Case Studies

Case Study I: Sam

Sam is a 3-year old boy who loves trains. He lives with his mother, Lily, in an apartment in a
large Midwestern city. Lily is a 20-year old single mother who recently immigrated to the United States
from Thailand. She has had little experience with children but felt lucky that Sam was such an easy baby
compared to others she saw around the apartment complex. Sam seemed content and began walking and
talking like other children of the same age. However, Lily became concerned when Sam stopped talking
at 15 months of age. He began to cover his ears with his hands and screamed for up to 2 hours each
evening. Lily took Sam to a clinic and was told that he might have an ear infection; he was prescribed
antibiotics for 2 weeks. When he returned to the clinic to be reexamined, Sam screamed and ran around
the waiting room, tearing the magazines. As a result, he was referred to the Developmental Unit at the
Childrens Hospital, where he was examined by a team of doctors and therapists. After 3 hours of testing,
Sam was diagnosed as having autism and expressive language delays. Once he received his initial
diagnosis, he was referred to an early intervention program, where he attends 4 mornings a week. Lily is
unfamiliar with the services available to children with disabilities in the United States and is grateful to
finally have a service coordinator who understands her language and interprets reports and meeting
discussions for her. Sam is learning to use the Picture Exchange Communication System (PECS) at
preschool and can use picture cards to request favorite foods, drinks, toys, and activities. Lily also uses
PECS at home and has noticed that Sam does not scream as much as before. However, Sam always
screams if anyone touches or moves his trains; he spends hours each day arranging the pattern of cars he
selects for the day. Any infringement on this activity at home or at preschool results in an incident of
screaming, hitting, or biting.

Case Study II: Gary

Gary is widely recognized as the biggest football fan in town; he hasnt missed a Tigers game in
his small West Coast town in 6 years. He is 34 years old and works as custodian at the community college
where the Tigers play on Saturday afternoons. Gary has been diagnosed as having severe intellectual
disability and depression. He lives in a group home located near the center of ton and within walking
distance of his job, church, and favorite diner. All of the local townspeople know Gary and wait for his
arrival at the same time each day. With no family in the area, Gary relies on friends and group home staff
for transportation to the grocery store, shopping mall, doctors office, and pharmacy. He often needs
assistance when coordinating appointments with his work schedule and daily routine. He is taking
medication to help control his severe depression. The pharmacist is Garys friend and calls to remind him
to refill his prescriptions each month. When the pharmacist was on vacation last year, Garys prescription
lapsed and he experience severe symptoms of depression requiring overnight hospitalization.

Case Study III: Jessica

Jessica is Sophies best friend. Jessica and Sophie are seventh graders at George Washington
Middle School, located in a suburb of a large city. Jessica lives with her mom, dad, and two younger
brothers in a house across the street from her school. She has been diagnosed as having a moderate
developmental disability, cerebral palsy, and a seizure disorder. She is enrolled in a life skills classroom
for half of the day; in the afternoons, she takes part in integrated class activities. The school personnel
have been trained to handle seizures and support her movement in a wheelchair throughout the school.
Sophie is usually the one who volunteers to accompany Jessica through-out the school and community;
the two girls are inseparable.