# 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  
**Paul H. Brookes Publishing Co.**  
Post Office Box 10624  
Baltimore, Maryland 21285-0624  
USA

Copyright © 2021 by Paul H. Brookes Publishing Co., Inc.  
All rights reserved.

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## Contents

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

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## Finding a Voice: An Elementary Schooler 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).

### Introduction  
Gideon is a 10-year-old boy with autism spectrum disorder (ASD) and Down syndrome.

#### Baseline Status  
Gideon’s baseline status includes his communication profile, social profile, and family and community context.

##### Communication Profile  
- Gideon communicates with a few approximated signs.  
- Uses vocalizations but largely communicates through bringing desired objects to his mother.  
- Expresses frustration through pushing objects or people away.  
- Uses an Accent 1000 AAC device with the Lamp Words for Life user area.

##### Social Profile  
- Attends a local elementary school and is included in the general education classroom.  
- Supported by a paraeducator throughout the day.
- Most commonly interacts with his mother and shows interest in peers by smiling and waving.

### Summary of Most Significant Needs  
Gideon’s most significant needs are related to communication. He is unable to communicate urgent medical needs and his inability to communicate inhibits relationships with peers.

### Assessments for Communication Treatment Planning  
Gideon had little functional verbal communication, prompting an AAC assessment planned using the Participation Model.  
During the assessment, Gideon demonstrated adequate awareness, communicative intent, and joint attention.

### Interventions Used to Achieve Major Goals  
Gideon attends speech-language intervention once per week. His therapy follows a social-pragmatic developmental approach centered on his primary interests.

#### Aided Language Stimulation  
SLP verbalizes a word while producing it on Gideon’s device to provide exposure to verbal language.

#### Expansion  
The SLP repeats Gideon’s utterances while adding grammatical detail to support language development.

#### Verbal Modeling  
The SLP uses modeling to demonstrate a target skill before expecting Gideon to do so himself.

#### Pause Time  
The SLP provides time for Gideon to respond, allowing processing time before expecting a communication attempt.

### Outcomes  
Gideon made progress toward goals including core vocabulary use and increased utterance length throughout the semester. He currently uses approximately 30 different words on his AAC device, whereas he began with only two to three words spontaneously.

### Learning Activities  
1. Consider additional evaluation instruments to identify treatment goals for children with ASD.
2. Discuss adjustments to the assessment plan if a child’s primary service provider is the school-based SLP.
3. Explore how an AAC device can be used across settings.