CASE STUDY

AUTISIM SPECTRUM DISORDER

Patient

: Fiona G.

Date of Birth

: September 13, 2004

Age

: 12years old

Parents

: Mr. and Mrs. G

Clinician

:Dr. XLZ

HISTORY AND GENERAL OBSERVATION

Fiona G. is a 12 year old girl who has been diagnosed to have Autisim
Spectrum Disorder. Fiona G. has for developmental assesment bacause
of speech delay and problems in social relatedness as she was turning 2
years of age.
The diagnosis was a consensus made confirmed after seeing two
developmental pediatician. She has many intervention program which
initially included and one is a Home program which conducted by her
Aunt who was also a teacher at the Center for Autisim & Related

Disorders (CARD). An Occupational Therapy Program was likewise

advised to augment the intervention provided by (CARD).
However when Fiona G. was enrolled at (CARD) for 2 years, the latter
program of therapy was discontinued. Educational intervention was
discontinued as well and Fiona G. resumed therapy at a nearby center as
well as a home progrm. Speech Therapy was indicated through a home
program in 2011 but untill 2012. Fiona G. Educational intervention is
limited to inconsistent session provided by regular school. This clinician
saw Fiona G. From 2009 to 2012 on yearly intervals and quite recently in
2013. Fiona G. has made significant gains and currently show skills at her
chronologic ages 9 years to be a range of 3 years & 4 months (languange
& social skills) to 6 years and 8 months (motor & performances skill). She
has a good motor imitation and enjoy play but can easily frustrated. She is
given challenges that would entail cummunicating effectively. There is still
need to work in her social skills and perer interaction. Behaviour is still
fidgety and is easily destructed by the presences of certain toys in the
room. She continues to display stereotypies and taps her head with the
knuckles of her hands when frustrated.

CASE ANALYSIS
According to Diagnostic and Statistical Manual of Mental
Disorder fifth edition (DSM5) The essential feature of Autisim
Spectrum Disorder is different to another and has their own way of
seeing the world, which makes them interesting and unique. When
someone has ASD, it means that their brains are wired differently to other
people. However, the symptoms of ASD vary enormously from person to
person.
In the case of Fiona G. She find it difficult to interact socially and
communicate with others. She often has difficulty understanding what
other people are feeling and what interests others. Although she find it
difficult to talk to people and make friends, she still have the same
emotions as anybody else, even if its hard.
Fiona G. also like things to happen the same way. If something is out of
place or if routines change without warning, she can get upset or
frustrated. She is also bothered by sudden loud sounds, noises and bright
lights. She often have intense interests in particular topics and extremely
knowledgeable about her special interest areas, like arts and crafts.

THEORETICAL PERSPECTIVE
Three main theories attempt to explain how the ASD brain functions.
The lack of theory of mind argues that children with ASD are unable to
recognize that other people have independent mental states. They may
believe that everyone thinks just like they do, or they may simply not be
able to comprehend that others hold their own motivations for action. Also
referred to as mind-blindness, it can leave the child with ASD confused
about the actions of others. This lack of theory of mind is manifested in a
lack of empathy, inability to enter reciprocal relationships, or lack of desire
to maintain relationships. The lack of theory of mind may explain why
children with ASD have difficulty participating in natural language
development activities, such as model imitation, joint attention, and
symbolic play (Barnbaum, 2008; Baron-Cohen, 2009). Theory of mind
provides a rationale for many of the pragmatic issues with communication
children with ASD experience (Baron-Cohen; Noens & van BerckelaerOnnes, 2005).
The weak central coherence theory describes a mind that only sees
information in parts and not wholes. Information is stored and retrieved
separately. It is specific and not generalized to other situations. The ASD
mind has a preference for processing pieces of information instead of

extracting the larger meaning of the information (Happ & Frith, 2006).
Communication requires many pieces of information from different
sources to be quickly analyzed and contextualized; therefore, a weak
central coherence can be detrimental. Noens and van Berckelaer-Onnes
(2004, 2005) argue that this theory best explains all the communication
deficits, both expressive and receptive, found in ASD. It can also explain
delayed echolalia or the use of neologisms seen in ASD. Children with
ASD do not recognize the meaning of the entire message, including its
context, the first time. They instead focus on a portion of the message,
possibly a phrase. Later, they may repeat that phrase, attempting to
capture the meaning and context of the first message, but their recalled
portion of the message is not enough to be meaningful to others.
The weak executive function theory old that the ASD mind has impaired
executive function. Executive function allows a person to plan, organize,
multi-task, make high-level decisions, and override or inhibit automatic
behaviors or impulses. It permits for flexibility in thinking and learning.
Without executive function, it is difficult to change thinking after a concept
has been learned (Barnbaum, 2008; Perner & Lang, 2000).
Communication requires a great deal of flexibility and adapting over time
as language continues to increase in complexity Prizant et al., 2003). An

ex ample of communication impairment in ASD is pronoun reversal. After

children with ASD hear "Do you want water?" and then receive water, it is
difficult for them to adapt their communication when making a request. So
the children repeat what they first heard "You want water" instead of
stating "I want water."
INDIVIDUALIZED EDUCATION PLAN
The INDIVIDUALIZED EDUCATION PLAN (IEP) states that the level of
performances of Fiona comply fairly as directed in a specific task and
demonstrate fair attention span in performing behavior when she like the
activity. Shes still need to work with her social skills and peer interaction.
Her cognitive ability is below her age but can complete the assigned task
in class.
So that the annual goal for the individualized teaching approach is to
develop and improve the reading and comprehension skills, give verbal
response properly and independently, and to express herself
appropriately.Expand her vocabulary and learn to fallow 2 to 3 step
command and interactions.

OBJECTIVES
To read
color,name/independen
tly

SKILLS TO
BE
DEVELOPED

TIMEFRAM
E

Cognitive

6 months

flashcards

6 months

Actual
speaking &
chart

6 months

Actual
writing &
chart

OUTPUT

Skills
To answer WHquestion/ independently Cognitive
Skills
To named
numbers/independently

Number Skills

RECOMENDATION

For the Child:

As for the child, I think Fiona should be in a regular class so that she
will be able to develop her social skills and peer interaction more and learn
to express herself.
For the SPED Teacher:

In terms of General Teaching Strategies theres nothing to be

recommend for, because the SPED teacher of the Multi-Level A, modify
their instructional strategies well in a number of ways. They demonstrate
and model expected skills and provide visual schedules of the days

events in a location easily seen by the student. Additionally, the teacher

works to make eye contact with Fiona and expect to acquire her attention.
This can be challenging because students with ASD may have difficulty
maintaining eye contact due to difficulties with modulating visual input.
The teacher also gave Fiona a verbal reminder about the schoolwork or
other task. The teacher also used other strategies to increase the
motivation in students with ASD like Fiona, such as allowing short breaks
between teaching sessions and providing time for the student to be alone
if needed. The teacher shows her wide effort in guiding and teaching the
child to be more independent in doing their task.
For the Parents:

To Fiona parents I think theres nothing to be recommend for

because her parents always accompany her going to school in and out.
And gave her a proper attention to play and to teach personal hygiene and
household.

For the Shadow Teacher:

To the assigned shadow teacher, my recommendation is to please

continue the proper care, love and attention to Fiona because I noticed
that shes really competent in guiding Fionas studies. She has the ability
to discipline Fiona and help to improve her skills. She put a lot of effort in
assessing and approaching Fiona.

For myself:

I have a lot to learn especially in handling students with same

condition as hers. I have to learn proper approaches in managing
tantrums and