Name: Kendy L.

Parujinog Code: 3311

Professor: Ms. Odyssa V. Tag at Subject: Abnormal Psychology

Case: Autism Spectrum Disorder

I. Case Overview

Mikey is eight years old, male, who was diagnosed with ASD with a severity
requiring substantial supports at age four by his pediatrician. Mikey is in third
grade and has seen an occupational therapist through his public-school system
for the past two years. Mikey has difficulty in maintaining social interactions and
engaging in age appropriate play with his peers and sibling. Mikey’s parents have
expressed that he is having a difficulty with his morning routine, causing
behavioral issues. When Mikey has these issues, his entire day is thrown off,
resulting in trouble concentrating on schoolwork and increasing difficulties
interacting with his peers throughout the day. Mikey’s parents would like a home
evaluation and recommendations from an occupational therapist in order to allow
him to better function, especially during the mornings. Mikey’s family would be
willing to purchase accommodations to better help Mikey function, and would
commit to occupational therapy treatment outside of the school. Mikey’s parents
revealed that Mikey will sometimes scream when he was awakened by noises in
the house such as the blender, his alarm clock, or his sister crying. They have
found that Mikey has a difficult time waking, getting ready for school, interacting
with peers, and completing casework during these days. They have also stated
that Mikey has trouble sleeping through the night and he frequently appears
fatigue but is unable to nap during the day. Mikey was observed to crave pro
preceptive input, as evidenced by flopping on the floor, and demonstrating poor
motor coordination. Mikey was unable to engage in interactive play with his
three-year-old sister, and when ask to share toys with her, he ignored the
request. When observed during the play, Mikey was preoccupied with a single
spinning toy engrossed in ritualistic, repetitive play with the object. Mikey was
observed turning the lights on and off repetitively in his room for several minutes
before transitioning into a different room.

II. Reason for Referral

The client was referred because of his unusual emotions and behaviors. The
client also has a difficulty in maintaining social interactions and appropriate play
with his peers and siblings. Mikey’s parent revealed also that sometimes Mikey
 screamed when he was awakened by a noise, and that is not a normal as
individual person.

III. Diagnoses

Mikey present the symptoms and behaviors that are consistent with a DSM V-
diagnosis of 299.00 (F84.0) Autism Spectrum Disorder.

IV. Justification

Based on the case presented, the Psychologist in training concludes that Mikey
appears to have 299.00 (F84.0) Autism Spectrum Disorder. To qualify for this
disorder Mikey meets the criteria below.

Criteria Given Facts

A. Persistent deficits in social Mikey has difficulty in maintaining social

communication and social interaction interactions and engaging in age
across multiple contexts, as manifested by appropriate play with his peers and sibling.
the following, currently or by history
(examples are illustrative, not exhaustive;)

1. Deficits in social emotional reciprocity,

ranging for example, from abnormal social
approach and failure of normal back and
forth conversation; to reduced sharing of
interests, emotions, or affect; to failure to
initiate or respond to social interactions.

2. Deficits in nonverbal communicative Mikey has difficulties expressing his

behaviors used for social interaction, emotions when he will have establishing
ranging, for example, from poorly his morning routines that will lead to
integrated verbal and nonverbal irrelevant behaviors.
communication; to abnormalities in eye
contact and body language or deficits in
understanding and use of gestures; to a
total lack of facial expression and
nonverbal communication.
 3. Deficits in developing, maintaining, and Mikey has difficulty in maintaining social
understanding relationships, ranging for interactions and engaging in age
example, from difficulties adjusting appropriate play with his peers and sibling.
behavior to suit various social contexts; to
difficulties in sharing imaginative play or in
making friends; to absence of interest in
peers.

Specify current severity:

Severity is based on social communication
impairments and restricted repetitive
patterns of behavior.

B. Restricted, repetitive patterns of Mikey is having a difficulty with his morning

behavior, interest or activities routine. Mikey was observed turning the
lights on and off repetitively in his room for
1. Stereotyped or repetitive motor several minutes before transitioning into a
movements, use of objects, or speech, different room.
(e.g., simple motor stereotypies, liming
up toys or flipping objects, echolalia,
idiosyncratic phrases).

2. Insistence on sameness, inflexible Mikey will sometimes scream when he was

adherence to routines, or ritualized awakened by noises in the house such as
patterns of verbal or nonverbal the blender, his alarm clock, or his sister
behavior (e.g., extreme distress at crying.
small changes, difficulties with
transitions, rigid thinking patterns.
greetings rituals, need to take same
route or eat same food every day).

3. Highly restricted, fixated interests that
are abnormal in intensity or focus (e.g.,
strong attachment to or preoccupation
with unusual objects, excessively
circumscribed or perseverative
interests).
When observed during the play, Mikey was
preoccupied with a single spinning toy
engrossed in ritualistic, repetitive play with
the object.

4. Hyper or hyporeactivity to sensory Mikey will sometimes scream when he was

input or unusual interest in sensory awakened by noises in the house such as
aspects of the environment (e.g., the blender, his alarm clock, or his sister
apparent indifference to crying.
 pain/temperature, adverse response to
specific sounds or textures, excessive
smelling or touching of objects, visual
fascination with lights or movements.

Specify current severity:

Severity is based on social communication
impairments and restricted repetitive
patterns of behavior

C. Symptoms must be present in the early Mikey is 4 years old.

developmental period, (but may not
become fully manifest until social demands
exceed limited capacities, or may be
masked by learned strategies in later life).

D. Symptoms cause clinically significant Mikey has problems establishing social

impairment in social, occupational, or other interactions, failure to do course work at
important areas of current functioning. home and school.
Not specified.
E. These disturbances are not better
explained by intellectual disability
(intellectual developmental disorder) or
global developmental delay. Intellectual
disability and autism spectrum disorder
frequently co-occur; to make comorbid
diagnoses of autism spectrum disorder
and intellectual disability, social
communication should be below that
expected for general development level.

Note: Individuals with a well-established Noted.

DSM-IV diagnosis of autistic disorder,
Asperger’s disorder, or pervasive
developmental disorder not otherwise
specified should be given the diagnosis of
autism spectrum disorder. Individuals who
have marked deficits in social
communication, but whose symptoms do
not otherwise meet criteria for autism
spectrum disorder, should be evaluated for
social (pragmatic) communication disorder.
V. Treatment Plan

Family-based Intervention

Family-based interventions for autism spectrum disorder (ASD) emphasize the

idea that family involvement in therapy is central to meeting children’s
developmental needs. In particular, parents not only drive the decision-making
about interventions, but they also take a key role in delivering them. In the case
of Mikey, this will provide guidance, training, information and support to his family
members on how to deal with him.

Research on how well family-based interventions work is limited but growing. The
success of these interventions depends on having strong and collaborative
parent-professional relationships. Their effectiveness also relies on addressing
the needs of the whole family, so that everyone in the family benefits, not just the
child with ASD. This will be effective to Mikey since he is still 4 years old and his
immediate source of motivation and communication is his family.

The specific treatment program suited for Mikey is the More Than Words
Program. More Than Words Program is a family-centered, group-based training
program. It focuses on training parents to help autistic children develop
communication skills. This program is for parents of autistic children aged under
six years which is why Mikey will benefit more from this. This will aim to promote
Mikey’s communication skills by educating his parents. His parents will learn
techniques to encourage him to communicate as part of daily life at home. The
program is also designed to provide social support to his parents.

The training program is usually run at a clinic or early intervention center by a

certified psychologist. It has three main parts: Initial assessment. Group program
– groups of eight families attend 8-10 weekly sessions (2.5 hours each) at a
center. Coaching sessions – three for each family. Parents are video-recorded at
home as they use the skills they’ve been taught with their children. The program
trainer provides feedback on the recorded material. Aside from these center-
based aspects of the program, the program is mainly implemented in children’s
natural environments by parents.

KENDY L. PARUJINOG