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CASE
STUDY of AN AUTISTIC CHILD
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ACKNOWLEDGEMENT
We
wish to acknowledge the contribution of the parents of this child who
generously shared their knowledge and experience and NASHAIMAN school for
special education ,PAKISTAN which provided us with opportunity to have conversation with
child and his parents
Below
is case study of an autistic child X who was diagnosed with this disorder in
early age.
CASE STUDY
Patient
X lives at home with his parents and four other siblings. Birth order of
patient X is second last. This is chronological birth order not perceived
one. X will be of ten years of age in
November, 2015. X’s father did not showed any psychological or neurological
impairment yet her mother had some speech problems, other than that both
parents don’t have any history of psychological issue. X belongs to a middle
class family where there family income is average i.e. 13,000 Rupees
approximately. Father is government employ and mother is house wife.
PRENATAL,
BIRTH HISTORY:
According
to parents, X was product of normal pregnancy with no exposure to medicines or
toxins. Yet mother had lung pain during pregnancy which was normal for her
during birth of other five children. But lung pain during pregnancy period of X
was much more severe. As mother reported
that one day she faced severe lungs pain, as quoted:
“Mjhay
aisa lga jaisay kisi kisi nay aik dam gala(neck) zoor say duba de ho. Mera
saans band ho gya ho jaisay”
Yet
mother did not reached for any medical assistance and got better after a while.
After birth First cry of X was delayed. Other than that he was a normal baby
with average weight.
AFTER
BIRTH
Shortly
three months after birth, X developed pneumonia. Records do not show of any
change in child activities but mother reported that she observed a slight
change in his behavior. X showed sudden change in facial expressions and was
showing emotions without any apparent reason i.e. smiling and empty face.
Milestones
of X were delayed. He started sitting without support in six months and started
talking in 2-31/2 years of
age. Because of his delayed milestones and lack of responsiveness parents got
worried and contacted child specialist. Dr. diagnosed him hearing issues
because of middle ear infection and on
basis of abnormal results of BERA TEST, T3,T4,TSH tests. in early age he was
use to listen as well as respond. Mother reported his responses to her lullaby in
his early age, he use to repeat after mother too.
Doctor
suggested them to have their child operated in order to cure his middle ear
infection. Parents decided to visit another doctor before taking big decision.
Other doctor referred them to Dr. Munir (psychiatrist). Later Dr. Munir
diagnosed X with autism after observation; till this time no tests were taken
in order to confirm diagnosis. Dr asked them to visit him 2 times a week in
order to rule out other disorders. As discussed earlier, they belong to middle class
family and did not have many resources to visit 2 times a week, yet they saw
another psychiatrist in their own town.
RELATION
WITH PARENTS:
X
has close and intimating relation with his parents. He is close to both and
often hug them In order to show his affection.
RELATIONSHIP
WITH SIBLINGS:
X
has good relations with his other siblings.
Mother reported that he is more close to elder sister then other
siblings. After birth of his younger brother he showed behavior of hating his
brother as if being possessive of his mother. But later that issue was resolved.
X is capable of showing emotions as well as able to recognize faces. X use to
sleep with his parents till he was 9 year old after that he started sleeping
with other siblings in separate room.
BEHAVIORS:
During
interview parents reported many behaviors that were characterized of autism
spectrum disorder.
X
is capable of showing some specific emotions. He shows feeling of love and
affections for his parents and siblings and gets angry when someone is not
understanding him or trying to impose something on him. Mother reported that
when he gets angry he hit wall with his head several times and often get
uncontrollable.
X
is being reported of showing repeated actions. Repeated actions involved rapid
head movement in nodding position, repeating same motor movements again and
again. X loves car and love to play with cars. When he is out he tries to chase
busses and adore riding them. Other than that during interview he drew waves
again and again on board with help of chalk and started saying ‘ALLAH’
again and again. He has good motor coordination and can run and walk easily.
During
interview, X was making certain voices but was unable to say words. These
voices were not made when he was trying to say something, he was playing and
continued to make this voices; ughhh, ghaaa etc.
X
cannot talk but try to repeat words that are common and are repeated after him
again and again. Her mother repeated some words in front of him and he learned
them. Similarly X’s eldest sister is working with him and trying to make him learn
basic words. At current he can speak eye, ear, tongue, Allah, mama, papa.api
etc. words are not that clear but one can understand them. X can recognize
eyes, ears and tongue too.
Mother
reported of him getting angry when he is not able to speak properly or unable
to say words. When his father is in distint city and calls him. As mother
quotes:
“
kaan say lga kay bolnay ke koshissh krta hay jaisay kuch kah rha ho magar
srf mouh hlaata hay awaaz nahi nkalti”
X
starts to laugh and cry without reason as if he is in his imaginary world. He
lacks ability to make Eye contact with people except parents. Parents told that
till 8 years he wasnot able to make eye contact even with them but now he can.
X
show significant difficulty in following stimuli. Other them that he is an Active
child, ‘respond to “assalam o alaikum” and shake hand. His sleep
patterns are normal i.e. 7-8 hours other then few days when he does not sleep
at all.
X
tries to imitate his eldest sister and his mother by taking their DUPATTA and
wearing it. He started to show this imitation behavior at 10 years of age.
SOCIAL
RELATIONSHIPS
X
is unable to listen or talk properly but he show response to some specific
words. Parents decided to send him to school as they thought it would be much
better to learn something then nothing.
X
started his school in 9 years of age. This school is for special children yet
they lack facilities for autistic children. X has friends in his school and in
his neighborhood. Earlier, Children in his neighbor used to bully him. Mother
reported that he used to show anger when children laugh at him as if he is
understanding what they are saying.
Mother
told X remains ore happy when he is among normal children rather than with
special children. If X likes someone he goes and stands beside them but if he does
not like them he even pushes them and tries to hurt them.
THERAPIES:
X
is getting speech therapy in his school but other than that he is not getting
any other therapy or medication. There are other school in Lahore and
Rawalpindi but X’s parents are not so economically strong to afford costly
treatments and are concerned about X when he will get younger, who will take
care of him and how h will survive in this world.
