to seek substantial support from healthcare professionals. He is in year 2 of study and has been receiving ASD treatment for the past one year. Callin experiences a lot of difficulties while initiating interactions with other people, such as parents, teachers, and fellow peers. It is also a challenge for him to maintain initiated interactions due to communication problems.

Reason for Referral

            Callin’s parents noted that he has some challenges and problems with his daily routines, therefore resulting in behavioral issues. These problems have lowered Callin’s academic performance for a few months. The low performance can be attributed to a lack of concentration during class lessons. Callin’s parents decided to go to school to discuss recent developments about her son with his teachers. His teachers also expressed their concerns about Callin, and they were forced to interview some of his friends so that they may collect vital data that could be used to make useful decisions. The following information was gathered about Calling:

Loneliness: Callin’s fellow friends said that most of the time, he stayed alone and not interested in playing and interacting with other students. They also noted that he was overactive in certain noises and smells.

Difficulties in Understanding: Callin’s fellow peers said that Callin was unresponsive; therefore, it was difficult to interact or communicate with him effectively. Also, some teachers said that sometimes it was difficult for him to answer questions in classrooms. However, sometimes he provided abnormal answers to teachers’ questions.

Strange Behavioral Patterns: The children said that Callin was unable to communicate using non-verbal cues such as eye contact. He also had characteristics of repeating some behaviors, such as jumping. Moreover, sometimes he becomes fixate and obsessed with some activities, i.e., those that have interested him. Furthermore, he was unwilling to deviate from his normal daily routine; therefore, he refused to carry out activities that he is not used to. He also concentrated for a short period, then he loses focus, even in the classroom, which lowered her school performance.

Following the above developments, it became necessary for Callin’s parents to seek referral services.

Evaluation Procedure

           The Callin’s ASD conditions were observed every morning and evening from Monday to Sunday. For effective evaluation, a Sensory Profile would be conducted.

Evaluation Results

Callin’s Parents Interview and Observation

Callin’s parents said that their son was over-reactive to any kind of noises such as an alarm clock and his siblings’ cry. They also noted that Callin is experienced a lot of difficulties when it comes to waking up and preparing for school. Besides, he was also tired and exhausted during the day, which was caused by trouble sleeping that resulting in numerous flopping in the ground.

Moreover, he did not manage to play effectively with his young sister, who is now four years old. Callin’s parents also said that their son showed fixate interests, especially when he was playing with his sister. He concentrated on a single activity, such as throwing a ball for a long time.

Treatment Plan

            In Callin’s school, an outpatient therapist advised teachers and pupils on better ways that they can use to assist those students who have ASD. The treatment plan consisted of medication and application of better intervention strategies. In school, teachers ensured that they had integrated teaching methods that are friendly to Callin; for instance, teachers ensured that they had developed a predictable daily routine. However, the routine was only changed in a special event. In those events, an appropriate picture was designed and given to Callin one day before so that he can have a better understanding and be prepared for the new activities. Other than predictable routines, teachers also ensured that they had provided fewer choices for students to select when answering choices. This is because the studies have shown that more choices lower artistic child’s concentration, and he can be more confused.

Moreover, the teachers reduced unnecessary noises within the school, and even when teaching for Callin to remain calm and unreactive. Loud voices make children with ASD to be agitated as well as confused. Furthermore, Callin’s friends were encouraged to interact often with him, therefore developing his social skills as well as social behavior. Besides, Callin’s parents and teachers worked their level best to create a stress-free environment for Callin. Again, it is vital for ASD children to study in a calm environment. Last but not least, visual learning was enhanced at school to increase Callin’s interactive skills.

At weekends, Callin was restricted from participating excessively in playing and carrying out other activities. The occupational therapist at home provided the necessary treatment and advised Callin’s parents on better ways that they can use to take care of their ASD children effectively and efficiently. Apart from parents, he also advised Callin’s brothers and sisters on effective interaction techniques that they can integrate and assist their sister.

Model used-Person-Environment-Occupation-Performance (PEOP) Model: This model is made up of the following three components:

• Person’s characteristics-This component involves characteristics that are exhibited by an individual, such as values and interests and also their psychological aspects.
• Environment: This component entails natural environment and social support, among other factors.
• Characteristics of the task- Regarding these tasks, people interact with their surrounding environment while performing tasks, therefore his actions have some impacts on the surrounding environment.

The occupation performance of an individual is affected by these interactions. The effective implementation of this model requires better coordination between a victim and an occupational therapist because it is client-centered. It requires an individual to come up with his own goals. Therefore, these factors that determine occupational performance play some vital roles in developing an effective intervention plan.

Theories used-Cognitive Behavioral Theory (CTB). The CTB approaches are based on the fact that cognition plays a vital role in how an individual responds to different situations in life. Therefore, CTB models focus on how individuals adapt to specific events in life. An individual’s feelings are determined by factors such as judgment and appraisals that are related only to particular circumstances. These feelings have both positive and negative effects on adaptation. Other than an individual’s cognitive, CBD also includes approaches that play essential roles in treating Posttraumatic Stress Disorder (PTSD). In this theory, children are guided on ways that they can adopt to bring their arousal level to be normal in case there are some problems experienced. Arousal level can be divided into high, low, and normal. High level is characterized by upset and anxiousness, low is characterized by frequent fatigue, and feeling motivation while an appropriate behavior characterizes normal. In Callin’s case, an occupational therapist would sit with Callin and determine his arousal level, afterward, better intervention strategies may be developed. Callin may also be taught how he can adapt to his daily routines.

            Sensory Integration theory: This theory has focused on ways that can be used to solve issues that are related to information processing. In this theory, children will respond appropriately to non-verbal forms of communication when they process inputs correctly. This theory will facilitate the development of treatment strategies, which can help to reduce Callin’s ASD severity level.

Conclusion

To sum up, this paper has focused on the case study of ASD and provided some of the intervention techniques for Callin, who is a 7years old male who was diagnosed with ASD. ASD is a sophisticated disorder that can affect an individual’s communication and social interaction. Therefore, occupational therapists need to develop better strategic plans basing on models and theories related to ASD, such as the PEOP model, sensory integration, and cognitive-behavioral theories.

References