Study of a Child with Autism
She was born on January 10, 2001 and the eldest of two siblings. In 2008, because of continued concerns with her being “Mikhail”, she was brought to DRP. Pangolin, a child neurologist. She was diagnosed with mild Florentine seizures and was prescribed Keeper MGM/day. In June 2011, she was brought to another child neurologist, DRP. Lucian for follow up. She was advised to continue medications and take a follow up EGG. She was further referred by her pediatrician to DRP.
Mark Resin Cruz for developmental assessment. The initial impression was Intellectual Disability and he recommended SPED schooling for her. Likewise, because she is of school age, she was also referred to Psyched, Inc. For Psycho educational Evaluation to determine her current level of cognitive and academic functioning. Ajax, (as she is fondly called) was able to crawl at 4 months, gave her first smile at 5 months, was able to sit by 7 months, talked by 8 months, walked by 11 months and ran at 1 year and 9 months old.
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She spoke phrases by 2 years of age and was able to speak in complete sentences at 4 years of age. Jail is a fair complexioned 11 year old girl, of light build with black eyes and long hair. According to her mother, her immunization are complete and hearing and visual screening results are normal. She has a pleasant personality and seems to be in a happy mood at all times. According to Finland Adaptive Behavior Scales (VASS) test, she was rated as mildly deficient in the colonization domain (age equivalent of 5 years and 7 months).
With her interpersonal relationships, she is able to identify others, responds to social communication and make her own friends. She has a best friend of the same gender. She also initiates social small talk when meeting acquaintances. She remembers birthdays of friends and family, but does not yet make or buy small gifts for them. She still has difficulty maintaining cooperative relationships with friends and tends to insist on getting her own way. For play and leisure, Jail watches television, listens to the radio for entertainment and is able to follow simple game rules without being reminded.
She participates in non-school sports such as badminton. For coping skills, she is able to keep secrets or confidences and uses appropriate table manners. However, she still has difficulty controlling anger and hurt feelings as well as apologizing for hurting other people’s feelings. Furthermore, according to the Teacher Report Form completed by two of her teachers, the consistently identified problem areas were on the social relationships, thought problems, attention problems and rule breaking behavior.
Items rated “often true” by all three respondents were: “Doesn’t get along with other kids”, “Can’t get her mind off certain thoughts; obsessions”, “Fails to finish things she starts “Can’t concentrate, pay attention for long”, “Poor school work”, “Inattentive or early distracted”, “Lying or cheating. The ADAPT (Draw-a- Person) test showed her to be Test) which provides information about attitudes and socio emotional well being, her responses indicated generally positive attitudes towards the self, family and friends and also some concern about school performance.
However, her mother reported that her strengths include being affectionate, kind and loving. On the VIM tests, her visual motor integration skills were within the 4th percentile for her age range. Her score was within the low performance range and she performed at the level of 6 years and 2 months. Her performance indicated much difficulty on this task. She had problems with reproducing angled and AD shapes. She was right handed and held the pencil in a tripod grasp with closed web space.
Based on the Finland Adaptive Behavior Scale(VASS) test given to her, she was rated as mildly deficient in the communication domain (age equivalent of 7 years and 5 months). She is able to point to body parts, follow instructions requiring two actions, and can listen to the teacher for at least 5 minutes. She is able to attend to entertaining materials for at least 60 minutes and attends to school or public lecture for more than 15 minutes. She is able o speak in full sentences and use plural nouns and verb tense. She is able to give information about herself such as age and birthday.
However, she has some difficulty with expressing complex ideas. She is able to write in cursive most of the time and writes short notes or messages. She also reads books of at least fourth grade level when asked to do so. However, she does not use reading materials such as dictionary, and does not read on her own initiative. Based on the Kauffman Test of Educational Achievement Second Edition (STEAK-II), her letter and word recognition skills were thin Below Average to Average range and performance was comparable to mid grade 2 level.
Reading comprehension skills were within Lower Extreme to Below Average range and performance was comparable to mid -Grade 1 level. She was able to read single words and point to pictures depicting the word but has difficulty with understanding one-sentence instructions despite being able to read the sentence. She also has difficulty answering both literal and inferential questions. It indicates that she has difficulty with understanding the details of what she has read and analyzing/making conclusions about the passage. Spelling skills were within Below Average to Average range.
Her performance was comparable to mid-Grade 3 level. She was able to spell words in the skill areas of single/double consonant, consonant digraph, long vowel and r-controlled vowel. She committed errors of insertion and omission of syllables which performance indicates difficulty with grade level spelling tasks. Written expression skills were within Lower Extreme to Below Average range and performance was comparable to early Grade 1 level. She was able to write name but had difficulty writing sentences in English. She performed below expected range n for sentence structure, grammar, capitalization and punctuation.
She also exhibited weakness in producing comprehensible and functionally effective writing that adhered to task. Her writing suggests gaps in wore usage or semantics, proper sentence construction and overall verbal sophistication in English. Upon administration of the Stanford Bines Intelligence Scale Fifth Edition (SUB-5), Jail obtained a full Scale IQ range of 49-57 which placed her level of cognitive functioning within the Mild to Moderate range of Mental Retardation. Fluid Reasoning (FRR) abilities were within the Mild to Moderate range.
She had difficulty in solving problems using words and language concepts and problems using pictorial or figural patterns. The Knowledge Abilities (AKA) tests were within the Mild to Moderate MR. . She had difficulty defining words and responded mostly in single words. Likewise, she had more difficulty with demonstrating procedural knowledge when presented with pictures of objects and asked to show what she should do with the objects. Her Quantitative Reasoning (CRY) abilities were in the Mild MR. to Low Average range; she had difficulty with numbers and number concepts.
She was able to answer a single-digit addition problem. She was inconsistent in solving simple addition and subtraction word problems. She was able to demonstrate an understanding of single-digit number quantities and increasing quantity and with recognizing number patterns. Her Visual-spatial Processing (VSP) abilities were within the Mild MR. to Borderline range. She had difficulty seeing patterns, relationships, spatial orientations or the gestalt whole among the diverse pieces of a visual display. She was able to show understanding of simple positions such as “front” and “behind”.
However she had more difficulty with directions and positions in relation to a reference point. She was able to fit simple geometric shapes into their correct slot in the form board. She was also able to complete simple patterns by moving plastic pieces into place; however, she had more difficulty with completing complex patterns. Her Working Memory (WHOM) ability was within the Mild to Moderate MR. range. Immediate auditory memory for rote material was below average and likewise immediate visual memory. She had difficulty storing and immediate recalling both verbal and non verbal information.
In the visual associative memory test, Jail performed within below average and she was unable to recognize paired familiar objects. On the delayed visual memory, her scores were within average range. She was able to recognize paired familiar objects and unrelated objects. She was diagnosed with mild epileptic seizures in 2008 and was prescribed medications to prevent convulsions; however, she’s not taking any medication as of the present. She does not manifest any maladaptive behaviors. Jail was adopted at 3 days of age. Her biological mother reportedly chain smoked throughout her pregnancy.
Her nutritional status was questionable. Jail was born via normal spontaneous vaginal delivery and was born full term but an unknown birth eight. Jail live with her parent’s who are both college graduates. They work with the Philippine National Police and run their own franchise business. She has a 4 year old brother whom she loved dearly. She resides in a lower income class community in Tagging, approximately 5 kilometers away from Boniface Global City. The area is densely populated and most of the residents are in the military service (active or retired).
However, 80% of the populace were migrants – families who have transferred to the place due to demolition and relocation by the government. Crimes of all sorts are very rampant in heir community and most perpetrators are either ex military men, ex policemen or unemployed youth. Her school is a Just a few kilometers away from her home and is within walking distance. Jail lives with a cousin, way and other house helpers. Jag’s parent’s have the same reaction with others who learned that their child has a disability – shock, remorse, denial and finally acceptance.
The feeling that they had had to overcome these feelings to help their child. Ajax, because of hardheadedness most of the times, received spanking as discipline. At times, they would Just ignore her wrongdoings because of her disability. She loves her brother very much and acts like the big sister to him. She easily makes friends but loses them as easily because of her moody attitude. She would pick up a fight when she does not get her way or does not know how to cope in a situation. She would also do the same with a cousin and their house helps. When at home she would watch TV or listen to music in her cell phone.
She would also visit friends who live nearby or would go to the mall with them. Her daily routine starts as she wake up at 6:00 in the morning, takes a bath, change into her school clothes and eat breakfast as she rush to her 7:ma’am class which would be until 12:pm. After school and having lunch, she would laze around and watch TV and after a while listen to music. According to her mother, she never opens her textbooks nor do her assignments even with constant reprimanding. During Saturdays and Sundays, she would stay at home or would invite friends over to her house. At times, she would visit friends who live nearby and go to the mall.
She has a dog and a rabbit but she spends most of her time listening to music in her cell phone. Ajax, fit the general profile of a child with mental retardation. A lot of factors indexed her growth and development as an individual. Firstly, she was born by a mother who obviously posed a health risk to her unborn child during her pregnancy because of chain smoking. Majority of children who are born by chain smoking mothers even in their pregnancy developmental disorders. Attention deficit hyperactivity disorder, also called ADD, occurs more frequently in children of mothers who smoked.
Studies have identified a range of other behavioral and cognitive problems associated with maternal smoking, including a 50 percent increase in rates of mental retardation (D Thompson, Jar. ND L Marcella, MD, MPH 2011). Secondly, she was diagnosed with the disability at a later age. Thirdly, because she was diagnosed at a later age, it was obvious that no intervention was done to address her disability. Her educational program did not provide her the intervention she needed in preschool and sadly no intervention was still done during her elementary.
She was simply dismissed as being “Mikhail”, hyperactive and a slow learner. Her school FAILED MISERABLY in identifying her behavioral problems and “learning difficulties”. Fourthly, the fact that her parent’s both worked full time and jack the time to personally supervise her as she is growing up and have dismissed her behaviors and academic performance to her immaturity may have contribute further to her disability. These factors further widened the gap in her cognitive deficits and hindered her to somehow reach her optimal development as she is growing up. B.
EDUCATIONAL PROFILE Jail began schooling at the age of 3 h at the MAC Interiors School. The following year, she was transferred to the La Immaculate Conception School, where she was enrolled in preschool. She has stayed at the same school ever since. During preschool, Jail was observed to be restless and did not listen to her teachers. During skills because she did not know how to read and write yet. By Grade 1, she was able to write her name and read 3-letterheads. However, her mother reported that Jail only learned to spell words during Grade 2. During the early grades she also had difficulty learning math and science.
During Grade 3, Jail was enrolled in a Summon math class, and her mother reported that this was the only time that she started learning basic math operations (addition, subtraction, multiplication). At school, she ad difficulty remembering lessons and continued to struggle with reading. According to her mother, Jag’s grades were generally in the mid-ass range during Grades 1 to 3. During Grade 4, Jail received failing grades in her major subjects such as Math, English and Science. Her performance worsened during Grade 5. She had recently been failing all her subjects.
Examination of her academic records for Grade 1 to Grade 4 revealed marks in the high ass to low ass. Before the school year 2011-2012 closes, her mother was advised by the Guidance Counselor that Jail could not be promoted to Grade 6 because of her consistent failures. If she would re enroll for the next school year, she would be readmitted to Grade 5 not Grade 6. Upon hearing this, Ajax’ s parent’s decided to transfer her to another school who would accommodate her in the Grade 6 level despite her academic performance. Jail was admitted the following school year in the Grade 6 level at SST.
Bernard Academy less than a kilometer away from their house. However, after the first quarter and upon discovering that her books still remain unanswered and there seem to be no progress, her mother decided to transfer her again to another school nearby which can accommodate her disability. Ajax, was placed in the Grade 5 class of 8 students since the school does not have a Grade 6 class yet. It is a small school with a population of only 106 students. It is the only school within their area that accepts students with disabilities into the regular class. Most of her classmates are a year younger than her.
She easily made friends especially with the girls. For reading activities, Jail was given a different reading material than her classmates. Considering that her reading only falls on the Grade 2 level, her teachers would give her reading material on the Grade 2 and Grade 3 level. She is also encouraged to participate in recitation especially in Filipino subjects. Jail is given journal writing activities to develop her writing and composition skills, however, she writes her Journal in Filipino. Some of her lessons would be given in the computer to differ the lesson presentation.
To address her social deficits, she is involved in group classroom activities and from time to time assigned a peer to assist and encourage her. She also Joins school activities for further exposure. She exhibits no maladaptive behaviors except for occasions when she would be caught with a blank stare. To further develop self help skills, she is assigned household and personal chores to do at home as part of their PEP (Educations Panamanian at Panhandling) subject. To address her gross motor skills, she takes part in games and other physical activities as part of their Physical Education subject every Wednesday.
Jail was placed into the mainstream program as recommend by the Developmental Pediatrician and the Developmental Psychologist who conducted her Psycho educational Assessment. Her parent’s also decided to transfer her to an inclusive school that cater to children with intellectual disability. Her current school being inclusive is sensitive to the needs of students with disabilities. In fact, it has several students with Autism, Developmental Delay and Learning Disabilities which are accommodated from preschool to Grade 5.
The class size is relatively small to ensure a more personalize instruction and readily address other concerns. The staff has training on detecting learning disabilities and behavioral problems among children, teaching strategies and behavioral management. The students have been oriented about the characteristics of this rope of students and have been advice to accommodate and assist them. Aside from the regular class placement, she attends a SPED center three times a week for two hours for her Pull Out sessions in order to address more extensively her deficits in the different domains of learning.
Unfortunately, many factors contribute to Jag’s mental retardation – first was her prenatal condition which posed a great risk on her development. Her uncaring biological mother chain smoked throughout her pregnancy which might be the primary reason why Jail has mental retardation. Children of mothers who smoked during pregnancy are more likely to show: decreased mental performance scoring at age one year, decreased academic performance scores in the school-age child, reduced I. Q. Increased learning difficulties (children were 25 percent more likely to have learning disabilities if their mother smoked greater than 20 cigarettes a day), increased hyperactivity and increased behavioral problems. There are many potential long term consequences for babies born to smoking mothers, although once an infant is born, it’s difficult to tell whether complications are caused by mooing during pregnancy or exposure to second hand smoke. An increase in cognitive and behavior defects, along with a 50 percent increase in mental retardation without known cause, are noted by DRP.
Van Emmer. Second, her educational program particularly her early childhood teachers fail to recognize her disability at a young age thus the necessary intervention was not given to her. Early childhood teachers nowadays are trained to detect developmental delay in children and should be responsible enough to inform the parent’s of their child’s behavioral and academic concerns. Ajax, being in the Mild to Moderate range in her cognitive functioning could probably be place in the secondary level for age appropriate placement and only for colonization purposes.
The school must have an inclusive program for students with special needs and the focus of instruction would be more on the functional and vocational skills she would later need in early adulthood. A functional curriculum, sometimes referred to as a life skills curriculum, is designed to teach functional life skills, or in other words, the skills necessary to live, work, and have fun in an inclusive immunity (Buck; Brown et al. ,1979).