Autism spectrum disorder (ASD)

 

Tomeika is a three-year-old girl. She was recently diagnosed with autism spectrum disorder (ASD).
Tomeika is able to make many vocalizations and is able to say one recognizable word. Tomeika will say “juice”, which she pronounces as “oos.” Throughout the day, Tomeika cries and falls to the floor to gain access to food, obtain a favorite toy, or when she wants to be picked up. Her parents, Mr. and Mrs. Williams, would like for Tomeika to communicate her desires with words, but do not know how to help her. Tomeika recently began attending an early childhood special education classroom for learners with ASD in the County Public School System for six hours a day, four days a week. On Wednesdays, Tomeika and her peers do not go to school. Instead, on this day, Tomeika’s interventionist, Mrs. Dell, has parent conferences in her students’ homes. During the conferences, Mrs. Dell discusses educational programming, learner progress, areas of concern, and also provides training to parents.
• Which diagnostic information would be most critical for you to collect in the first visit?
• What is the primary goal for the treatment of this patient’s family problem based on current US clinical practice guidelines?
• Which complementary and alternative medication treatments would you recommend?
• Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient. (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?
• Florida Autism Center of St Augustine, a Division of Blue Springs

Sample Solution

Scenario: Tomeika, 3-year-old with ASD

 

Tomeika presents with significant communication challenges and disruptive behaviors to gain access to desired items or attention. Her parents are seeking guidance on how to help her communicate verbally.

 

1. Which diagnostic information would be most critical for you to collect in the first visit?

 

In the first visit, the most critical diagnostic information to collect would center on gaining a comprehensive understanding of Tomeika’s current communication abilities, behavioral functions, developmental history, and the family’s specific needs and priorities. This would involve a multi-faceted approach:

  • Detailed Behavioral and Communication Assessment:
    • Functional Behavior Assessment (FBA) for Crying/Falling: Understand the function of Tomeika’s crying and falling behavior. This involves identifying the antecedents (what happens before the behavior, e.g., she sees a toy she wants), the behavior itself (crying/falling), and the consequences (what she gains, e.g., food, toy, being picked up). This is crucial for developing effective intervention strategies.
    • Baseline Communication Repertoire: Precisely document her current vocalizations and the one recognizable word (“oos” for “juice”). Understand the conditions under which she uses this word (e.g., only when she sees juice, or also when requesting it more generally?).

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