Case Studies for the Treatment of Autism Spectrum Disorder

Edited by

Patricia A. Prelock, Ph.D.
Provost and Senior Vice President
Department of Communication Sciences and Disorders
University of Vermont, Burlington

Rebecca J. McCauley, Ph.D.
Professor
Department of Speech and Hearing Science
The Ohio State University, Baltimore · London · Sydney

Excerpted from Case Studies for the Treatment

Contents

• Series Preface
• Editorial Advisory Board
• About the Editors
• About the Contributors
• Acknowledgements
• Introduction
• Case Studies
  • Case 1: Finding a Voice: An Elementary Schooler With Autism Spectrum Disorder (ASD) and Down Syndrome
  • Case 2: Promoting Early Social Communication Skills: A Preschooler With ASD
  • Case 3: Teaching Social Skills and Self-Regulation to Decrease Challenging Behavior and Improve Quality of Life: A Preschooler With ASD
  • Case 4: Understanding Foundational Developmental Capacities Related to Language: A Toddler With ASD
  • Case 5: Replacing Challenging Behavior With a Better Way to Communicate: A Fourth Grader With ASD
  • Case 6: Implementing the Joint Attention, Symbolic Play, Engagement, and Regulation (JASPER) Intervention: A Toddler With ASD
  • Case 7: Using Enhanced Milieu Teaching With an Emerging Verbal Communicator: A Young Child With ASD
  • Case 8: Coaching in Early Childhood Intervention: A Toddler With ASD
  • Case 9: Supporting Relationships and Learning in Secondary School: A Teenager With ASD and Intellectual Disability
  • Case 10: Using Pivotal Response Treatment to Improve Social Communication and Behavior Skills: A Young Child With ASD
  • Case 11: Facilitating Social Communicative and Social Emotional Competence: A Third Grader With ASD
  • Case 12: Making Friends and Maintaining Relationships: A Preteen With ASD
  • Case 13: Understanding the Causes and Consequences of One’s Own Challenging Behaviors: An Elementary Schooler With ASD and Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Case 14: Learning to Approach and Vocalize With Peers During Playground Time Using Self-Modeling: A Preschooler With Moderate to Severe Autism
• Index

Finding a Voice

An Elementary Schooler With Autism Spectrum Disorder (ASD) and Down Syndrome

Introduction

Gideon is a 10-year-old boy with autism spectrum disorder (ASD) and Down syndrome. Case 1 engages with the intervention approach and strategies discussed in Chapter 4, Augmentative and Alternative Communication Strategies (Wegner, 2021).

Baseline Status

Gideon’s baseline status includes his communication profile, social profile, and family and community context. Assessing baseline is critical for identifying potential augmentative and alternative communication (AAC) device features and developing appropriate goals.

• Communication Profile:

  • Communicates using a few approximated signs for highly preferred items.
  • Uses an Accent 1000 AAC device with the Lamp Words for Life user area.
  • Before receiving the AAC device, communicated through a low-tech communication book with pictures.

• Social Profile:

  • Attends a general education classroom supported by a paraeducator.
  • Frequently interacts with peers within school but not outside.

• Family and Community Context:

  • Lives at home with parents and older half-brother.
  • Receives various therapies including speech-language therapy and occupational therapy.
  • Has a strong advocate in his mother who maintains good relationships with his medical team.

Summary of Most Significant Needs

Gideon’s most significant needs relate to communication:

• Unable to express urgent medical needs.
• Difficulty in communicating basic needs such as using the bathroom.
• Potential for social isolation due to communication barriers.

Assessments for Communication Treatment Planning

An AAC assessment was conducted immediately after moving to the area. The assessment process, based on the Participation Model, identified barriers to participation related to opportunity and access.

Interventions Used to Achieve Major Goals

Gideon attends weekly speech-language intervention at a clinic, benefiting from a social-pragmatic developmental approach aligned with his interests. Strategies include:

• Aided Language Stimulation: Verbalizes words while using the device.
• Expansion: Repeats and adds detail to Gideon's utterances.
• Verbal Modeling: Demonstrates target skills before expecting Gideon to produce them independently.
• Pause Time: Allocates time for Gideon to process and respond during activities.

Outcomes

• Goal 1: Core Vocabulary Use
  • Increased use of words like yes, no, want, and I in multiple-word utterances.
• Goal 2: Increased Utterance Length
  • Progress noted in expanded utterances while using the device.
• Goal 3: Increased Device Use for Various Functions
  • Encouraged use for commenting and choice-making, not exclusively for requests.

Learning Activities

1. Additional evaluation instruments to identify treatment goals.
2. Adjustments to the assessment plan based on the primary service provider's role.
3. Discussing the use of an AAC device across settings with family training needs.

References

Beukelman, D. R., & Mirenda, P. (2013). Augmentative and alternative communication: Supporting children and adults with complex communication needs (4th ed.). Paul H. Brookes Publishing Co. Binger, C., et al. (2010). Teaching educational assistants to facilitate communication. American Journal of Speech-Language Pathology.