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Case Study - “Quinn”

Quinn is a 3rd grade student who has carried an autism diagnosis since she was 2 years old. Both of her parents also have a great deal of medical problems and developmental delays. Her doctor noticed language delays, lack of eye contact and expression, and behavioral problems which is what led to her autism diagnosis. Because Quinn’s parents are developmentally delayed, she has grown up receiving a good deal of support from outside community services. Her teachers have also played a huge role in her life. When Quinn started Kindergarten, she had many behavioral issues. She was mostly nonverbal, and when she became angry she would do things like stab with pencils and throw large objects, like books and chairs. She had to be pulled out of the classroom often due to her behavior. At one point her school hours were reduced and she only attended school half a day. With the help of outside supports, including occupational therapy and speech therapy, her verbal communication has increased, and starting in 2nd grade she was able to begin attending full days of school again. Now, in 3rd grade, Quinn has made progress in all areas. She is pulled for speech for 30 minutes, two times a week. She stays in the regular education classroom for most of the school day. The special education teacher pulls her for 45 minutes for reading, 45 minutes for math, and 30 minutes for social and emotional skills. She is progressing forward when it comes to her behavior in the classroom. Most of the time she is happy to be at school, but she has her “off” days where negative behaviors are shown. These behaviors usually occur when Quinn is asked to complete an unpreferred activity. Quinn is behind her peers when it comes to academics, and does not enjoy reading or writing. When asked to write, Quinn often refuses and will throw her pencil/crumple up her paper. Her teachers have strategies in place, like providing a reward, in order for Quinn to complete the task at hand. 

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How is Autism Defined?

The federal definition of Autism Spectrum Disorder falls under Section 300.8 c(1) and states:

(i) Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.

(ii) Autism does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in paragraph (c)(4) of this section.

(iii) A child who manifests the characteristics of autism after age three could be identified as having autism if the criteria in paragraph (c)(1)(i) of this section are satisfied.

Last modified on May 2, 2017

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“According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide used to diagnose mental disorders, individuals with ASD have:

Difficulty with communication and interaction with other people

Restricted interests and repetitive behaviors

Symptoms that hurt the person’s ability to function properly in school, work, and other areas of life”

Friend, M. P. (2018). Special education: contemporary perspectives for school professionals. Pearson.

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According to the Autism Speaks organization, Autism Spectrum Disorder can be defined as “a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.”

What Is Autism? (n.d.). Retrieved from https://www.autismspeaks.org/what-autism

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Prevalence

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Signs of ASD

Children can start showing signs of Autism Spectrum Disorder at a very young age. Some children will show many of the symptoms while others will show few. Signs of Autism in a child vary greatly. Here are some indicators that show risk of an Autism Spectrum Disorder:

By 6 months: Lack of smiling and eye contact

By 9 months: Lack of smiling and other facial expressions, and lack of back and forth contact

By 12 months: Lack of pointing, showing, reaching, babbling and response to name

By 16 months: Few or no words

By 24 months: Lack of two word phrases

At any age: Loss of speech, lack of eye contact, preferring to be alone, language development delays, repetitive behaviors, restricted interests, difficulty understanding other people’s feelings, difficulty understanding social cues, and difficulty with minor changes in routine

It is important that a medical professional diagnoses the child, so if you feel your child is exhibiting these signs, call a doctor.  

Learn the Signs of Autism. (n.d.). Retrieved from https://www.autismspeaks.org/signs-autism

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Causality

Biological Factors:

Researchers speculate that DNA causes the developmental dysfunction in the brains of those with Autism Spectrum Disorder (ASD)

Genetics also play a role. There is a high frequency of ASD among siblings when compared to other disorders.

Brain Make Up

MRI shows abnormalities in the cerebellum (controls motor coordination, balance, and cognition)

The frontal lobe (controls social and cognitive function)and temporal lobe (understanding facial expressions, social cues and memory) have fewer cells, higher cell density, or less volume than typical individuals 

IMMUNIZATIONS DO NOT CAUSE AUTISM. THERE IS NO RESEARCH OR DATA THAT SUPPORTS THE IDEA THAT IMMUNIZATIONS COULD CAUSE AUTISM

Friend, M. P. (2018). Special education: contemporary perspectives for school professionals. Pearson.

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Characteristics

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Evaluation Procedure

The Evaluation Procedure needs both formal and informal assessments. There are standardized tools for this purpose. Some include the Autism Diagnostic Interview, the Modified Checklist for Autism in Toddlers, and the Asperger Syndrome Diagnostic Scale.

Both formal and informal intelligence tests are administered. These will measure academic achievement. Language is usually assessed during this time as well. Adaptive behavior(self-help skills and community function) will also be assessed.

Developmental characteristics will be assessed. A Psychoeducational Profile is an instrument that is often used and asks parents about their child’s development in areas like gross and fine motor skills, language, and related areas.

Behavior will be assessed as behavior challenges are common in students with ASD. Parents, teachers, and other adults that frequently interact with the child may be asked to complete a behavior checklist or profile.

Eligibility will be discussed after all of the assessment data is complete. A team that consists of educators, parents, and medical professionals will use these questions to guide their decision on if the child will receive services: 

Does a disability exist?

Does it have a negative impact on educational performance?

Is the student eligible for special education services?

Will the student benefit from those services?

Answers to these questions will determine eligibility. This can be a very stressful time for parents and they may need a strong support system at this time.

Friend, M. P. (2018). Special education: contemporary perspectives for school professionals. Pearson.

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Trends and Influencing Issues

It is clear that early intervention for children with Autism Spectrum Disorder gives them a greater likelihood of success for the child’s functioning. While this is good information to know, some challenges exist. One is that there is no way to reliably diagnose a child younger than one year old. Another issue is that many parents who have children diagnosed with autism spectrum disorder feel that they were originally told nothing is wrong when previously voicing concerns. Children who come from families of a higher socioeconomic status are also more likely to receive an early ASD diagnosis. This places children in families of a lower socioeconomic status at a huge disadvantage as they do not get the appropriate interventions

Another issue is the need for a greater understanding of the neurological, behavioral, and developmental characteristics of ASD. If this was better understood, it would be a likely possibility that children could be diagnosed even younger than they are now. This would make it possible for children to receive appropriate interventions earlier.

Issues can arise when talking about what can be considered an appropriate intervention. Problems can arise when professionals want to use interventions that have worked for them personally in the past but do not necessarily have the evidence to back them. Because individuals with ASD are all unique, it can be difficult to find practices that can be generalized as helping all those with autism.

Lastly, because the number of students with ASD has grown, it is important that teachers are appropriately trained on how best to meet the needs of their students.

Friend, M. P. (2018). Special education: contemporary perspectives for school professionals. Pearson.

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Resources and Assistive Technology

There are many different resources that can help individuals with ASD in the classroom and at home. Click below to read about some of them.

Visual Supports: There are many different visual supports that can be used for those with ASD that help meet their own specific needs. It may be beneficial for some to have commonly used things around the home or classroom labeled. Others may benefit from a picture schedule, checklist or chart of things to do throughout the day. This can help those with ASD know what to expect throughout their day which can help keep them on track and make transitions easier. Thinking about the individual needs of the child can help decide which type of visual support is best for them.

Prompting: Prompts are used as a cue to an individual to exhibit a certain behavior. The goal is that eventually the individual can exhibit the desired behavior without requiring any prompting. Some prompts are more restrictive, for example, physical prompts. Physical prompting happens when someone physically helps the individual to achieve the goal ( for example hand over hand) Less restrictive prompts can be used as well. Some of these include gestures, verbal prompts and written prompts. Using prompts will help individuals in the home and at school. 

Social Stories: The use of social stories is another tool when working with individuals with ASD. A social story describes a specific social situation. Social Stories can be created by anyone! They can be written, drawn, or just simply talked about with the individual. Many details are given like where they are, what they see, what they hear, what they are doing, who they are with in hopes of helping the individual learn how to respond and navigate the situation. Some studies report there is no evidence this is a strong way to help individuals with ASD, but others feel strongly that this is a great way to support them. In the simple social story below, the child has a history of hitting his mom when he is upset or angry. The social story talks through strategies that will help the child and teach them how to better react.

Home Base: Home base is a place that students can go when they need a place to calm down. It can also be used as a preventative measure. Students can start in their calm space at home base at the beginning of the day in hopes to set up a good day. They can also go there before doing things that may overwhelm them. It’s also there for them when they have been overwhelmed and need to calm down.

SOCCSS: This strategy helps students understand the cause and effect relationship. It helps students understand that their decisions can influence the outcomes of many situations. SOCCSS stands for:

Situation: The student must understand the who, what, where, and when of the situation at hand.

Options: The student then brainstorms the different ways they could respond to the situation. All responses should be recorded, even the ones that are not an appropriate response.

Consequences: The student will identify one or more consequences for every option listed. (This is often the most difficult step for the student)

Choices: Based on what consequences they decided, the student will rate the option as positive or negative. 

Strategy: The teacher will help the student come up with a strategy to use the option they chose next time a similar situation arises.

Simulation: This step will help the student practice the strategy they came up with.

Assistive Technology: Technology can be used for those with ASD in a variety of different ways. Apps for smart devices are more commonly helping individuals with ASD communicate with others. According to the organization Autism Speaks, “Individuals with autism who have more difficulty communicating can use technology to make their “voices” heard regarding decisions, which helps foster the self-advocacy skills that are so important as they age into adulthood.” Video based intervention for those with ASD is being used more often as technology becomes more available. Video modeling can help individuals with ASD learn social skills, self-help skills and academic skills. Many individuals with ASD enjoy using technology. It can help them learn and grow, but can also be used as a motivational tool for those who really enjoy using a smart phone, laptop or tablet.

Friend, M. P. (2018). Special education: contemporary perspectives for school professionals. Pearson.

How Technology Can Help. (n.d.). Retrieved from https://www.autismspeaks.org/tool-kit-excerpt/how-technology-can-help

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References

Friend, M. P. (2018). Special education: contemporary perspectives for school professionals. Pearson.

How Technology Can Help. Retrieved from https://www.autismspeaks.org/tool-kit-excerpt/how-technology-can-help

Learn the Signs of Autism. Retrieved from https://www.autismspeaks.org/signs-autism

Social Stories for Autism, ADHD and PDD-NOS. (2014, April 17). Retrieved from https://epidemicanswers.org/social-stories-for-autism-adhd-pddnos/

The National Autistic Society - Visual supports. Retrieved from https://www.autism.org.uk/about/strategies/visual-supports.aspx

What Is Autism? Retrieved from https://www.autismspeaks.org/what-autism