Case Summary

Fasial was 8 years old. He was studying in a school for special children in Islamabad. He
had 4 siblings, 3 sisters and 1 brother and he was last born.

Client was having difficulty in maintaining social interactions, initiating speech, making
proper sentence structure and engaging in age appropriate with his peers and siblings. Faisal’s
mother expressed that he is having difficulty with his morning routine, causing behavioral issues.

Psychological tests like RISB and CARS Childhood Autism Rating Scale was administered
on the client. The result showed that he has Autism Spectrum Disorder.
Bio Data:

Name: Faisal

Age: 08

Gender: Male

Education: 3rd standard

No. of Siblings: 05

Birth Order: 5th

Informant: Mother

Residence: Rawalpindi

Presenting Complaints:
Symptoms:

1: Deficits in nonverbal communication.

2: Stereotyped and repetitive motor movements

3: Deficits in developing, maintain and understanding relationships.

Family History:

His father was 42 years old. He was a police man. His nature was soft and polite. His
mother was a house wife. He has a good relationships with his parents. He had 4 siblings. 3 sisters
and 1 brother. He has a friendly relationship with them. He is living in a nuclear family.

History of Present Illness:

The client was 8 years old. The symptoms of client was started at the time of birth. At the
time of pregnancy the client’s mother was diagnosed with gestational diabetes, so she used some
kind of heavy medicines to overcome it, that effect the baby in prenatal period. She also reported
that they were living in a place near to a chemical plant, when she was pregnant with the client.

General Home Atmosphere

The client home atmosphere was normal. Client belongs to a middle class family. He has
a good relationship with his parents and siblings. They provide him good and healthy atmosphere.

Personal History

The client was born through normal delivery. He did not achieve many of his
developmental milestones at appropriate age i.e. speaking, responding etc. he interacts with only
selective people which he likes. He is social and friendly only with his parents and siblings. He
usually avoid people when he go out. He had difficulties in initiating communications from past
years.

Educational history

The client was studying in a school for special children. He is in 3rd standard.

Premorbid History

Though client was reported normal at the time of delivery. But he did not achieve his
milestones on appropriate time. He had some social and health issues also.

Psychological Assessment

Informal Assessment

Client Interview

For exploring the important factors of client’s situation and psychological analysis, a
clinical interview was conducted by the trainee psychologist.

Clinical interview was conducted in a comfortable environment. The client was not willing for
maintain proper eye contact. He was reluctant and had an improper speech. The interview was
unstructured interview. The trainee psychologist took an extensive interview about the client’s life
history to understand the course development and prognosis of illness.

Behavioral Observation

Client was not comfortable and could not maintain throughout the session. He was quite
naughty and busy in different mischiefs. Most of his history was presented by his mother who was
a reliable source. The client appearance was good and he was wearing jeans and shirt. Though his
orientation about time and day was good but he did not have any insight about his problem.
Defense Mechanism

The client did not use any defense mechanism.

Formal Assessment

CARS (Childhood Autism Rating Scale)

CARS was administrated on the client. The client scores on CARS was 34 which indicates
mild to moderate Autism.

HTP (House Tree Person)

Close doors and windows shows that client was not willing for interacting with people. Pointy
leaves of tress shows the aggressive nature of client. Missing hands indicates the antisocial
tendencies.

Diagnosis

299.00 Autism Spectrum Disorder

Prognosis

The client does not have any insight about his condition, therefore chances of prognosis
are low.

Management Plan

Behavioral Therapy

No cure or medicine exists for Autism. The goal of giving therapy is to maximize the
child’s ability to function by reducing Autism’s symptoms, and supporting developmental and
learning. Relationship Development Intervention is used as a behavioral therapy which focuses on
the social behavior of the client. It will help the client in maintain healthy and social interaction.

Play Therapy

Trainee psychologist also offer play therapy for the client. Play therapy can improve his
social and emotional skills, increase his language or communication skills, and expand the ways
he play with toys and relate to other people.