Introduction
The case study is about the life of Chris, a twelve-year-old boy of American descent. He currently resides in Arizona with his parents. Chris was diagnosed with a disorder that is classified as Asperger’s syndrome. This classification is based on the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) that specialists used to determine Chris as suffering from Asperger’s syndrome (Sarmiento & Lau, 2020). Chris’s psychiatrists diagnosed him with the syndrome at 32 months. The diagnosis began when his single mum noticed some differences with Chris based on her other kids, twins. She noticed that Chris mostly struggled with interacting with people. Additionally, his speech patterns seemed odd to her, and he did not have many facial expressions. His psychiatrist further noticed other peculiar mechanisms, such as obsessions in participating objects or topics to the point of excluding any other. Chris is currently located in Arizona and is in school, his caregivers include a trained autism caregiver, his teacher, and his mum.
Infant Development (Birth to Twelve Months)
Motor autonomy is an infant’s main task in their first year. The process is a series of distinguishable stages that prepare an infant for early childhood (Esposito & Venuti, 2009). Each stage is characterized by a lack of symmetry and progressively involves the development of reflex patterns that combine with those existing. Early identification of autism spectrum disorders (ASD) is vital for treatment. Chris was born healthy and the doctors declared him to be healthy and in good condition. During his first year, he achieved several milestones characterized by this particular age group. Children are known to develop at their own pace, and the delay in his milestones did not raise any red flags for his mother. In his first month, Chris could lift his head while lying on his stomach, indicating that he was generally developing as lying is an active posture even in the first days of life.
In the first months of life, rolling movement in infants is identifiable. Chris could roll around by the fourth month, indicating increased strength and coordination. He would roll back and forth for extended periods but was sometimes unable to complete the rotation pattern, a sign of a child within the autism spectrum. Additionally, Chris became very sensitive to loud sounds and would quickly react to them. Despite this being a milestone met by most infants early on, his mother missed the severity of his sensitivity, an indicator of autism.
Infants begin to crawl soon after they can sit and eventually can stand. Typically, infants between six and eight months of age begin to sit without external support. This particular milestone was delayed for Chris; he began sitting at ten months, with his weight unequally distributed. He continually fell backward from a sitting position without using protective reflexes, such as using his arms to support his fall. Chris began crawling asymmetrically at around twelve months and could not stand during his first year.
Infants develop a sense of separation anxiety and can identify strangers within their first year. Children on the spectrum exhibit extreme emotion and a lack of control (Esposito & Venuti, 2009). This is commonly experienced with children from the age of six months. As a result, they get clingy and fear strangers. When separated from his mother, Chris would get anxious and could not control his emotions. He would aggressively flap his arms but would not cry much.
Early Childhood Development (1-5 years)
Notably, early childhood is very significant for parents who wish to ensure the effective development of their children. Although Chris’ mother had noticed several issues and delays
during the first year, they were not particularly alarming as it is still a tender age. She did not describe it as significantly slow. When Chris turned two years old, he was expected to achieve certain milestones. The first concern was based on Chris’ motor skills because, at one and a half years, Chris could not stand well without his mother’s or other support. Most toddlers start to walk at the ages of between twelve and fifteen months (Cederlund, M., & Gillberg, 2017). However, some may start to walk at the age of fifteen to eighteen months and, with help, may be able to tackle more challenges, such as climbing stairs and furniture or running. His mother noticed that by the time Chris was two years old, he still could not coordinate well in his movement and standing upright. He began to learn physical skills when he was almost three years old.
Childhood development ascertains that between one and a half years to two years, a child is expected to start using pens, spoons, and drinking from a cup (Cederlund, M., & Gillberg, 2017). They should also gain more control of their movements to enable them to handle small objects such as toys and stones. Chris began to develop these skills at the age of five years. Additionally, when Chris was edging towards one and a half years, his mother noticed that Chris did not possess the skills to attempt to use objects around them.
In terms of emotional milestones, Chris’ mother and, later on, his caregivers noticed that his development was delayed. For example, even when Chris was two years old, he did not portray any emotional attachments to people around him and showed little affection. At age two, a child is expected to have developed on a social-emotional level by paying attention to facial expressions, participating in joint attention, understanding, and expressing emotion.
Middle Child Development (6-12 years)
The first issue developed in school is performing below grade level relative to I.Q. This posed a significant problem due to the need to relate with other students to live in harmony, listen and understand their teachers, and form personal relationships. Unlike other children in his age group, Chris struggled with organizing his content while writing. Also, he struggled to understand other people’s perspectives. Chris also experienced problems with problem-solving, particularly educational problems that involve vast chunks of information that require to be broken down. Also, most kids his age and teachers challenged Chris’ social-communication abilities. This is because most children have relatively advanced socio-emotional skills that enforce effective solutions and communication. Chris struggled with socializing and communicating due to his underdeveloped literal way of thinking and lack of empathy. This led to aloofness and missing out on vital school experiences.
Furthermore, Chris had an Executive Functioning Deficit which could be interpreted through his school performance. Executive Functioning is integral to learning as it enables the student to advance in content retention, organization, and educational success (Brighenti et al., 2018). Chris experienced several problems involving the physical organization of materials, mental organization and scheduling, and multitasking. Chris could not execute middle school tasks such as self-regulation and task prioritization. Moreover, Chris would easily be distracted when in school and had a low attention span. All these factors adversely affected his performance in school, as his grades were often below average. The main identified symptom of Asperger’s by Chris’ teachers is his poor social skills and limited socio-emotional reciprocity. His interaction with his peers is limited, and he is unable to express himself well during class presentations and group projects assigned to them. However, with the knowledge of his condition, the teachers have continuously engaged him to build on these core skills.
Interventions Needed
Difficulties engaging with peers and adults and establishing social interactions have been known as one of the distinguishing features of individuals in the autism spectrum. Intervention techniques are necessary to promote the social outcome of children in the autism spectrum (Odom et al., 2021). Adult-led teaching, group-based social skills training, and individualized skill training are some interventions the school has made paramount in educating children like Chris. Chris has been able to receive group-based social training in school. An instructor leads the intervention to assist in learning skills such as emotional recognition and problem-solving. According to Jonsson et al., (2018), despite these interventions being delivered clinically, other social skill training skills, such as the Program for Education and Enrichment of Relational Skills (PEERS), generate positive results in skill acquisition. Targeting and intervening in communication skills for students within the autism spectrum are categorized as; developmental, behavioral, and naturalistic (Sandbank et al., 2020). The combination of these areas by the teachers in Chris’ school continues to show positive outcomes in his advanced social skills as he prepares to join junior high.
Conclusion
The case study concerns Chris, who was diagnosed with Asperger’s syndrome at 32 months. His mother and caregivers noticed delays in his development based on the milestones timelines when he was approximately 18 months old. These delays included struggling with speech, motor skills, emotional capacity, and social interactions. These emotional, communication, and executive functioning delays further manifested into his middle age and affected his studies, relationships, and personal life. Interventions to his condition involve early training in social and emotional skills and constant engagement with the child.
References
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